JMIR Publications

ABSTRACT

Background:

The impact of the COVID-19 pandemic on mental health in primary care remains uncertain.

Objective:

To know the impact of the COVID-19 pandemic on the incidence of mental health problems and the provision of care for patients with mental health problems in primary care.

Methods:

Pre-pandemic incidence of care provision for mental health problems was compared to that in 2020 and 2021 by using INTEGO, a Belgian primary care morbidity registry. Care provision was defined as the total number of new registrations in a patient’s electronic medical record. Regression models evaluated the association of demographic factors and care provision in patients with mental health problems, both before and during the pandemic.

Results:

During the COVID-19 pandemic, the incidence of depression and anxiety increased, whereas eating disorders, substance abuse and personality problems decreased. During the five COVID-19 waves, the overall incidence of mental health problems dropped and rose again when measures were relaxed. A rise of 8.7% and 40% in care provision for patients with mental health problems was seen during the first and second year of the COVID-19 pandemic. Care provision was higher in older patients, males, patients living in center cities (centrumsteden), patients with lower socioeconomic status (SES), native Belgians and patients with acute mental health problems. Compared to pre-pandemic care provision, a reduction of 10% was observed in people with a low SES.

Conclusions:

This study showed an overall increase in care provision for mental health problems in primary care in the first two years of the COVID-19 pandemic. Low SES remained a determining factor for more care provision, but care provision dropped significantly in people with a low SES. Our findings suggest that the pandemic in Belgium was also largely a ‘syndemic’, affecting different layers of the population disproportionately.