Scottish COVID-19 Mental Health Tracker Study Wave 5 Report

Executive summary

This is the final report of the Scottish COVID-19 (SCOVID) Mental Health Tracker Study, covering findings for a range of mental health outcomes across all the five waves of the Study. This report presents cross-sectional findings for the overall sample, as well as specific groups which appear to have been most at-risk for poor mental health outcomes^[1].

The Wave 5 findings are based on questionnaire data collected between 1st June to 9th July 2021. This period coincided with the easing of lockdown restrictions across the UK. Specifically, at the end of April and across May 2021, shops and sports facilities opened, restrictions in household mixing were removed, and hospitality restrictions eased. Additionally, the COVID-19 vaccination programme was underway across Scotland. Therefore, Wave 5 represents a period of returning to normality and a reduction of pandemic restrictions.

This final report concentrates on a smaller selection of mental health and wellbeing outcome measures compared with previous SCOVID reports, as they represent important outcomes and indicators of mental health in the population, namely: suicidal thoughts, depressive symptoms, anxiety symptoms, and mental wellbeing.

Wave 5 cross-sectional findings show:

• 10.6% of respondents reported suicidal thoughts within the week prior to completing the Wave 5 survey,
• 21.7% reported moderate to severe depressive symptoms,
• 18.2% reported moderate to severe anxiety symptoms, and
• The average mental wellbeing score was 22.08 (out of a possible score of 35).

Compared with the previous waves, data from Wave 5 suggest that there was some improvement in mental health for the whole sample. For example, at Wave 5, a smaller proportion of the sample reported depressive symptoms than at previous waves, the overall sample reported higher mental wellbeing scores, and suicidal thoughts were about the same as at Wave 1. In contrast, anxiety symptoms were higher than the previous three waves, suggesting there was still an impact upon people's mental health.

Looking across the waves, there was a trend for people to report poorer mental health at times of higher restrictions (i.e., Wave 1: Spring 2020, Wave 3: Autumn 2020, and Wave 4: Winter 2021) and better mental health at times of fewer restrictions (i.e., Wave 2: Summer 2020 and Wave 5: Summer 2021). This suggests that people's mental health and wellbeing were impacted by the COVID-19 restrictions and lockdowns, although it appears that as restrictions eased these mental health outcomes tended to improve.

This report also provides insight into factors that may be associated with a higher risk for poor mental health. A number of characteristics were chosen based upon previous wave report findings that showed a correlation with poorer mental health: i.e., pre-existing mental health conditions, pre-existing physical health conditions, unpaid carer responsibilities, caring for young dependents, and vaccine hesitancy. On average, and across this range of factors, particular age and sex groups tended to report worse mental health outcomes across the waves of the SCOVID study than their age and sex counterparts, as well as the sample average. These groups were:

• Young women
• Young men
• Young adults
• Women

Due to small numbers of subgroup samples, it was not possible to robustly investigate further intersectional analyses, to see, for example, if young women with a pre-existing mental health condition were at even more elevated risk of poor mental health. Despite this, findings from the report suggest that further intersectional conclusions can be drawn. For example, respondents who have a pre-existing mental health condition or physical health condition are more likely to report worse mental health than those who do not, and young women are also more likely to report poorer mental health than other age and sex groups. As such, a young woman who has a mental or physical health condition is likely to be at a greater increased risk for poorer mental health, than if the young woman did not have a pre-existing condition.

Evidence from the final report of the SCOVID study suggests that there is an inequality in how the pandemic has impacted people across Scotland. We advise that the vulnerable subgroups highlighted, namely young adults and women with a mental health condition, a physical health condition, unpaid caring responsibilities, or vaccine hesitancy, be prioritised when implementing mental health policy and research to mitigate the impact of the COVID-19 pandemic upon the mental health of the Scottish population. More specific recommendations are located at the end of the report.

