Background: The effects of coronavirus disease 2019 (COVID-19) on the population's mental health and well-being are likely to be profound and long lasting.Aims: To investigate the trajectory of mental health and well-being during the first 6 weeks of lockdown in adults in the UK.Method: A quota survey design and a sampling frame that permitted recruitment of a national sample was employed. Findings for waves 1 (31 March to 9 April 2020), 2 (10 April to 27 April 2020) and 3 (28 April to 11 May 2020) are reported here. A range of mental health factors was assessed: pre-existing mental health problems, suicide attempts and self-harm, suicidal ideation, depression, anxiety, defeat, entrapment, mental well-being and loneliness.Results: A total of 3077 adults in the UK completed the survey at wave 1. Suicidal ideation increased over time. Symptoms of anxiety, and levels of defeat and entrapment decreased across waves whereas levels of depressive symptoms did not change significantly. Positive well-being also increased. Levels of loneliness did not change significantly over waves. Subgroup analyses showed that women, young people (18–29 years), those from more socially disadvantaged backgrounds and those with pre-existing mental health problems have worse mental health outcomes during the pandemic across most factors.Conclusions: The mental health and well-being of the UK adult population appears to have been affected in the initial phase of the COVID-19 pandemic. The increasing rates of suicidal thoughts across waves, especially among young adults, are concerning.

Two leading theories within the field of suicide prevention are the interpersonal psychological theory of suicidal behaviour (IPT) and the integrated motivational-volitional (IMV) model. The IPT posits that suicidal thoughts emerge from high levels of perceived burdensomeness and thwarted belongingness. The IMV model is a multivariate framework that conceptualizes defeat and entrapment as key drivers of suicide ideation. We applied network analysis to cross-sectional data collected as part of the Scottish Wellbeing Study, in which a nationally representative sample of 3508 young adults (18-34 years) completed a battery of psychological measures. Network analysis can help us to understand how the different theoretical components interact and how they relate to suicide ideation. Within a network that included only the core factors from both models, internal entrapment and perceived burdensomeness were most strongly related to suicide ideation. The core constructs defeat, external entrapment and thwarted belonginess were mainly related to other factors than suicide ideation. Within the network of all available psychological factors, 12 of the 20 factors were uniquely related to suicide ideation, with perceived burdensomeness, internal entrapment, depressive symptoms and history of suicide ideation explaining the most variance. None of the factors was isolated, and we identified four larger clusters: mental wellbeing, interpersonal needs, personality, and suicide-related factors. Overall, the results suggest that relationships between suicide ideation and psychological risk factors are complex, with some factors contributing direct risk, and others having indirect impact.

Although many suicide risk factors have been identified, there is still relatively little known about the factors that differentiate those who think about suicide from those who make a suicide attempt. Using the integrated motivational-volitional model (IMV) of suicidal behaviour as a framework, this study hypothesised that (i) motivational and volitional phase factors would differentiate non-suicidal controls from those who had a history of suicidal ideation or suicide attempts, and (ii) within a multivariable model only volitional phase factors would differentiate between those who had a history of suicidal ideation and those who had attempted suicide. The Scottish Wellbeing Study (n = 3508) is a nationally representative study of young people (18-34 years) recruited throughout Scotland. Using multinomial regression analysis, three groups (non-suicidal control (n = 2534), lifetime suicide ideation (n = 498) and lifetime suicide attempt (n = 403) groups) were compared on motivational and volitional phase variables. Consistent with the IMV model, motivational and volitional phase variables differentiated the control group from both the ideation and attempt groups. Only volitional phase variables differentiated between the suicide attempt group and the suicidal ideation group in the multivariable model; with those reporting a suicide attempt being higher on acquired capability, mental imagery about death, impulsivity, and being more likely to know a friend who had made a suicide attempt. Having a family member or friend die by suicide or a family member attempt suicide did not differentiate between the groups. The findings were based on cross-sectional data derived from self-report measures. These findings provide further support for the IMV model, and highlight potential targets for clinical intervention.

Background: There are few prevalence studies of suicide attempts and non-suicidal self-harm (NSSH).Aims: We aimed to estimate the prevalence of thoughts of NSSH, suicidal thoughts, NSSH and suicide attempts among 18- to 34-year-olds in Scotland.Method: We interviewed a representative sample of young adults from across Scotland.Results: We interviewed 3508 young people; 11.3 and 16.2% reported a lifetime history of suicide attempts and NSSH, respectively. The first episode of NSSH tended to precede the first suicide attempt by about 2 years. Age at onset of NSSH and suicide attempt was younger in females. Earlier age at onset was associated with more frequent NSSH/suicide attempts. Women are significantly more likely to report NSSH and suicide attempts compared with men.Conclusions: One in nine young people has attempted suicide and one in six has engaged in NSSH. Clinicians should be vigilant, as suicide attempts and NSSH are relatively common.Declaration of interest: None.