Concealed effects of the COVID-19 pandemic: Monitoring suicidal ideation trends and risk factors among Dutch youth since the COVID-19 Omicron lockdown (Preprint)
Authors: Rahmon Imme , Postema Abigail , Bosmans Mark , Marra Elske , Dückers Michel 
Published: September 2024

BACKGROUND

During previous pandemics, both viral infections and public mitigation measures were shown to bear potential mental health risks worldwide. As psychological well-being was confirmed to be affected among youth during the COVID-19 pandemic, concerns arose about potential increases in suicide rates attributed to the pandemic's adverse impact.

OBJECTIVE

This study aimed to examine trends and risk factors for self-reported suicidal ideation among Dutch youth at the end of, and 12 and 18 months after the Omicron COVID-19 lockdown, activated in December 2021.

METHODS

We performed a repeated cross-sectional study, in which quarterly online questionnaires were used to study self-reported suicidal ideation among two youth panels (N ~ 5.000 youth per wave, aged 12-25 years) representative of the Dutch population. Quarterly trends were assessed between September 2021 and September 2023. In March 2022 (immediately after the Omicron lockdown), and in March 2023 and September 2023 (12 and 18 months thereafter), selected sociodemographic, physical/mental health, and social activity variables were analyzed as potential risk factors for self-reported suicidal ideation, using random forest and logistic regression analyses.

RESULTS

This study was based on data from nine survey waves, totaling 42,099 participants, with an average item response rate of 98.9% across all waves to the question on experiencing suicidal ideation in the previous three months. Since the start of the COVID-19 Omicron lockdown in December 2021, self-reported suicidal ideation in the Netherlands increased significantly from 8.6% in December 2021 to 18.8% in September 2023 (P < .001). Applying survey weights to reflect the national Dutch population aged 12-25 years revealed similar patterns. In March 2022, 4,751 youth participated in the survey, with subsequent measurements in March 2023 comprising 5,285 and in September 2023 5,079 participants. In all multivariable analyses, variables relating to mental health were indicated as significant risk factors with comparable association strengths across survey waves. Among these, the strongest associations were observed in youth experiencing severe loneliness (aOR = 7.00; 95% CI = 4.74 - 10.6) and poor psychological well-being (aOR = 3.33; 95% CI = 2.63 - 4.24). Demographic variables did not demonstrate strong associations with suicidal ideation.

CONCLUSIONS

The current multi-wave cross-sectional survey-based monitoring approach highlights the crucial impact of the COVID-19 context on observed changes in self-reported levels of suicidal ideation among Dutch youth after the Omicron lockdown. In addition, loneliness and poor psychological well-being have been identified as significant risk factors for suicidal ideation across all survey waves. This indicates that, in times of crisis, suicide prevention programs may be best targeted towards those experiencing poor psychological well-being and loneliness, but are unlikely to require adaptation to specific crisis contexts.