The Impact of the COVID-19 Pandemic on Suicide Rate Trends in the Tsunami-Disaster-Affected Area Following the Great East Japan Earthquake

Abstract

Abstract. Background: People who experienced the Great East Japan Earthquake (GEJE) were expected to have additional levels of psychological burden resulting from the stressful conditions imposed during the coronavirus disease 2019 (COVID-19) pandemic; consequently, suicide rates may increase. Aim: We aimed to carry out continuous monitoring of suicide rates in the affected area following the GEJE under COVID-19 pandemic conditions. Method: This descriptive study monitored the suicide rates of the coastal area of Miyagi Prefecture, where disaster-related mental health activities have been continuing following severe damage caused by the tsunami disaster. An exponential smoothing time-series analysis that converted suicide rates into a smooth trend was conducted. Results: Although the suicide rate in the affected area was higher than the national average in February 2020, it showed a declining trend during the COVID-19 pandemic, while showing an increase trend in the national and non-affected areas. Limitations: Uncertainty about the direct reasons for suicide and the short time-scale observation are the limitations of this study. Conclusion: Although the national suicide rate increased, this was not the case for the affected area. Our findings may provide important lessons for suicide prevention during the COVID-19 pandemic, which needs careful regional monitoring of the state of suicide and of high-risk approaches such as disaster-related mental health activities.

Relationship Between Severity and Length of Exposure to COVID-19 Parameters and Resulting Government Responses and the Suicide Crisis Syndrome (SCS)

“…These findings add to the extant literature in that they address how variation in the severity of exposure to pandemic-related stressors across individuals and countries can impact suicide risk. Likewise, these results may shed light on previous findings of a decrease in suicide deaths 7,8 or suicide-related emergency room visits 9 in the early stage of the pandemic. Our findings point to an effect of time, such that chronicity of exposure to pandemic stressors appears to increase the severity of SCS symptoms.…”

“…10 Suicide Risk During the Pandemic Unsurprisingly, a number of studies have shown an increase in suicide risk during the pandemic. 3,7,8 Likewise, in a large (N = 24 378) online, cross-sectional survey study of Chinese university students, mandatory quarantined status was positively associated with self-harm/suicidal ideation (OR = 4.98). 7 Further, in a systematic review by Farooq et al, common contributors to suicidal ideation across international studies included loneliness, financial strain, academic stress related to quarantine, and physical and mental exhaustion, particularly in health care workers.…”

“…Similarly, Orui et al reported an increase in national suicide rates in Japan but a decrease in areas affected by the 2011 tsunami. 8 Thus, local conditions appear to impact the response to the trauma of the pandemic. Likewise, in a Spanish study of emergency room (ER) visits pre and post lockdown, there was a decrease in both the number of visits to the ER and in patients presenting with suicidal behavior in the initial 3 months of the pandemic.…”

“…3,5 However, the research has not been consistent, with some studies showing either no change relative to pre-pandemic levels 6,7 or even a decrease. [7][8][9] Three possible reasons for these discrepant findings include (1) use of inadequately sensitive markers of suicidal risk 10 ; (2) variation in the severity of the impact of the pandemic across individuals and countries 5,6,8 ; and (3) the possible time-sensitive nature of the mental health impact. 5,7,9,11 Thus, to reach a fuller understanding of the impact of the global pandemic on suicide risk, it is critical to address all 3 factors.…”