Longitudinal insights into psychiatric presentations and service utilization among older adults in Alberta from 2017 to 2022: Effects of the COVID-19 pandemic

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Background: Psychiatric service utilization is influenced by psychological distress, demographic, and contextual factors. This study examined trends in psychiatric presentations among community-dwelling older Albertans (65+) from pre-pandemic to postpandemic phases. Methods: A retrospective longitudinal cohort design analyzed psychiatric presentations using Alberta physician billing data from 2017 to 2022 using ICD-9/10 codes. Rates were compared across pandemic phases. Descriptive statistics, one-way analysis of variance, and general linear model (GLM) evaluated the effects of the pandemic, sex, geographic location, and healthcare setting. Results: There were over 1.68 million psychiatric presentations among older adults during the study period. Overall presentations increased by +24.82% during the pandemic, primarily due to a +26.66% rise in outpatient visits, which stabilized but did not return to pre-pandemic levels. Females comprised 62.82% of encounters, with a nonsignificant +27.75% increase during the pandemic that stabilized. Males showed a +39.95% increase during COVID-19, then a −9.86% decline postpandemic – both nonsignificant. GLM analysis identified geographic location and healthcare setting as significant predictors of psychiatric presentations among older adults; females and urban residents had higher outpatient use. In outpatient settings, urban residence predicted presentations, while rural status approached significance for emergency visits. No significant trends were found for inpatient care. Conclusion: Findings suggest the mental health impact of the pandemic persisted post-pandemic, exacerbating disparities in psychiatric service utilization, highlighting the need for targeted interventions such as telepsychiatry and expanded outpatient services. Future research should focus on interventions aimed at reducing geographic disparities in mental healthcare access.

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