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1.
EClinicalMedicine ; 51: 101573, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-1966513

ABSTRACT

Background: Predicted increases in suicide were not generally observed in the early months of the COVID-19 pandemic. However, the picture may be changing and patterns might vary across demographic groups. We aimed to provide a timely, granular picture of the pandemic's impact on suicides globally. Methods: We identified suicide data from official public-sector sources for countries/areas-within-countries, searching websites and academic literature and contacting data custodians and authors as necessary. We sent our first data request on 22nd June 2021 and stopped collecting data on 31st October 2021. We used interrupted time series (ITS) analyses to model the association between the pandemic's emergence and total suicides and suicides by sex-, age- and sex-by-age in each country/area-within-country. We compared the observed and expected numbers of suicides in the pandemic's first nine and first 10-15 months and used meta-regression to explore sources of variation. Findings: We sourced data from 33 countries (24 high-income, six upper-middle-income, three lower-middle-income; 25 with whole-country data, 12 with data for area(s)-within-the-country, four with both). There was no evidence of greater-than-expected numbers of suicides in the majority of countries/areas-within-countries in any analysis; more commonly, there was evidence of lower-than-expected numbers. Certain sex, age and sex-by-age groups stood out as potentially concerning, but these were not consistent across countries/areas-within-countries. In the meta-regression, different patterns were not explained by countries' COVID-19 mortality rate, stringency of public health response, economic support level, or presence of a national suicide prevention strategy. Nor were they explained by countries' income level, although the meta-regression only included data from high-income and upper-middle-income countries, and there were suggestions from the ITS analyses that lower-middle-income countries fared less well. Interpretation: Although there are some countries/areas-within-countries where overall suicide numbers and numbers for certain sex- and age-based groups are greater-than-expected, these countries/areas-within-countries are in the minority. Any upward movement in suicide numbers in any place or group is concerning, and we need to remain alert to and respond to changes as the pandemic and its mental health and economic consequences continue. Funding: None.

2.
Pirkis, Jane, Gunnell, David, Shin, Sangsoo, DelPozo-Banos, Marcos, Arya, Vikas, Analuisa Aguilar, Pablo, Appleby, Louis, Arafat, S. M. Yasir, Arensman, Ella, Ayuso-Mateos, Jose Luis, Balhara, Yatan Pal Singh, Bantjes, Jason, Baran, Anna, Behera, Chittaranjan, Bertolote, Jose, Borges, Guilherme, Bray, Michael, Brečić, Petrana, Caine, Eric D.; Calati, Raffaella, Carli, Vladimir, Castelpietra, Giulio, Chan, Lai Fong, Chang, Shu-Sen, Colchester, David, Coss-Guzmán, Maria, Crompton, David, Curkovic, Marko, Dandona, Rakhi, De Jaegere, Eva, De Leo, Diego, Deisenhammer, Eberhard, Dwyer, Jeremy, Erlangsen, Annette, Faust, Jeremy, Fornaro, Michele, Fortune, Sarah, Garrett, Andrew, Gentile, Guendalina, Gerstner, Rebekka, Gilissen, Renske, Gould, Madelyn, Gupta, Sudhir Kumar, Hawton, Keith, Holz, Franziska, Kamenshchikov, Iurii, Kapur, Navneet, Kasal, Alexandr, Khan, Murad, Kirtley, Olivia, Knipe, Duleeka, Kolves, Kairi, Kölzer, Sarah, Krivda, Hryhorii, Leske, Stuart, Madeddu, Fabio, Marshall, Andrew, Memon, Anjum, Mittendorfer-Rutz, Ellenor, Nestadt, Paul, Neznanov, Nikolay, Niederkrotenthaler, Thomas, Nielsen, Emma, Nordentoft, Merete, Oberlerchner, Herwig, O'Connor, Rory, Papsdorf, Rainer, Partonen, Timo, Michael, Phillips, Platt, Steve, Portzky, Gwendolyn, Psota, Georg, Qin, Ping, Radeloff, Daniel, Reif, Andreas, Reif-Leonhard, Christine, Rezaeian, Mohsen, Román-Vázquez, Nayda, Roskar, Saska, Rozanov, Vsevolod, Sara, Grant, Scavacini, Karen, Schneider, Barbara, Semenova, Natalia, Sinyor, Mark, Tambuzzi, Stefano, Townsend, Ellen, Ueda, Michiko, Wasserman, Danuta, Webb, Roger T.; Winkler, Petr, Yip, Paul S. F.; Zalsman, Gil, Zoja, Riccardo, John, Ann, Spittal, Matthew J..
SSRN; 2022.
Preprint in English | SSRN | ID: ppcovidwho-331684

