Suicide risk hits “crisis level” during 5th wave of COVID-19 in HK

The University of Hong Kong (HKU)’s Suicide Prevention Early Warning System issued a “crisis level” alert in March 2022, with those over 65 years of age at the highest risk.

The system works by collecting data from suicide news reports on a daily basis and analyzing demographic characteristics such as age, gender, districts and suicide methods. By comparing the situation with the same period last year, the daily number of suicide cases and suicide risk can be estimated. [https://suicideearlywarning.hku.hk/eng/recentrisks; Stat Med 2019;38:5103-5112]

“The past 7 days’ suicide index reached 3.69 on 20 March 2022, crossing the ‘crisis level’ threshold of 3.65. It escalated to 4.05 the next day,” warned Professor Paul Yip, Director of the Centre for Suicide Research and Prevention at HKU. “It is the first time the warning system has been triggered since its launch in 2020.”

The rise could be attributed to fear of coronavirus disease 2019 (COVID-19), isolation under social distancing restrictions, as well as depleted family and community support. The Suicide Prevention Services hotline had received 50 percent more calls this year vs the previous 12 months, over 80 percent of which were related to the pandemic.

The pandemic has hit the elderly especially hard as they are usually unable to obtain real-time information due to unfamiliarity with technology. “Previously, I could go to community centres directly and seek help about daily life or computers. Now, I can’t. Therefore, I have a lot of questions piled up,” said an elderly individual in an interview for a qualitative study. [J Geriatr Psychiatry Neurol 2022;35:206-214] “Some elderly individuals were forced to isolate themselves from their families under the antiepidemic measures, while others worried about infecting their family members after contracting the virus,” added Vincent Ng, Executive Director of the Suicide Prevention Services.

Additionally, a cross-sectional study (n=1,972; female, 56.1 percent) conducted by HKU during the acute phase of the COVID-19 pandemic (February 2020 to March 2020) showed that loneliness and rumination were positively associated with depressive symptoms in older adults aged 65 years or above, indicating that elderly people who live alone are more prone to developing depression during the pandemic. [Innov Aging 2021;5:igab034]

“Social distancing measures have introduced not only physical distancing but also emotional disconnectedness. It is this emotional disconnectedness that leads to the sense of isolation and a sense of being abandoned by family members or by the community,” explained Yip. “[Social distancing] has an adverse impact on our mental health, and the feeling of isolation will easily lead to suicide thoughts.”