Impact of the COVID-19 pandemic on utilization of mental health services among children and adolescents using an interrupted time series analysis.

Additionally, after removing the seasonality component, the Mann-Kendall test showed that there was a significant trend ( P < .001); therefore, we also included the trend effect in the BSTS model.

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By contrast, after the start of the COVID-19 pandemic, the mean NOV for initial visits for mental health services increased among girls and adolescent females but decreased among all other groups; the mean NOV for follow-up visits for mental health services increased in all groups, reflecting an increasing trend that is depicted in Supplementary Figure S4.

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In Japan, suicide is a major cause of death among children and adolescents, and the incidence of suicide remains high among these age groups, contrary to a decreasing trend in adult suicide rates 17 .

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