International journal of public health · 2026
COVID-19 testing and mental health service utilization in Ontario: a population-based cohort study.
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Saqib Kiran, Goel Vivek, Dubin Joel A, VanderDoes Jeremy, Butt Zahid Ahmad
Аннотация
OBJECTIVE: To examine differences in mental health-related healthcare utilization for anxiety and depression between individuals who did and did not undergo COVID-19 PCR testing in Ontario. Background: The COVID-19 pandemic has been associated with changes in mental health and healthcare utilization.
METHODS: We conducted a population-based retrospective cohort study using linked ICES data, including 6,175,114 adults (January 2020-March 2021). Exposure was PCR-positive, PCR-negative, or untested. The outcome was time to first mental health-related healthcare use for anxiety and depression, identified using validated codes. Adjusted hazard ratios (aHRs) were estimated using Cox models with propensity score matching.
RESULTS: Individuals who underwent testing had higher mental health-related healthcare utilization than untested individuals. This was observed in PCR-positive (aHR 6.37; 95% CI 6.25-6.50) and PCR-negative groups (aHR 5.91; 95% CI 5.87-5.95). Higher utilization occurred among younger individuals, females, and socioeconomically disadvantaged groups. Results were consistent in matched analyses.
CONCLUSION: Individuals underwent testing had higher mental health service utilization; similar estimates across PCR-positive and PCR-negative groups suggest testing reflects underlying vulnerability and healthcare-seeking behavior rather than a causal effect on mental health outcomes.
METHODS: We conducted a population-based retrospective cohort study using linked ICES data, including 6,175,114 adults (January 2020-March 2021). Exposure was PCR-positive, PCR-negative, or untested. The outcome was time to first mental health-related healthcare use for anxiety and depression, identified using validated codes. Adjusted hazard ratios (aHRs) were estimated using Cox models with propensity score matching.
RESULTS: Individuals who underwent testing had higher mental health-related healthcare utilization than untested individuals. This was observed in PCR-positive (aHR 6.37; 95% CI 6.25-6.50) and PCR-negative groups (aHR 5.91; 95% CI 5.87-5.95). Higher utilization occurred among younger individuals, females, and socioeconomically disadvantaged groups. Results were consistent in matched analyses.
CONCLUSION: Individuals underwent testing had higher mental health service utilization; similar estimates across PCR-positive and PCR-negative groups suggest testing reflects underlying vulnerability and healthcare-seeking behavior rather than a causal effect on mental health outcomes.