Factors influencing self-harm thoughts and behaviours over the first year of the COVID-19 pandemic in the UK: longitudinal analysis of 49 324 adults

BACKGROUND: There is concern that the COVID-19 pandemic and its aftermath will result in excess suicides by increasing known risk factors such as self-harm, but evidence on how pandemic-related risk factors contribute to changes in these outcomes is lacking. AIMS: To examine how different COVID-19-related experiences of and worries about adversity contribute to changes in self-harm thoughts and behaviours. METHOD: Data from 49 324 UK adults in the University College London COVID-19 Social Study were analysed (1 April 2020 to 17 May 2021). Fixed-effects regressions explored associations between weekly within-person variation in five categories of adversity experience and adversity worries with changes in self-harm thoughts and behaviours across age groups (18-29, 30-44, 45-59 and 60+ years). RESULTS: In total, 26.1% and 7.9% of respondents reported self-harm thoughts and behaviours respectively at least once over the study period. The number of adverse experiences was more strongly related to outcomes than the number of worries. The largest specific adversity contributing to increases in both outcomes was having experienced physical or psychological abuse. Financial worries increased the likelihood of both outcomes in most age groups, and having had COVID-19 increased the likelihood of both outcomes in young (18-29 years) and middle-aged (45-59 years) adults. CONCLUSIONS: Findings suggest that a significant portion of UK adults may be at increased risk for self-harm thoughts and behaviours during the pandemic. Given the likelihood that the economic and social consequences of the pandemic will accumulate, policy makers can begin adapting evidence-based suicide prevention strategies and other social policies to help mitigate its consequences.