Effect of the Coronavirus Disease 2019 Pandemic on Suicide-Related Trauma Burden at a Level 1 Trauma Center

Abstract

Introduction: In March 2020, the first coronavirus disease 2019 (COVID-19) cases were reported in New York and a stay-at-home order was enacted soon after. Social isolation combined with pandemic-related stressors profoundly affected mental health. We hypothesize that there was an increase in violent suicide attempt during the COVID-19 pandemic lockdown compared to previous years. Methods: We queried our institutional trauma registry for total number of trauma activations and identified adult patients with International Classification of Diseases-10 diagnosis of intentional self-harm. We compared incidence during the lockdown to corresponding time periods from previous years. Demographic and injury characteristics were compared, as were outcomes such as mortality. Results: We observe a significant uptrend in patients requiring trauma intervention after suicide attempts from July 2019 through July 2020 (r = 0.8, P < 0.001) despite a significant downtrend in trauma volume at our institution during the same period (r = [FIGURE DASH]0.7, P = 0.003). Although not statistically significant, patients attempting violent suicide during lockdown were more likely to have preexisting psychiatric diagnoses, to live alone, to have injury severity score >9, and to require surgical intervention. Three COVID-period patients died in the emergency room compared to zero in the comparison group. Conclusion: Our data show a rise in violent suicide attempts during the pandemic lockdown despite an overall decrease in trauma volume. The ramifications of a stay-at-home order seem to have the most profound impact on individuals with preexisting mental health disease. Early establishment of mental health outreach programs may mitigate the reverberating psychosocial consequences of a pandemic.

The effect of the SARS-CoV2 pandemic and lockdown on non-Covid ICU admissions: Experience from a South African tertiary hospital

“…The number of patients admitted to the ICU after a suicide attempt increased during the lockdown period compared with the previous year, however these differences were not statistically significant, as have been demonstrated in other parts of the world. [28] Locally, increases in common mental disorders, such as anxiety and depression and psychological distress have been found in a cohort of perinatal women as well as people living with HIV in SA during lockdown. [29 , 30] …”

Acute and intensive care nurses' perspectives on suicide prevention with medically hospitalized patients: Exploring barriers, facilitators, interests, and training opportunities

“…There are added challenges for acute and intensive care nursing, given these settings have been on the front lines of the COVID‐19 pandemic. On the one hand, the pandemic may have increased stress and the risk of suicide among the patient population traditionally served at the hospital (Eden et al, 2022), making the need for suicide prevention services that much more important. On the other hand, the stress of the pandemic on the healthcare system and nursing workloads may reduce the capacity for adding suicide prevention activities that can reach the full population of at‐risk patients.…”

“…There are added challenges for acute and intensive care nursing, given these settings have been on the front lines of the COVID-19 pandemic. On the one hand, the pandemic may have increased stress and the risk of suicide among the patient population traditionally served at the hospital (Eden et al, 2022), making the need for suicide prevention services that much more important.…”