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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.

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.

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