LAUSR

Key Points Question Was the COVID-19 pandemic associated with changes in mental health–related utilization for individuals with severe mental illness in the United States? Findings In this cohort study of more than 650 000 Medicare beneficiaries with schizophrenia or bipolar I disorders, there were statistically significant decreases in mental health–related outpatient, emergency department, and inpatient use as well as medication fills, particularly early in the pandemic, despite widespread use of telemedicine. Statistically significant differentially greater decreases in outpatient utilization were observed among individuals who were Black, had dual Medicare-Medicaid eligibility, or had disability. Meaning In this study, individuals with severe mental illness experienced substantial disruptions in care during the pandemic, and these disruptions were greater among disadvantaged populations.