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Research Article: Identifying predictors of use of mental health services and supports during the COVID-19 pandemic: an analysis of the CHILD COVID-19 Add-on Study

Date Published: 2026-06-18

Abstract:
The aim of this work was to explore the rate of and factors associated with the use of mental health services and supports (MHSS) in a Canadian cohort of children and adolescents during the coronavirus disease 2019 (COVID-19) pandemic. We analyzed data from 1,554 parent–child dyads participating in the CHILD COVID-19 Add-on Study, surveyed between January 2021 and March 2022. The overall rate of self-reported access to MHSS over 15 months was 17% among 1,100 participants. Bivariate analyses identified multiple predictors associated with MHSS use. After adjustments in the logistic regression models, the following factors were significantly associated with MHSS use: accessing COVID-19-related income support [adjusted odds ratio (aOR), 0.56; 95% confidence interval (CI), 0.35–0.89]; missed school (aOR, 1.74; 95% CI 1.16–2.61); being slightly worried (aOR, 1.86; 95% CI 1.15–3.00) or very/extremely worried (aOR, 5.25; 95% CI 2.38–11.56) in the past 2 weeks compared with not worried; and having a chronic health condition (aOR, 2.78; 95% CI, 1.85–4.19). In contrast, having a mental health rating of very good (aOR, 0.45; 95% CI, 0.28–0.73; p <?0.01) or excellent (aOR, 0.30; 95% CI 0.17–0.52; p <?0.001) compared with good before COVID-19 was protective against MHSS use. Subanalysis comparting participants with a chronic health condition found similar effect sizes for being very/extremely worried (aOR, 5.67 vs. aOR 4.98) compared with not worried in the past 2 weeks, in relation to MHSS use. Mental health service use was notable during COVID-19, particularly among children with chronic health conditions. Further research on the use of MHSS is needed to provide effective mental healthcare for children.

Introduction:
Mental health challenges are a growing concern among children. The coronavirus disease 2019 (COVID-19) pandemic had wide-ranging effects on mental health across the lifespan, including heightened anxiety and depression, physical health complaints, sleep pattern disturbances, development of phobias, cognitive functioning issues, and trauma responses ( 1 , 2 ). In youth, there was a significant impact on mental health during COVID-19: Approximately one in five Canadian youths were affected by a mental health illness…

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