A fifth of vulnerable people in Britain thought about self-harming or killing themselves during lockdown, according to research shared with the Guardian, as a series of inquests underline the mental health toll of the Covid-19 pandemic. Findings from University College London reveal that 8,000 out of 44,000 people surveyed (18%) reported thoughts of self-harm or suicide, and 42% had accessed support services. A further 5% said they had harmed themselves at least once since the start of the UK’s lockdown. Research in 2014 found that 6% of English adults reported having self-harmed at some point in their lives. The new survey was self-selecting and promoted by organisations such as the UKRI Mental Health Networks, so respondents may be have been more vulnerable or engaged in the subject. Psychiatrists have warned of an increase in mental health referrals as a result of lockdown, and called for significant and sustained funding to keep services afloat. Police chiefs have also noted a pressure on their services, urging more investment. In interviews with the Guardian, the Royal College of Emergency Medicine and the College of Paramedics said isolation and furlough would hit A&E and ambulance services as regular treatment for mental health patients had been delayed or stalled. Recent inquests into suspected or confirmed suicides highlight the impact. In least 11 concluded or ongoing coroner investigations, the impact of Covid-19 was mentioned by coroners or family members as a potential factor. Cases include: A pub landlord who died days after Boris Johnson announced that people should avoid pubs, clubs and other social venues. The coroner said this news could have been a factor in his death. A man who had concerns about the financial implications of being self-employed during the pandemic. Another man who experienced depression and anxiety and was found dead shortly after losing his job because of the pandemic. A woman who died a day before her mother succumbed to coronavirus. A man found dead at his mother’s home, who had recently been furloughed and experienced mental health issues. Adrian James, the president of the Royal College of Psychiatrists, said: “The pandemic has had a serious negative impact on mental health. We are concerned by the number of people who were not able to get support during lockdown. To meet this anticipated demand we need to see urgent action from the government to deliver significant and sustained investment. Without it, services will struggle to cope.” Data analysed by the Guardian from nine out of 11 ambulance trusts shows that the number of mental health calls rose to 905 in June 2020, from 723 a year earlier. There were 843 calls in May 2020, up from 781 last year. The figures do not include the London ambulance service, one of the biggest trusts. Tracy Nicholls, the chief executive of the College of Paramedics, said: “Anxiety and depression are huge … If we have a second wave then we want to protect patients as much as we can. The role of the paramedic is not just to support life when in crisis but also to help educate and signpost people to all support available. “The impression generally is that it does feel as if there has been an increase in mental health calls among all ages, not specifically to one particular age group or gender.” Dr Catherine Hayhurst, the Royal College of Emergency Medicine’s mental health committee chair, said calls to her region’s mental health telephone support service had risen by about a quarter on the same time last year. She said the number of people attending A&E with mental health problems was rising again to near the level of 2019 but calls to her local crisis line were “much higher than they were pre-Covid-19 just in the last couple of weeks”. She said: “The main group affected is people who live alone or have pre-existing alcohol problems … It is also hard for people with pre-existing mental health problems.” Police figures also point to an increase in mental health incidents. Devon and Cornwall data showed that in March there were 1,023 mental-health-related incidents flagged to police, up from 816 in the same month last year and 582 the year before. In April there were 831, up from 727 in 2019 and 582 in 2018. John Apter, the national chair of the Police Federation of England and Wales, said: “The public would be shocked by just how much of an officer’s time is spent dealing with non-crime related incidents, with the majority of these involving mental health issues. What is needed is significant and sustained investment in all our public services to ensure those experiencing mental ill health get the help and support they need.” Joy Hibbins, the chief executive of Suicide Crisis, said its crisis service was dealing with a lot of clients. “For many people, psychological therapy for trauma abruptly halted,” she said. One of the issues with phone services, according to Hibbins, is that it is hard to monitor for suicide risk over a longer period of time. “You may miss what you notice from face-to-face meetings, and even if you try to replicate that online, I would not be confident to say that it is reliable.” Mental health services were starting up again in some areas, Hibbins said, although “slowly”, and they had been told that some were waiting to see if there would be a second wave as they felt starting and then having to stop would be more disruptive. The UCL study, being published on Monday, and based on responses between 21 March and 20 April, found that 9% of respondents had experienced psychological or physical abuse. About half of those respondents had had thoughts of suicide or self-harm, and 25% had engaged in self-harm behaviours during the past week. The researchers analysed data from the UCL Covid-19 social study on the psychological and social experiences of adults in the UK during the pandemic. Participants in the study completed online questionnaires on a weekly basis. An NHS spokesperson said: “The pandemic has turned lives upside down and for some people it will have put greater strain on their mental health. And while some people will have had reservations about seeking help during the lockdown, NHS services, including face-to-face appointments, have still been open to people who need them, despite the Covid-19 outbreak. “Services continue to adapt to maximise the mental health support we can provide to people who need it, including online and telephone support and the establishment of 24/7 open-access, all-age crisis services, and it is absolutely vital that anybody who thinks they would benefit from treatment continues to come forward and get help.” A spokesperson for the Department of Health and Social Care said: “We recognise the impact this pandemic can have on people’s mental health. We are providing £9.2m in funding to national and local mental health charities to support adults and children affected by the pandemic, and we continue to work with the NHS, Public Health England and others to support mental health and wellbeing throughout the ‘recovery’ phase. “Mental health services will continue to expand further and faster thanks to a minimum £2.3bn of extra investment a year by 2023/24 as part of the NHS long-term plan.”