COVID RELATED PROBLEMS	EXAMPLES/EXPLANATION
Mental health problems	Worsening of existing mental health problem/condition or a new mental health problem
Access to services	Mental health problem exacerbated by cessation or reduction of usual support services e.g., not finding virtual care delivery as effective as face to face
Isolation and loneliness	E.g., consequences of reduced contact with friends or family; people living alone and/or with limited social support networks who now have less access to the outside world
Reduced contact with family	E.g., children unable to visit due to parent being at high risk; or usual contact/support from family reduced; parents unable to have contact with children
Reduced contact with friends	E.g., virtual contact not the same as face to face and not able to see friends due to restrictions
Disruption to normal routine	E.g., unable to engage in usual activities such as sport. Include disruption to planned events e.g., house move, holiday etc
Entrapment	E.g., Feeling trapped in the house or with people they would rather not be with; simply finding lockdown difficult
Interpersonal conflict	E.g., strains in relationship with partner/family member due to being together so much more of the time
Employment	E.g., furlough, job loss, lack of job opportunities, unhappy working at home
Education/training	E.g., struggling with virtual learning; coping with returning to school following lockdown; apprenticeships stopped
Financial concerns	E.g., as a result of job loss/income reduction
Accommodation/housing	E.g., loss of accommodation or having to stay in accommodation they are unhappy with due to the pandemic
Substance misuse	E.g., increase in intake since lockdown; breading lockdown rules to obtain drugs or alcohol
Domestic abuse	Actual or threatened
Fear of COVID-19 infection	Fear of self becoming infected, fear of self infecting others, fear of others becoming infected
General COVID-19 related concerns	E.g., fears of the impact of the pandemic on the future; a sense of being generally overwhelmed by the pandemic
Bereavement issues	E.g., loss of someone who died following COVID-19 infection or loss not COVID-19 related but unable to carry out usual rituals such as family visits or funeral processes
Other	E.g., disturbed sleep due to concerns about the pandemic; reversed sleep pattern due to lack of routine; difficulties carrying out caring or home schooling; boredom

(Produced through research funded by the Department of Health and Social Care at the Centre for Suicide Research, University of Oxford, and the Multicentre Study of Self-harm in England, with the assistance of clinicians in Oxford Health NHS Foundation Trust's Emergency Department Psychiatric Service at the John Radcliffe Hospital, Oxford, and in Derbyshire Healthcare NHS Foundation Trust's Adult Mental Health Liaison Team South at the Royal Derby Hospital Service, Derby).