Impact of time and COVID-19 pandemic on GP mental health consultations in deprived neighborhoods

Abstract Background The stringent lockdown measures and limited physical access to GP care at the start of COVID-19 pandemic resulted into a decrease of mental health consultations. It raised concerns about the access of patients with mental health problems. The aim of this study is to investigate the mental health GP consultations amongst patients from deprived neighborhoods before and during COVID-19 pandemic, especially after the stringent lockdown in the Netherlands. Methods In an observational study (2018-2022), medical data of 360,645 patients were analyzed for the proportions of mental health consultations (segmented per month) by comparing the lockdown phase (March 2020-May 2020) and post-lockdown phase (June 2020-June 2022) with the pre-pandemic period the patients living in deprived and non-deprived neighborhoods. Results Analyzing a total of 759,863 mental health consultations showed that during the lockdown phase of COVID-19, less mental health problem consultations were observed than pre-pandemic. This decrease was not significant for patients from deprived neighborhoods, but the decrease was significant for patients from non-deprived neighborhoods, RR = 0.990; 95%CI=0.934-1.051 and RR = 0.918; 95%CI=0.885-0.953 respectively. Conversely, the number of post-lockdown phase consultations for patients in deprived neighborhoods was significantly increased compared to pre-pandemic levels (RR = 1.074;95%CI=1.002-1.152), but not for patients in non-deprived neighborhoods (RR = 1.000; 95%CI=0.959-1.043). This increase in post-lockdown phase consultations in deprived neighborhoods can be explained by the higher frequency of consultations per patient. Conclusions Consistently over time, demand for GP mental health care was and remains higher among patients from deprived neighborhoods, with an increase in post-lockdown consultations. Sufficient access to primary health care should be guaranteed to ensure treatment of mental health problems for social-economic disadvantaged groups. Key messages • Socioeconomic status has a negative sustainable impact on demand for mental health consultations in deprived neighbourhoods. • To ensure the treatment of mental health problems for social-economic disadvantaged groups, sufficient access to the primary health care should be guaranteed at all times.