AUTHOR=Saqib Kiran , Goel Vivek , Dubin Joel A. , VanderDoes Jeremy , Butt Zahid Ahmad 
  
TITLE=COVID-19 testing and mental health service utilization in Ontario: a population-based cohort study
  
JOURNAL=International Journal of Public Health
  
VOLUME=Volume 71 - 2026
  
YEAR=2026
  
URL=https://www.ssph-journal.org/journals/international-journal-of-public-health/articles/10.3389/ijph.2026.1609134
  
DOI=10.3389/ijph.2026.1609134
  
ISSN=1661-8564
  
ABSTRACT=ObjectiveTo 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.MethodsWe 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.ResultsIndividuals 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.ConclusionIndividuals 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.