Temporal Trends in Mental Health Service Utilization across Outpatient and Acute Care Sectors: A Population-Based Study from 2006 to 2014
Open accessAbstract
Objective: Although evidence suggests that treatment seeking for mental illness has increased over time, little is known about how the health system is meeting the increasing demand for services. We examined trends in physician-based mental health service use across multiple sectors. Method: In this population-based study, we used linked health-administrative databases to measure annual rates of mental health–related outpatient physician visits to family physicians and psychiatrists, emergency department visits, and hospitalizations in adults aged 16+ from 2006 to 2014. We examined absolute and relative changes in visit rates, number of patients, and frequency of visits per patient, and assessed temporal trends using linear regressions. Results: Among approximately 11 million Ontario adults, age- and sex-standardized rates of mental health–related outpatient physician visits declined from 604.8 to 565.5 per 1000 population over the study period ( P trend = 0.04). Over time, the rate of visits to family physicians/general practitioners remained stable ( P trend = 0.12); the number of individuals served decreased, but the number of visits per patient increased. The rate of visits to psychiatrists declined ( P trend < 0.001); the number of individuals served increased, but the number of visits per patient decreased. Concurrently, visit rates to emergency departments and hospitals increased (16.1 to 19.7, P trend < 0.001 and 5.6 to 6.0, P trend = 0.01, per 1000 population, respectively). Increases in acute care service use were greatest for anxiety and addictions. Conclusions: The increasing acute care service use coupled with the reduction in outpatient visits suggest, overall, an increase in demand for mental health care that is not being met in ambulatory care settings.
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Evaluation of trends over time in how mental health services are used can help guide decisions about resource allocation.
“As has been noted, “evaluation of trends over time in how mental health services are used can help guide decisions about resource allocation” 34 and program planning. 33”
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Chiu, M., Gatov, E., Fung, K., Kurdyak, P., & Guttmann, A. (2020) · Health Affairs · doi:10.1377/hlthaff.2020.00232 · Cited by 56 · see citing works
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- Authors
- Chiu, M., Gatov, E., Vigod, S. N., Amartey, A., Saunders, N. R., Yao, Z., Pequeno, P., & Kurdyak, P.
- Affiliations
- University of Toronto (CA)
- Institute for Clinical Evaluative Sciences (CA)
- Centre for Addiction and Mental Health (CA)
- Corresponding author
- Chiu, Maria
- ORCID
- Venue
- The Canadian Journal of Psychiatry
- Publisher
- SAGE Publications
- Published
- 2018-01-01
- Volume
- 63
- Issue
- 2
- Pages
- 94-102
- ISSN
- 0706-7437 (ISSN-L)
- 1497-0015
- PMC
- PMC5788139
- OpenAlex
- W2782488573
- Cited by
- 31
- References
- 29
- Citations by year
- 2025: 3 · 2024: 3 · 2023: 6 · 2022: 5 · 2021: 6 · 2020: 1 · 2019: 6 · 2018: 1
- FWCI
- 4.74
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- The Canadian Journal of Psychiatry (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Ontario Ministry of Health and Long-Term Care
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Keywords
- mental health service utilization, temporal trends, outpatient physician visits, general practitioners, psychiatrists, emergency department visits, hospitalization, acute care, outpatient care, mental illness, anxiety disorders, addiction, Ontario adults
- MeSH terms
- Facilities and Services Utilization, Adolescent, Adult, Aged, Aged, 80 and over, Ambulatory Care, Mental Disorders, Cross-Sectional Studies, Emergency Service, Hospital, Female, Health Services Needs and Demand, Hospitalization, Humans, Male, Mental Health Services, Middle Aged, Ontario, Young Adult
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