Factors influencing self-harm thoughts and self-harm behaviours over the first year of the COVID-19 pandemic in the UK: a 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 adverse experiences and adversity worries contribute to changes in self-harm thoughts and behaviours. Method Data from 49,324 UK adults in the UCL 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 experiences and adversity worries with changes in self-harm thoughts and behaviours across age groups (18-29, 30-44, 45-59, and 60+ years). Results 26.1% and 7.9% respondents reported self-harm thoughts and behaviours, respectively, at least once over the study period. More adverse experiences were more strongly related to outcomes than 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, whilst 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.