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A "substantial increase" in physicians in Canada sought mental health support during the COVID-19 pandemic, a new study reported.

Looking at nearly 35,000 practicing physicians in Ontario, the overall annual number of outpatient mental health and substance use visits increased by 27% per 1,000 physicians -- from 816.8 pre-pandemic to 1,037.5 during the pandemic -- reported Daniel T. Myran, MD, MPH, of Ottawa Hospital Research Institute, and colleagues.

This equated to a 13% increase in the rate of mental health and substance use visits per physician during the pandemic (adjusted incident rate ratio [aIRR] 1.13, 95% CI 1.07-1.19), an increase that appeared driven by those who had no prior mental health or substance use history (aIRR 1.72, 95% CI 1.60-1.85), the group wrote in .

Overall, the absolute proportion of physicians with one or more mental health and substance use visits within a year increased from 12.3% before to 13.4% during the pandemic (adjusted odds ratio [aOR] 1.08, 95% CI 1.03-1.14).

Increases in mental health visits seemed to be across the board, and didn't differ by sex/gender, age, or urbanicity, the researchers said. Regarding specific types of physicians, psychiatrists saw the highest rate of annual mental health and substance use visits during the pandemic (3,441.5 per 1,000 physicians), whereas surgeons had the lowest rates (370.9 visits per 1,000 physicians).

The author of an , however, said that despite this sharp uptick in COVID-related mental health visits for physicians, the findings should actually be "somewhat encouraging," since they show that physicians are actively seeking help, support, and the treatment they need.

"Creating additional avenues or opportunities for health care professionals to obtain mental health services will be paramount, while cognizant of the unique challenge surrounding reticence in seeking care within the profession," wrote Bernard P. Chang, MD, PhD, of Columbia University Irving Medical Center in New York.

The findings also aren't much of a surprise, since it is known that the pandemic took a heavy toll on the mental health of healthcare workers, Chang added. He also pointed to the benefits of telehealth resources in particular, saying that these discrete and flexible platforms are ideally suited for practicing physicians.

Myran and co-authors agreed, noting that their findings "may also be explained by reduced barriers to access for health care and mental health services among physicians during the COVID-19 pandemic," and that "in response to the pandemic there was a large expansion of virtual care options in Ontario."

"It is possible that physicians with both physical and mental health concerns that predated the pandemic increased their health services use owing to this change (e.g., appointments are easier to schedule and less visible and thus less stigmatized)," the researchers wrote.

The population-based cohort study included 26,266 individual counts of outpatient mental health and substance-use related codes prior to the pandemic, which were compared with 31,936 codes during the first 12 months of the pandemic. This equated to a 22.6% change in codes. The biggest uptick in code type was for adjustment reaction, followed by the cluster code for "anxiety, somatoform, dysthymia, dissociative, or psychosomatic," the researchers reported.

"Future research should focus on longer term outcomes associated with the pandemic and explore associated risk and protective factors for physicians' mental health to better target interventions," the group concluded.

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