Patterns of Suicide in the Context of COVID-19: Evidence From Three Australian States

Abstract

Aims: We aimed to determine whether there has been a change in the number of suicides occurring in three Australian states overall, and in age and sex subgroups, since the COVID-19 pandemic began, and to see if certain risk factors for suicide have become more prominent as likely underlying contributing factors for suicide.Method: Using real-time data from three state-based suicide registers, we ran multiple unadjusted and adjusted interrupted time series analyses to see if trends in monthly suicide counts changed after the pandemic began and whether there had been an increase in suicides where relationship breakdown, financial stressors, unemployment and homelessness were recorded.Results: Compared with the period before COVID-19, during the COVID-19 period there was no change in the number of suicides overall, or in any stratum-specific estimates except one. The exception was an increase in the number of young males who died by suicide in the COVID-19 period (adjusted RR 1.89 [95% CI 1.11–3.23]).The unadjusted analysis showed significant differences in suicide in the context of unemployment and relationship breakdown during the COVID-19 compared to the pre-COVID-19 period. Analysis showed an increase in the number of suicides occurring in the context of unemployment in the COVID-19 period (unadjusted RR 1.53 [95% CI 1.18–1.96]). In contrast, there was a decrease in the number of suicides occurring in the context of relationship breakdown in the COVID-19 period (unadjusted RR 0.82 [95% CI 0.67–0.99]). However, no significant changes were identified when the models were adjusted for possible over-dispersion, seasonality and non-linear trend.Conclusion: Although our analysis found no evidence of an overall increase in suicides after the pandemic began, the picture is complex. The identified increase in suicide in young men indicates that the impact of the pandemic is likely unevenly distributed across populations. The increase in suicides in the context of unemployment reinforces the vital need for mitigation measures during COVID-19, and for ongoing monitoring of suicide as the pandemic continues.

Changes in self-harm- and violence-related urgent psychiatric consultation in the emergency department during the different stages of the COVID-19 pandemic

“…A national surveillance showed that 10.7% responders had severe suicide ideation in the past month, and the phenomenon was significantly more prominent in female patients, minority population, unpaid caregivers, and essential workers [ 21 ]. Furthermore, unemployment during the pandemic may be related to an increased suicide rate [ 22 ]. Although no clear evidence is available to determine psychosocial factors directly contributing to their distress, younger people and women may be the most vulnerable with low financial support during the pandemic because of the social disadvantage.…”

Self-injury, suicidal ideation and -attempt and eating disorders in young people following the initial and second COVID-19 lockdown

“…The longitudinal study only included four months of lockdown, had a small population (n=1,241) and participants were only aged 9-16 years which could, together with differences in the lockdowns, explain why the findings differ from ours even though the methodology is very similar. We were not able to include suicides from the cause-of-death register to explore the potential increase in suicide among especially young women as suggested by preliminary unvalidated Danish data and current international literature [15][16][17][18] . Regarding EDs, previous studies used data on new ED diagnosis or hospital admissions which increased during lockdown contrary to our findings [19][20][21] .…”

“…An international register-based study including pre-liminary suicide data from 21 countries in all age groups, showed no evidence of increased suicide rates during the first year of the pandemic 15 . However, other studies have suggested increased suicide rates during lockdown when including young people only and pre-liminary and unvalidated data based on Danish registers reviled a signal of an increased number of suicides among young women aged 20-24 years [16][17][18] .…”

Suizidales Erleben und Verhalten im Rahmen der COVID-19-Pandemie

“…So zeigte sich beispielsweise in Studien aus Japan [ 25 ], dass es nach einem Rückgang der Suizidzahlen im Rahmen der ersten Infektionswelle (Februar bis Juni 2020) zu einer deutlichen Zunahme der Suizidzahlen im Rahmen der zweiten Infektionswelle (Juli bis Oktober 2020) gekommen ist [ 26 ] – besonders prononciert war dieser Zuwachs bei (Haus-)Frauen, Kindern und Jugendlichen [ 27 ]. Differenzielle Effekte zeigten sich auch in anderen Studien, so fanden sich beispielsweise Hinweise darauf, dass Suizide in Maryland insbesondere unter Afroamerikanern [ 28 ] und in Australien bei jungen Männern (< 25 Jahre; [ 29 ]) zugenommen haben. Hinter den Gesamtzahlen verbergen sich somit potenzielle Unterschiede zwischen demografischen Gruppen und/oder geografischen Gebieten.…”