ABSTRACT
Introduction Each year, nearly 9,000 people die from suicide in France, and more than 150,000 attempt suicide. In spite of a decrease for the last 30 years, rates of suicide in France remain higher than the European mean. Since 2018, a national suicide prevention strategy of the Ministry of Health has been in place. In 2020, this new strategy has been exposed to the COVID-19 pandemic. Methods First, the different actions of the national suicide prevention strategy will be presented, followed by the results of the available data regarding the impact of COVID-19 on suicidal gestures. These data are 1) hospitalizations for self-harm (ICD-10 codes X60 to X-84) from the national health database;2) calls to poison control centers and 3) visits to the emergency room for a suicide attempt. The latest figures available will be presented. Results The analysis of these data compared to 2019 highlights two main periods. Between March and December 2020, a significant decrease in suicide attempts was observed (8.5%), with a rapid drop during the first week of the first confinement in mid-March 2020, in women and men, and in all age groups except old-aged people. Since January 2021, a significant increase in suicide attempts has been observed among teenage girls, including high-lethality acts. Moreover, among the young and the elderly, the figures are now similar to 2019. Only numbers for middle-aged adults continue to decline. Conclusions The impact of the COVID-19 pandemic on suicide attempts appears to be variable over time, according to age and gender. The old-aged people and young people, especially adolescent girls seem to have suffered the most from this situation. It is still too early to know whether the new national suicide strategy has had any positive impact. However, the pandemic has highlighted certain weaknesses in the French system, in particular the lack of recent data on mortality by suicide, and the heavy dependence on a fragile mental health medical system.
ABSTRACT
BACKGROUND: The first wave of the COVID-19 pandemic in France was associated with a reduced number of hospitalizations for self-harm, with the exception of older people. The on-going pandemic may have both sustained and delayed effects. METHODS: Data were extracted from the French national hospital database (PMSI), a nationwide exhaustive database. The number of self-harm hospitalizations (ICD-10 codes X60-84) between September 1, 2020 and August 31, 2021 (N = 85,679) was compared to 2019 (N = 88,782) using Poisson regression models. RESULTS: There was a decrease in the total number of self-harm hospitalizations during the studied period versus 2019 (-3.5%; Relative Risk [RR] [95% Confidence Intervals] = 0.97 [0.96-0.97]; p < 0.0001). However, sex and age effects were identified. While adults aged 30-59-years-old showed a decrease (monthly decreases: -12.6 to -15.0%), we found an increase in adolescent girls (+27.7%, RR = 1.28 [1.25-1.31]; p < 0.0001), notably since January 2021. Moreover, the numbers were similar to 2019 in adolescent boys, in youths aged 20-29 years, and in people aged 70 and more. Hospitalizations in intensive care units decreased (-6.7%, RR = 0.93 [0.91-0.96]; p < 0.0001) and deaths at hospital following self-harm remained stable (+0.6%, Hazard Ratio = 0.99 [0.91-1.08], p = 0.79). CONCLUSIONS: During this second stage, the number of self-harm hospitalizations remained at a lower level than in the prepandemic period. However, significant variations over time, age, and sex were observed. Young people (notably adolescent girls) appear to have particularly suffered from the persistence of the pandemic, while older people did not show any decrease since the beginning. Vigilance and continuing prevention are warranted.