Key findings for at-risk groups

Young women

• Compared with their age and sex counterparts, young women reported the worst mental health over the pandemic; across most waves they reported the highest rates of suicidal thoughts, depressive symptoms, and anxiety symptoms, and the lowest mental wellbeing.
• The SCOVID data suggest that young women appeared to be at highest risk of poor mental health when COVID-19 mitigation restrictions on movement and socialising were in place. Indeed, at Wave 5, young women reported the lowest rates of suicidal thoughts, depressive symptoms, and highest mental wellbeing than at any other stage of the pandemic.
• Looking at Wave 5 specifically:
  • 14.8% of young women reported suicidal thoughts,
  • 34.9% reported depressive symptoms, and
  • 36.8% reported anxiety symptoms.
  • The average mental wellbeing score for young women was 19.80 (out of a possible score of 35), lower than the average of 22.08.
• At Wave 5, compared with young men, young women were more likely to be in the lower SEG and have a pre-existing mental health condition, factors that make them more at risk for poor mental health.

Young men

• Compared with their (male) age counterparts, young men reported the worst mental health over the pandemic; across most waves they reported the highest rates of suicidal thoughts, depressive symptoms, and anxiety symptoms, and the lowest mental wellbeing.
• The SCOVID data suggests that young men appeared to be at highest risk of poor mental health when COVID-19 mitigation restrictions on movement and socialising were reduced, specifically at Wave 2 (Summer 2020) and Wave 5 (Summer 2021). This is in contrast to other groups.
• Looking at Wave 5 specifically:
  • 12.1% of young men reported suicidal thoughts,
  • 38.2% reported depressive symptoms, and
  • 24.1% reported anxiety symptoms.
  • The average mental wellbeing score for young men was 20.14 (out of a possible score of 35), lower than the average of 22.08.
• At Wave 5, compared with young women, young men were more likely to be a key worker, a factor that make them more at risk for poor mental health.

Young Adults

• At almost all waves, young adults (18-29 years) reported higher rates of suicidal thoughts, depressive symptoms, anxiety symptoms, and lower mental wellbeing than those in the older age groups.
• Overall, young adults tended to report higher rates of depressive symptoms, anxiety symptoms and lower wellbeing when restrictions were in place, and lower rates of suicidal thoughts, depressive symptoms, and highest wellbeing scores when restrictions were easing (e.g., at Wave 5).
• Trend data for these mental health outcomes across the waves, suggest that for young adults, mental health appeared to improve over the pandemic, though overall their mental health remained poorer than older adults.
• Looking at Wave 5 specifically,
  • 13.4% of young adults reported suicidal thoughts,
  • 36.6% reported depressive symptoms, and
  • 30.4% reported anxiety symptoms.
  • The average mental wellbeing score for young adults was 19.97 (out of a possible score of 35), lower than the average of 22.08.
• At Wave 5, compared with the older age groups, young adults were more likely to be a key worker, and more likely to have a mental health condition compared with 60+ year olds, these factors place them at higher risk of poor mental health.
• At almost all waves, young adults with a pre-existing mental health condition, a physical health condition, or unpaid caring responsibilities reported worse mental health, compared with those who had any of these conditions in the older age groups.

Women

• At most waves, women reported higher rates of depressive symptoms, anxiety symptoms, and lower mental wellbeing than men. Women tended to report similar rates of suicidal thoughts to men, and at Waves 2 and 5 men reported higher rates.
• Overall, women tended to report higher rates of depressive symptoms, anxiety symptoms and suicidal thoughts when restrictions were in place (e.g., at Wave 4 during a national lockdown).
• Looking at Wave 5 specifically,
  • 9.3% of women reported having suicidal thoughts,
  • 22.5% reported depressive symptoms, and
  • 19.6% reported symptoms.
  • The average mental wellbeing score for women was 21.85 (out of a possible score of 35), lower than the average of 22.08.
• Compared with men, women were more likely to be in the lower SEG, have had a change to working status during the pandemic, have caring responsibilities, and have a physical health condition; these factors place them at higher risk of poor mental health.
• Compared with men with a pre-existing mental health condition or a physical health condition, women in these groups consistently reported higher rates of depressive symptoms and anxiety symptoms across the waves.
• At most waves, women with unpaid caring responsibilities or young dependents (under 5 years) reported higher rates of suicidal thoughts, depressive symptoms, anxiety symptoms, and lower mental wellbeing, than men who had unpaid caring responsibilities or young dependents.