Suicide rates remain stable during first months of COVID-19 pandemic

Suicide numbers in high-income and upper-middle-income countries remined largely unchanged or declined in the early months of the coronavirus disease 2019 (COVID-19) pandemic compared with expected levels based on the pre-pandemic period, according to results of an interrupted time-series analysis.

“Our study is the first to examine suicides occurring in the context of the COVID-19 pandemic in multiple countries. Results of the primary analysis showed a broadly consistent picture, albeit from high-income and upper-middle countries, of suicide numbers remaining unchanged or declining in early months of the COVID-19 pandemic,” said the authors who are members of the International COVID-19 Suicide Prevention Research Collaboration (ICSPRC). [Lancet Psychiatry 2021;doi:https://doi.org/10.1016/S2215-0366(21)00091-2]

“The picture is neither complete nor final, but serves as the best available evidence on the pandemic’s effect on suicide so far. We need to continue to monitor real-time data and be alert to any increase in suicide rate,” they continued.

“Policy makers should heed the value of high-quality, timely suicide data in suicide prevention efforts, and should remain vigilant and be poised to respond [eg, by resourcing mental health services and providing financial safety nets] if the situation changes as the long-term mental health and economic effects of the pandemic unfold,” they suggested.

Overall, there was no evidence of a significant increase in the observed number of suicides in the early months of the COVID-19 pandemic (from 1 April 2020 to 31 July 2020, in the primary analysis) in any country or area compared with the expected number of suicides derived from modelling the trends in monthly suicides using available data in each country or area within a country before the pandemic (from at least 1 January 2019 to 31 March 2020).

A significant decrease in suicide rates during the early months of the COVID-19 pandemic was observed in 12 countries or areas, namely, New South Wales, Australia (rate ratio [RR], 0.81; 95 percent CI 0.72 to 0.91]); Alberta, Canada (RR, 0.80; 95 percent Cl, 0.68 to 0.93); British Columbia, Canada (RR, 0.76; 95 percent 0.66 to 0.87); Chile (RR, 0.85; 95 percent Cl, 0.78 to 0.94); Leipzig, Germany (RR, 0.49; 95 percent 0.32 to 0.74); Japan (RR, 0.94; 95 percent Cl, 0.91 to 0.96); New Zealand (RR, 0.79; 95 percent Cl, 0.68 to 0.91); South Korea (RR, 0.94; 95 percent Cl, 0.92 to 0.97); California, US (RR, 0.90; 95 percent Cl, 0.85 to 0.95); Illinois (Cook County), US (RR, 0.79; 95 percent Cl, 0.67 to 0.93); Texas (four counties), US (RR, 0.82; 95 percent Cl, 0.68 to 0.98); and Ecuador (RR, 0.74; 95 percent Cl, 0.67 to 0.82) compared with the expected numbers before COVID-19.

In the study, real-time suicide data from 21 countries (16 high-income and five upper-middle-income countries, including national data from 10 countries and data from 25 regions across another 11 countries) were sourced from 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 resources.

Data were included if they came from an official government source and were available monthly from at least 1 January 2019 to 31 July 2020. Searches were restricted to countries with >3 million residents for pragmatic reasons, and areas with populations of <3 million within countries were included.