COVID-19 lockdowns did not increase suicide rates among young adults

When Danish society went into lockdown during the coronavirus pandemic, many feared the worst for young people and whether it would have far-reaching consequences for their quality of life and psychological well-being. Concerns also focused on whether the situation would aggravate mental ill health and mental challenges at the severe end of the scale – whether the incidence of suicide, suicidal thoughts, self-harming and eating disorders would rise among young people.

A new study recently published in the distinguished journal Nature Human Behaviour shows that the concerns may have been largely unfounded.

A research project conducted by the Department of Public Health, University of Copenhagen, and the Danish Research Institute for Suicide Prevention is the source of the good news. The researchers behind the study found that the proportion of young adults reporting eating disorder symptoms, self-harming, suicidal thoughts and suicide attempts was no higher during the COVID-19 lockdown than in previous years. The figures are based on data from the large national Danish birth cohort, Bedre Sundhed i Generationer (Better Health for Generations).

During the COVID-19 crisis, public attention focused sharply on the impact of the two major Danish lockdowns, particularly on adolescent mental well-being. Accordingly, the researchers in this study examined whether more adolescents self-reported eating disorder symptoms, self-harming, suicidal thoughts and suicide attempts.

They examined the young adults in several ways.
One approach involved the researchers’ collecting data from about 25,000 18-year-olds. Here, they compared adolescents who had answered questions about eating disorder symptoms, self-harming, suicidal thoughts and suicide attempts before lockdown with other adolescents answering the same questions during the lockdown.

Using this methodology, the researchers found no differences in the proportion reporting eating disorder symptoms, self-harming, suicidal thoughts and suicide attempts before and during the lockdown.

In the second part of the study, approximately 7,500 young adults answered questions about eating disorder symptoms, self-harming, suicidal thoughts and suicide attempts both prior to (before 11 March 2020) and again one year after the first lockdown (April-May 2021).

On this point, they found that the proportion of young adults with eating disorder symptoms dropped from 14% to 12% among young women, while the figure for men was the same, 3%. The proportion of both genders self-reporting self-harming dropped: for women from 14% to 8%, while the figure for men dropped from 6% to 3%. Similarly, the proportion having suicidal thoughts dropped from 25% to 18% among women and from 18% to 15% among men. The proportion of suicide attempts was the same before and after the lockdown for women while rising by 0.4% from a baseline of 0.5% before the lockdown among men. The number of suicide attempts was low, particularly for men, for which reason this estimate is associated with great uncertainty. Sensitivity analyses planned in advance signalled no increase in suicide attempts among men.

‘The two methodologies have different strengths and weaknesses, and our overall conclusion is that the survey does not indicate an increase in young adults with eating disorder symptoms, self-harming, suicidal thoughts and suicide attempts,’ says Stine Danielsen, a PhD student from the Danish Research Institute for Suicide Prevention, Mental Health Services, Capital Region of Denmark. She is the lead author of the study recently published in Nature Human Behaviour.

‘The drop in eating disorder symptoms, self-harming and suicidal thoughts were reported through questions posed to the same young adults twice and may be explained by the greater likelihood that adolescents with more personal resources will participate repeatedly. Accordingly, one has to exercise caution in concluding that fewer had eating disorder symptoms, exhibited self-harming behaviour or had suicidal thoughts after the COVID-19 lockdown. It’s also important to stress that our figures show an average estimate. Some young people will probably have experienced the lockdown, with its social restrictions, as being tough to live with, while others will have found the period beneficial in terms of less pressure and stress from social activities,’ Stine Danielsen explains.

The research received funding from the Lundbeck Foundation via an Ascending Investigators grant awarded to Trine Madsen, a senior researcher with Mental Health Services, Capital Region of Denmark.

How the researchers examined the young adults’ mental health

• The study is based on the Danish national birth cohort, Bedre Sundhed i Generationer (BSIG), which followed around 96,000 young adults born from 1996-2003, from embryo state to early adulthood.

• Method 1: This approach is based on responses from a range of 18-year-olds who answered questions either before or during different lockdown periods and up until spring 2021.

• Method 2: In this approach, the same individuals answered questions before the lockdown when they were 18 and again in April to May 2021. The young adults were aged 19-23 during the lockdowns.