Coronavirus (COVID-19): mental health tracker study - wave 1 report

1. Background

1.1 Study overview and aims

In December 2019, a novel coronavirus was identified in Wuhan, China. Since then the associated disease COVID-19 has affected millions of people worldwide.

In addition to the physical health impact, the effects of COVID-19 on mental health and wellbeing are likely to be profound, long-lasting, and will extend beyond those who have been directly affected by the virus (Holmes, O'Connor et al., 2020). As a result, it is important to monitor population-based health and mental health outcomes to detect groups who may be most affected by COVID-19 and to what extent such effects will generalise across all aspects of mental health. We know from the SARS outbreak in 2003 that anxiety increased, and suicide rates also increased in some groups (e.g. Yip et al., 2010; Gunnell et al., 2020; Tsang et al., 2004). We need to act now, therefore, to understand and mitigate the mental health risk in Scotland following the COVID-19 pandemic.

The Scottish COVID-19 (SCOVID) Mental Health Tracker Study is part of a UK-wide study ('Tracking the impact of the COVID-19 pandemic on mental health and wellbeing (COVID-MH) study') which started on 31^st March 2020 just after lockdown measures were imposed. In May 2020 the Scottish Government commissioned an additional Scottish sample to allow close to real-time data on the mental health and wellbeing of the Scottish population over a 12-month period. The Scottish survey measures are aligned with the COVID-MH study to allow direct comparisons with other regions of the UK. The findings from the SCOVID Mental Health Tracker Study will help us to understand the impacts of the pandemic on Scottish population mental health and wellbeing, particularly the differential impacts on different population groups.

Key research aims for Wave 1 of the SCOVID Mental Health Tracker Study

1. To describe people's mental health and wellbeing in Scotland in the face of the COVID-19 pandemic between 28th May and 21st June 2020.

2. To gain an overview of the COVID-19 contextual factors, specifically people's experiences of COVID-19 and the impact this has had upon their lives.

1.2 Methodology

Wave 1 recruitment for the SCOVID Mental Health Tracker Study occurred between 28^th May and 21^st June 2020 which coincided with the Phase 1 easing of lockdown measures in Scotland^[4]. Recruitment was conducted by Taylor McKenzie, a social research company. Members of an existing online UK panel (Panelbase.net) were invited by email to take part in an online survey on health and wellbeing. The Wave 1 respondents will be followed up over subsequent waves which will be timed around 6, 12, 24 weeks and 12 months following Wave 1, or in line with important COVID-19 related events. Figure 1.1 provides an overview of key events/policy decisions for Scotland in relation to the COVID-19 tracker studies.

Image description:

This figure is a timeline which shows the time points of the COVID-19 pandemic, as well as the time points of Waves 1 and 2 of the SCOVID study, and Waves 1, 2, 3, 4, and 5 of the UK study. The timeline shows that in Dec 2019, COVID-19 was identified in Wuhan, on 31st January 2020 the first COVID-19 cases were identified in the UK, and on 24th March the UK entered Lockdown. Wave 1 of the UK study ran from 31st March to 9th April, Wave 2 of the UK study ran from 10th April to 27th April, and Wave 3 of the UK study ran from 28th April – 11th May. On 13th May, restrictions were eased in the UK and Wave 4 of the UK study ran between 27th May and 15th of June. Wave 1 of the SCOVID study ran between 28th May and 21st June, and on 29th of May Scotland entered Phase 1 of the easing of lockdown. On 1st June, England began to reopen and scale up, called Step 2. On 19th June, Scotland entered began to reopen and scale up, called Phase 2. On 4th July, England entered Step 3. On 10th July, Scotland entered Phase 3. Wave 5 of the UK study and Wave 2 of the SCOVID study both began on 17th July, however Wave 5 of the UK study ended on 7th August, whereas the SCOVID study ran until 17th August.

Consistent with the UK sample, a quota sampling methodology was employed to recruit a close to nationally representative sample of adults (n= 2,604) from across Scotland. Quotas were based on age, gender, housing tenure, and highest educational qualification. To give insight into the mental health and wellbeing of those living in urban/rural areas and within different NHS Health Boards, further quotas based on location within Scotland were also recruited. The majority of the quotas were met (see annex Tables B-D) however, individuals without educational qualifications are underrepresented in the sample.

Respondents were asked to complete demographic measures such as age, gender, sexual orientation, ethnicity, occupation, and living situation as well as questions related to COVID-19. Additionally, respondents completed mental health and wellbeing questions including measures of anxiety, depression, distress, loneliness, defeat, entrapment, and self-harm as well as measures of mental wellbeing and social support. A range of questions exploring contextual factors such as sources of emotional and social support and lifestyle factors were included along with perceptions, experiences, and the impact of COVID-19 related restrictions.

This report presents weighted data, reflective of the Scottish population. Consequently, although 2604 people took part, the results are adjusted such that the sample reports on 2514 respondents.

Within the report, inferential statistical tests were used to investigate differences between key subgroups. The subgroups were: age, sex, ethnicity, socio-economic grouping, a pre-existing mental health condition, additional responsibilities (dependents, carers), and occupational circumstances (key worker, change in working status). The report focusses on the statistically significant differences^[5] between key subgroups rather than discussing findings for each of these subgroups according to each study measure.

The main body of the report focuses on the results of the core mental health outcomes of depressive symptoms, anxiety symptoms, suicidal thoughts, general health, and mental wellbeing for the full range of subgroups outlined above. Contextual measures, such as lifestyle, employment, are reported on more briefly with fewer subgroup analyses. The annex contains more detailed information on contextual factors.

Additionally, it is important to note that there are no pre-COVID-19 findings for the mental health measures for this study's sample. Therefore, we do not know if the rates reported across the mental health indices have actually increased or decreased for respondents from before the COVID-19 lockdown. Wherever possible comparisons are made to other comparable research, such as the Scottish Health Survey (McLean et al., 2019), but it should be noted as these are different samples they are not directly comparable. Further, this report presents findings from Wave 1 of the SCOVID Mental Health Tracker Study, and therefore we cannot yet illustrate trends in respondents' mental health over time. These changes will be covered in future reports with data from further waves.

Ethical approval was obtained on 21^st May 2020 from the University of Glasgow's Medical, Veterinary and Life Sciences ethics committee to add a Scottish only sample to the existing UK study being led by the University of Glasgow (UK COVID-MH Ethics approval: 200190146).