Background: The effects of COVID-19 on the population's mental health and wellbeing are likely to be profound and long-lasting. Aims: To investigate the trajectory of mental health and wellbeing during the first six weeks of lockdown in adults in the UK. Method: A quota survey design and a sampling frame that permitted recruitment of a national sample was employed. Findings for waves 1 (31 st March to 9 th April 2020), 2 (10 th April to 27 th April 2020) and 3 (28 th April to 11 th May 2020) are reported here. A range of mental health factors was assessed: pre-existing mental health problems, suicide attempts and self-harm, suicidal ideation, depression, anxiety, defeat, entrapment, mental well-being, and loneliness. Results: A total of 3077 adults in the UK completed the survey at wave 1. Suicidal ideation increased over time. Symptoms of anxiety, levels of defeat and entrapment decreased across waves whereas levels of depressive symptoms did not change significantly. Positive wellbeing also increased. Levels of loneliness did not change significantly over waves. Subgroup analyses showed that females, young people (18-29 years), those from more socially disadvantaged backgrounds, and those with pre-existing mental health problems have worse mental health outcomes during the pandemic across most factors. Conclusions: The mental health and wellbeing of the UK adult population appears to have been affected in the initial phase of the COVID-19 pandemic. The increasing rates of suicidal thoughts across waves, especially among young adults, are concerning.

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The experience of psychosis can lead to depression, anxiety and fear. Acceptance and Commitment Therapy (ACT) facilitates individuals to accept difficult mental experiences and behave in ways that are consistent with personally held values. This study was a single (rater) blind pilot randomised controlled trial of ACT for emotional dysfunction following psychosis.Twenty-seven participants with psychosis were randomised to either: ten sessions of ACT plus treatment as usual (TAU) or TAU alone. The Hospital Anxiety and Depression Scale, Positive and Negative Syndrome Scale, Acceptance and Action Questionnaire, Kentucky Inventory of Mindfulness Skills and Working Alliance Inventory were used. Individuals were assessed at baseline and 3 months post-baseline. The individuals randomised to receive ACT found the intervention acceptable. A significantly greater proportion of the ACT group changed from being depressed at time of entry into the study to not being depressed at followup. The ACT group showed a significantly greater increase in mindfulness skills and reduction in negative symptoms. Results indicated that individuals randomised to ACT had significantly fewer crisis contacts over the study. Changes in mindfulness skills correlated positively with changes in depression. ACT appears to offer promise in reducing negative symptoms, depression and crisis contacts in psychosis.

These findings provide further support for the IMV model, and highlight potential targets for clinical intervention.

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