Coronavirus (COVID-19): mental health tracker study - wave 2 report

5. Conclusions

Tracking the mental health and wellbeing of the Scottish population during the COVID-19 pandemic is important to understand the wider implications of the pandemic and lockdown, beyond those who have been directly impacted by the virus. This report outlines the findings from Wave 2 of the Scottish COVID-19 Tracker Study, which is the second wave in a longitudinal study spanning one year from May 2020, and a total of 5 waves. The aim of the study is to better understand mental health and wellbeing of the Scottish population during the COVID-19 pandemic and lockdown, and during the easing of COVID-19 restrictions. As data collection began in May 2020, after Covid-19 pandemic restrictions had already been put into place, this study is unable to report on how mental health and wellbeing has changed from before the pandemic in comparison to the Wave 2 survey period (17^th July and 17^th August 2020). However, comparison between Wave 1 and Wave 2 suggests an increase in overall mental wellbeing between these two waves.

Looking the at the overall sample, although rates of depression and anxiety did not significantly change from Wave 1 to Wave 2, several other indicators of mental health and wellbeing improved. Specifically, mental wellbeing increased, and rates of high GHQ-12 (indicating distress and possible psychiatric disorder), loneliness and distress all decreased. This suggests that overall, individuals perceived their mental wellbeing to have improved from Wave 1 to Wave 2, in line with the easing of lockdown restrictions.

This trend to improvement in mental health measures is consistent with findings from the UK COVID-MH study, which reported a decrease in rates of anxiety, defeat and levels of entrapment, and an increase in mental wellbeing, across waves 1-3 (covering a time frame of 31^st March to 11^th May 2020; O'Connor et al., 2020). Despite this evidence of an improvement in mental wellbeing between waves, it should be noted that although there is no directly comparable pre-COVID-19 data, findings from the 2019 Scottish Health Survey (SHeS; McLean et al., 2019) suggests that mental distress as measured by the GHQ-12 was still lower before the pandemic; high GHQ-12 cut-off was met by 17% of the SHeS (2019) sample, compared to 28.8% of the SCOVID Wave 2 sample. The Wave 2 SCOVID rate is more in line with the 29.2% of participants in the UK-based Understanding Society COVID-19 Study who reported high GHQ-12, conducted in late April 2020 (Li and Wang, 2020). It should be noted that these rates are not directly comparable, due to variation in recruitment between studies (e.g., Understanding Society is a household panel study whereas the SCOVID study recruited its sample through an online panel company).

An important marker of mental health and wellbeing that did not follow these trends is rates of reported suicidal thoughts, which increased from Wave 1 to Wave 2, specifically for young men and individuals with a mental health condition. This finding is also consistent with findings from the UK COVID-19 mental health study (O'Connor et al., 2020). It has been suggested that this could reflect a lagged effect, or it may be that the items assessing mental health measures such as depression focus on the past (i.e., Over the last two weeks, how often have you been bothered by any of the following problems?) whereas the suicidal question is tapping uncertainty or concerns about the future (i.e., thinking about suicide is an option for the future, which remains uncertain despite easing of lockdown). The trajectories of an increase in suicidal thoughts highlight the need to be vigilant, although an increase in suicide rates is not an inevitable consequence (Gunnell et al, 2020).

Consistent with the Wave 1 report, several subgroups reported higher rates of indicators of poor mental health at Wave 2, and these included young adults, women, people with a pre-existing mental health condition and those from a lower SEG. Findings from the Wave 2 report also suggest that several subgroups within the sample saw a change to indicators of mental health and wellbeing from Wave 1 to Wave 2. For example, the proportion of men reporting moderate to severe depressive symptoms and suicidal ideation increased from Wave 1 to Wave 2, whereas women's rates of moderate to severe depressive symptoms and high GHQ-12 (indicating distress and possible psychiatric disorder) scores decreased from Wave 1 to Wave 2. For young adults (18-29 years) rates of moderate to severe anxiety increased from Wave 1 to Wave 2, and for young men rates of suicidal ideation increased from Wave 1 to Wave 2. (It should be noted that the follow-up rate for young men was low, so findings for this group should be interpreted with caution). A higher proportion of respondents with a pre-existing mental health condition reported anxiety and suicidal thoughts in Wave 1 compared to Wave 2. However, there were also decreased rates of high GHQ-12 (indicating distress and possible psychiatric disorder) and increased levels of mental wellbeing among this group.

Thus far, the findings suggest that overall the mental health and wellbeing has improved on several markers from Wave 1 to Wave 2, which roughly coincides with a significant easing of lockdown restrictions. The worrying trend on suicidal thoughts needs to monitored, and will be reported on in subsequent waves. Wave 3 data was collected from 2^nd October to 4^th November 2020, which coincided with an increase in restrictions, particularly for hospitality, across many regions in Scotland, and this might help us understand the impact that increased restrictions could have upon mental health.