Amidst the growing COVID-19 pandemic, the United States faces a crisis that has been building over the past twenty years: rising suicide rates. According to a recent data brief released by the Centers for Disease Control and Prevention, suicide rates rose by 35% from 1999 to 2018.
A viewpoint published in JAMA Psychiatry warns that the secondary consequences of social distancing measures may include further increases in suicide. Mark Reger, PhD, and Ian Stanley, MS, both from the Veterans Affairs Puget Sound Health Care System, Seattle, Washington, as well as Thomas Joiner, PhD, department of psychology, Florida State University, Tallahassee, pointed to the economic, psychosocial, and health-related risk factors that may affect these intertwined crises.
The authors identified economic stress as a major concern given that “economic downturns are usually associated with higher suicide rates.” Social isolation, resulting in elevated levels of loneliness, and lower access to support from affinity groups, are other factors that could worsen the suicide crisis.
The authors also fear that public health interventions and restrictions may act as barriers to mental health treatment accessibility, especially in overwhelmed emergency departments, which are significant sites for mental health care.
For individuals with preexisting medical conditions, particularly depressive or anxiety disorders, around-the-clock news coverage and an atmosphere of “national anxiety” can function as a further stressor. The authors also warned that suicide rates may increase as a result of a surge in the sale of firearms, which are the most common method of suicide in the United States, during the outbreak, and seasonal trends, with rates usually peaking in late spring and early summer.
Overworking and burnout among healthcare providers is already a significant societal issue, and the COVID-19 pandemic will certainly raise stress levels for frontline
healthcare workers. In particular, the authors point to providers’ concerns about “shortages of necessary personal protective equipment, overwhelmed facilities, and work stress.”
To stem the potential rise in the suicide rate, the authors provided a comprehensive list of suicide prevention opportunities, including providing telemedicine services for mental health, maintaining physical distancing yet remaining socially connected, and using telephone-based and written outreach to individuals at risk for suicide. However, they also noted that suicide rates could decline through the “pulling-together effect, whereby individuals undergoing a shared experience might support one another, thus strengthening social connectedness.” Furthermore, the pandemic may reshape perspectives on mortality and health overall in a positive way.
The authors concluded by stating that current interventions must take into account “multiple US public health priorities, including suicide prevention.”
Reger MA, Stanley IH, Joiner TE. Suicide mortality and coronavirus disease 2019 – a perfect storm? JAMA Psychiatry. 2020. doi:10.1001/jamapsychiatry.2020.1060