Changes in utilization of in-person and virtual outpatient mental health visits before and during the COVID-19 pandemic: An observational cohort study

While depression and anxiety increased with the COVID-19 pandemic, mental health (MH) care access plummeted. This accelerated the uptake of virtual visits, but the degree to which these supplanted in-person visits is unknown. This study aims to assess in-person and virtual MH visits prior to and during the pandemic. Visits from HealthPartners (Minnesota, Wisconsin), Henry Ford (Michigan) and Kaiser Washington (Washington, Oregon) from 2018 to 2022 were stratified by site and study period in this observational cohort study. Segmented linear regression analysis identified changes in the trend over time by detecting optimal breakpoints. A total of 1333,966 patients received MH care. Average monthly MH service utilization was 11% higher from September 2020 to December 2022 compared to calendar year 2019, driven by more patients seeking care. At their peak in mid-2020, virtual visits accounted for 25.6% of visits compared to 1.8% pre-pandemic. MH care utilization increased by the end of 2022 compared to pre-pandemic levels, driven by more people seeking care and supported in part by an increase in virtual visits.