ArticleJMIR mental health2026
Virtual Care Expansion and Physician Follow-Up Among Youth With First Mental Health Contact Through a Hospital: Population-Based Repeated Cross-Sectional Study.
Article in JMIR mental health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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8 authors.
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Abstract
backgroundTimely follow-up is crucial for youth whose first mental health contact is through a hospital; virtual care could facilitate this.
objectiveThis study aimed to examine the association between the significant expansion of virtual care in Ontario, Canada, and follow-up mental health care rates for these youths.
methodsWe conducted a population-based repeated cross-sectional study using linked health administrative databases. We identified first-contact emergency department (ED) visits or hospital admissions for self-harm, mood disorders, or psychosis from March 1, 2009, to February 29, 2024, among Ontario youth (aged 10-24 years). Virtual care was expanded in March 2020; we examined 2 expansion stages (temporary and permanent). Autoregressive integrated moving average analyses estimated level and slope changes (vs before virtual care) in age- and sex-standardized monthly rates of 7-day mental health follow-up. Subgroup analyses examined rurality and socioeconomic status.
resultsWe identified 42,208 first-contact ED visits and 17,701 first-contact hospital admissions. Pre-virtual care mean follow-up rates were 17.64 (SD 2.97) per 100 first-contact ED visits and 21.90 (SD 5.05) per 100 first-contact hospital admissions. Temporary expansion was associated with immediate increases in follow-up that declined (level changes: 4.81, 95% CI 2.82-6.81 for ED visits and 7.51, 95% CI 4.41-10.60 for hospital admissions; slope changes: -0.31, 95% CI -0.42 to -0.21 for ED visits and -0.32, 95% CI -0.48 to -0.15 for hospital admissions). Permanent expansion was associated only with an immediate decrease in ED visit follow-up (level change: -3.81, 95% CI -6.70 to -0.92) that was significant in rural (-1.06, 95% CI -1.93 to -0.184) but not urban (0.44, 95% CI -0.179 to 1.06) areas; results were otherwise similar between subgroups.
conclusionsVirtual care was not associated with sustained changes or equity improvements in mental health follow-up for high-acuity youth, representing a missed opportunity to extend physician reach and address barriers. Further research and quality improvement are needed.
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