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To examine changes in outpatient visits for mental health and/or substance use disorders (MH/SUD) in an integrated healthcare organization during the initial Massachusetts COVID-19 surge and partial state reopening. Observational study of outpatient MH/SUD visits January 1st-June 30th, 2018-2020 by 1) visit diagnosis group, 2) provider type, 3) patient race/ethnicity, 4) insurance, and 5) visit method (telemedicine vs. in-person). Each year, January-June 52,907-73,184 patients were seen for a MH/SUD visit. While non-MH/SUD visits decli