Suicide trends in the early months of the COVID-19 pandemic: an interrupted time-series analysis of preliminary data from 21 countries

Abstract

Background The COVID-19 pandemic is having profound mental health consequences for many people. Concerns have been expressed that, at their most extreme, these consequences could manifest as increased suicide rates. We aimed to assess the early effect of the COVID-19 pandemic on suicide rates around the world. MethodsWe sourced real-time suicide data from countries or areas within countries through a systematic internet search and recourse to our networks and the published literature. Between Sept 1 and Nov 1, 2020, we searched the official websites of these countries' ministries of health, police agencies, and government-run statistics agencies or equivalents, using the translated search terms "suicide" and "cause of death", before broadening the search in an attempt to identify data through other public sources. Data were included from a given country or area if they came from an official government source and were available at a monthly level from at least Jan 1, 2019, to July 31, 2020. Our internet searches were restricted to countries with more than 3 million residents for pragmatic reasons, but we relaxed this rule for countries identified through the literature and our networks. Areas within countries could also be included with populations of less than 3 million. We used an interrupted time-series analysis to model the trend in monthly suicides before COVID-19 (from at least Jan 1, 2019, to March 31, 2020) in each country or area within a country, comparing the expected number of suicides derived from the model with the observed number of suicides in the early months of the pandemic (from April 1 to July 31, 2020, in the primary analysis).Findings We sourced data from 21 countries (16 high-income and five upper-middle-income countries), including whole-country data in ten countries and data for various areas in 11 countries). Rate ratios (RRs) and 95% CIs based on the observed versus expected numbers of suicides showed no evidence of a significant increase in risk of suicide since the pandemic began in any country or area. There was statistical evidence of a decrease in suicide compared with the expected number in 12 countries or areas: New South Wales

Suicidal Behavior Prevention: The Time to Act is Now

“…What can we infer from these results? Firstly, that the self-reported increase in levels of anxiety, depression, and suicidal thoughts does not seem to have directly translated to a corresponding increase in completed suicides, at least in the countries examined in that study (Pirkis et al, 2021). The findings allow us to reflect on the contextual nature of suicidal behavior, which does not emerge automatically as a "symptom" of increased mental health problems (such as anxiety or depression), but instead presents as a complex, multifaceted, multicausal, dynamic phenomenon in which realities of different types and orders participate simultaneously .…”

“…The study by Pirkis et al (2021), the first to publish collaborative data from twenty-one countries about rates of suicide during the first few months of the pandemic, gave a clear result: there has been no record of an increase in the numbers of completed suicides during the beginning of lockdown. The numbers of deaths by suicide is not significantly higher than expected in any of the countries or areas examined by the study (including Spain).…”

“…Secondly, various protective factors seem to have been operating, such as a collective feeling of community, support for vulnerable people through information technologies, and spending long periods of time accompanied at home-reducing perceived stress and feelings of isolation or loneliness (Pirkis et al, 2021). In addition, sharing concerns, mutual support in times of despair, proper information about available services to help, making the population aware of and sensitive to the need for social support, breaking down the stigma associated with suicidal behavior, and sharing responsibility for caring for vulnerable people all seem to be valuable strategies for containing and even reducing rates of completed suicide (Pirkis et al, 2021). Indeed, those who belong to a community in which they feel loved and valued are much less likely to die from suicide (Knapp, 2020).…”

Covid-19: Suicide rates were static in rich countries in first months of pandemic, study finds

“…Numbers of suicides in high and upper middle income countries remained largely unchanged or were lower than expected levels in the early months of the covid-19 pandemic, shows a study in the Lancet Psychiatry 1…”

Distress and Anxiety during the COVID-19 Pandemic as Revealed through Helpline Calls

“…We consider the analysis of helpline calls as a complement, not a substitute, to established approaches, such as survey evidence [17] or suicide statistics [18,19]. Mental health surveys and suicide statistics can be highly informative measurement tools, but they tend to be low-frequency and available with a lag.…”