New research: These groups are particularly vulnerable in future crises
It has been six years since Denmark shut down due to the COVID-19 pandemic. New studies show which groups were at particular risk of suicidal thoughts and psychological distress during the pandemic – knowledge that, according to the researchers, can be used if society is again hit by a crisis.
The studies are based on data from the Danish part of the international survey COH-FIT, in which thousands of Danish adults were asked about their mental health during the pandemic lockdowns in 2020, 2021 and 2022.
Overall, the results indicate that certain groups consistently experienced higher levels of psychological distress and suicidal ideation during the crisis. People with previous or current mental illness, those who felt lonely, and those who faced financial losses after the outbreak were particularly affected. Researchers from the National Institute of Public Health, who conducted the studies, emphasize that this knowledge is important not only for understanding the covid-19 pandemic, but also for preparing the Danish society for future pandemics, crises, lockdowns, and societal disruptions.
“Our findings show that certain groups are particularly vulnerable to psychological distress during crises. This knowledge can help us identify who may need support. For example, suicidal ideation is an early indicator of psychological distress and may lead to suicidal behaviour if it is not addressed,” says Lau Caspar Thygesen, professor at the National Institute of Public Health and one of the researchers involved in the studies.
Many had suicidal ideation at the beginning
One of the studies specifically examines the occurrence of suicidal ideation among Danish adults during the pandemic.
In May 2020 – shortly after the first lockdown – 42 percent of the participants reported having experienced some degree of suicidal ideation. In the study, suicidal ideation was examined as a broad spectrum, ranging from passive thinking to active planning.
In the two later surveys, the proportion fell to 30 percent at the beginning of 2021 and to 28 percent at the beginning of 2022.
According to Trine Toft Sørensen, research assistant and one of the researchers behind the studies, this decline may reflect that many people gradually adapted to the situation, but also that society reopened.
At the same time, the analyses show that some risk factors appeared across all three pandemic waves.
“In particular, people who felt lonely during the lockdowns, and those who had previously attempted suicide, were at particular risk of suicidal ideation. The same was observed among people who faced financial losses, for example due to job loss or reduced income,” says Trine Toft Sørensen.
In addition, suicidal ideation was more frequent among people with lower educational level, men, and young adults.
Citizens with mental illness were hit harder
The second study looks more broadly at well-being during the pandemic and compares the development in both physical and mental health among people with and without mental illness.
The results show that mental health worsened in both groups during the pandemic, but considerably more among those with a current or previous mental illness. “Overall, mental health worsened during the pandemic, but people with current or previous mental illness were particularly affected. This was also seen in sleep problems: around half of participants with mental illness reported poorer sleep during the pandemic, compared with about one third of those without,” says Trine Toft Sørensen.
Loneliness also had a stronger impact on people with current or previous mental illness. Although loneliness decreased over time for everyone, the decline was smaller in this group. By contrast, physical health and stress showed less difference between groups. For example, around half of all participants reported increased stress during the first lockdown, regardless of whether they had a current or previous mental illness or not.
Lessons for future crises
According to the researchers, the results show that psychological consequences of crises do not affect everyone equally. Therefore, it is important that authorities and society use the experiences from the covid-19 pandemic to prepare and target preventive efforts for future crises.
According to Lau Caspar Thygesen, this may include early identification of vulnerable groups and the provision of psychological support or financial support measures, as well as cross-sector collaboration between health authorities, social services and workplace organizations to reduce psychological strain.
“The experiences can be used to better support vulnerable groups. This may prove crucial for preventing serious psychological distress and suicidal ideation,” says Lau Caspar Thygesen.
The study “Suicidal ideation across three waves of the Covid-19 pandemic in Denmark – identifying vulnerable subgroups using COH-FIT data” has been published in Journal of Affective Disorders.
The study “Health, Psychological Distress, and Functioning During the Covid-19 Pandemic Among Danish Adults with and Without a Preexisting Mental Illness” has been published in International Journal of Environmental Research and Public Health.
The project was supported by TrygFonden.
If you or someone close to you is experiencing suicidal thoughts, you can contact the Danish suicide prevention hotline Livslinien at +45 70 20 12 01.
Contact:
Professor Lau Caspar Thygesen, phone: +45 6550 7771, e-mail: lct@sdu.dk
Senior researcher Gunhild Tidemann Oxholm, phone: +45 6550 7770, e-mail: gunh@sdu.dk
Research assistant Trine Toft Sørensen, phone: +45 6550 8684, e-mail: trins@sdu.dk
National Institute of Public Health, University of Southern Denmark.