Child and Adolescent Virtual Mental Health and Duration of Treatment: A Retrospective Cohort Study

Abstract

The COVID-19 pandemic necessitated a rapid shift from in-person to virtual outpatient child and adolescent mental health services, raising questions about the impact on treatment duration. This study aimed to 1) describe episodes of care by treatment modality, 2) assess the influence of client characteristics, and 3) assess the impact of system factors. We used multilevel mixed-effects and zero-inflated negative binomial models, along with a time-to-event analysis, to examine episodes of care at IWK Mental Health and Addictions services. Findings indicated that virtual episodes of care were longer than in-person episodes at the beginning of the pandemic, but this trend reversed by 2023. The ratio of days to visits did not differ significantly between modalities, suggesting intersession wait times were not a factor. With increasing choice in modality post public health restrictions, understanding differences in treatment trajectories, including duration and outcomes, will be important for supporting clinical and system decision-making.