Assessing Suicide Trends During the Early Months of the COVID-19 Pandemic

Sitting Alone
An Elderly Caucasian Man’s Hands in His Blanketed Lap Sits Alone in a Living Room
With the COVID-19 pandemic having serious mental health effects for many people, the researchers sought to assess the early effect of the pandemic on suicide rates across the globe.

Study data published in Lancet Psychiatry outline suicide trends during the early months of the COVID-19 pandemic. In an analysis of data from 21 high-income and upper-middle-income countries, suicide figures were unchanged or lower compared with the pre-pandemic period. However, the longer-term impacts of the pandemic remain unexplored, and suicide trends should be continually monitored within the context of COVID-19.

Investigators obtained real-time suicide data using online government sources from various countries and regions within countries. Translated search terms “suicide” and “cause of death” were used to identify appropriate sources. Data were included if they were available at a monthly level from at least January 2019 through July 2020. An interrupted time-series analysis was used to model trends in monthly suicides before COVID-19 (Jan 2019 through March 31). The expected number of suicides derived from this model was compared with the actual number of suicides observed during the early months of the pandemic (April 1 through July 31, 2020). The expected and observed number of suicides were compared using rate ratios (RRs).

Data were sourced from 21 countries, among which 10 had national data and 11 had data for a specific region. A total of 16 of these countries were classified as high-income countries; 5 were upper-middle-income countries. There was no statistical evidence of increased suicide risk in any assessed region. In fact, a decreased risk of suicide was observed in 12 countries or subnational regions: New South Wales, Australia (RR, 0.81 [95% CI, 0.72-0.91]); Alberta, Canada (0.80 [0.68–0.93]); British Columbia, Canada (0.76 [0.66–0.87]); Chile (0.85 [0.78–0.94]); Leipzig, Germany (0.49 [0.32–0.74]); Japan (0.94 [0.91–0.96]); New Zealand (0.79 [0.68–0.91]); South Korea (0.94 [0.92–0.97]); California, US (0.90 [0.85–0.95]); Illinois (Cook County), US (0.79 [0.67–0.93]); Texas, US (0.82 [0.68–0.98]); and Ecuador (0.74 [0.67–0.82]). These trends were largely sustained in sensitivity analyses which changed the pandemic data period.

Based on this preliminary analysis, international risk for suicide did not appear to substantially increase during the early months of the pandemic. Investigators hypothesized that certain protective factors may have arisen during the early months of COVID-19, such as more active community assistance and strengthened household bonds. However, this study did not assess the effect of long-term pandemic exposure, which is likely more severe. Additionally, this analysis did not capture the experiences of lower-income countries.

“Policy makers should heed the value of high-quality, timely suicide data in suicide prevention efforts, and should prioritise mitigation of suicide risk factors associated with COVID-19 and take decisive action (eg, by resourcing mental health services and providing financial safety nets) to prevent the possible longer-term detrimental effects of the pandemic on suicide,” the study investigators wrote.


Pirkis JP, John A, Shin S, et al. Suicide trends in the early months of the COVID-19 pandemic: An interrupted time-series analysis of preliminary data from 21 countries. Lancet Psychiatry. Published online April 13, 2021. doi: 10.1016/S2215-0366(21)00091-2