Fear, self-isolation, stigma, physical distancing, lack of access to care, loss of employment and financial pressures may lead to an increase in the numbers of suicides, warn mental health experts.
In a comment published in the Lancet Psychiatry, members of the International COVID-19 Suicide Prevention Research Collaboration have said that the distress of these ‘unprecedented times’ will leave many people ‘vulnerable to mental health problems and suicidal behaviour’.
They warn that the ‘mental health consequences are likely to be present for longer and peak later than the actual pandemic’.
Of the many triggers that the experts warn about is irresponsible media reporting. ‘Repeated exposure to stories about the crisis can increase fear and heighten suicide risk. Media professionals should ensure that reporting follows existing and COVID-19-specific guidelines’.
As people remain confined to homes, they may also have enhanced access to ‘certain lethal means' (eg, firearms, pesticides, and analgesics) that might be more readily available or stockpiled at home, the report says.
The experts refer to evidence of increase in suicides in the US during the 1918–19 influenza pandemic and among older people in Hong Kong during the 2003 severe acute respiratory syndrome (SARS) epidemic.
While the suicide-related consequences of the pandemic might vary depending on countries’ public health control measures, sociocultural and demographic, the expert group offers a list of universal, selective and targeted interventions that can be made. These include: clear remote assessment and clear pathways for people who are suicidal, financial safety nets, labour welfare programmes, public health response to those who are facing domestic violence, public health messaging about reducing alcohol intake, and vigilance when dealing with distressed individuals.
The effects, as suggested by the experts, might be worse in resource-poor settings where economic adversity is compounded by inadequate welfare supports. Other concerns in these settings include social effects of banning religious gatherings and funerals, interpersonal violence, and vulnerable migrant workers. “COVID-19-related stigma and misinformation may be particularly acute in these settings..,” says the comment.
“Preventing suicide therefore needs urgent consideration. The response must capitalize on, but extend beyond, general mental health policies and practices,” the experts write.