ABSTRACT

Background When the COVID-19 pandemic began there were concerns that suicides might rise, but predicted increases were not generally observed in the pandemic’s early months. However, the picture may be changing and patterns may vary across demographic groups. We aimed to provide an up-to-date, granular picture of the impact of COVID-19 on suicides globally.Methods We identified suicide data from official public-sector sources for countries/areas-within-countries. We used interrupted time series (ITS) analyses to model the association between the pandemic’s emergence and total suicides and suicides by sex-, age- and sex-by-age in each country/area-within-country. We compared the observed number of suicides to the expected number in the pandemic’s first nine and first 10-15 months and used meta-regression to explore sources of variation.Findings We sourced data from 33 countries (24 high-income, six upper-middle-income, three lower-middle-income). There was no evidence of greater-than-expected numbers of suicides in the majority of countries/areas-within-countries in any analysis;more commonly, there was evidence of lower-than-expected numbers. Certain sex, age and sex-by-age groups stood out as potentially concerning, but these were not consistent across countries/areas-within-countries. In the meta-regression, different patterns were not explained by countries’ COVID-19 mortality rate, stringency of public health response, level of economic support, or presence of a national suicide prevention strategy. They were also not explained by countries’ income level, although the meta-regression only included data from high-income and upper-middle-income countries, and there were suggestions from the ITS analyses that lower-middle-income countries fared less well.Interpretation Although there are some countries/areas-within-countries where overall suicide numbers and numbers for certain sex- and age-based groups are greater-than-expected, these are in the minority. Any upward movement in suicide numbers in any place or group is concerning, and we need to remain alert to and respond to changes as the pandemic and its mental health and economic consequences continue.

3.
Front Psychiatry ; 12: 791209, 2021.
Article in English | MEDLINE | ID: covidwho-1686551

ABSTRACT

BACKGROUND: Early evidence suggests that the COVID-19 pandemic and associated interventions have affected mental well-being and associated health service use. AIMS: the aim of this study was to examine the effect of the COVID-19 pandemic and associated public health measures on helpline and telehealth service demand. METHODS: the study utilized a mixed methods research design. Segmented regression analyses were used first to identify changes in patterns of demand for Aotearoa/New Zealand national helplines (n = 11) from January 2020 until the end of March 2021. Thematic analysis of 23 in-depth interviews was used next to explore the reasons behind the quantitative findings from the perspective of various organizational stakeholders. RESULTS: the data from 1,244,293 Aotearoa/New Zealand national helplines' contacts between January 2020 and March 2021 showed a non-significant (1.4%) upward trend for the full range of observations. Throughout this period, a peak and trough pattern was observed. Significant demand increases were observed in anticipation of containment measures (12.4% increase from January to March 2020) and significant demand decreases coincided with relaxation of restrictions (6.9% decrease from April to June 2020). There were spikes in demand during public health interventions (i.e., mental health promotion, introduction of new helpline services) and regional lockdowns, but these did not result in significant changes in trends. In general, the demand for helplines stabilized at a new higher level. Most of the contacts occurred by telephone calls. Contacts by other methods (webchat, text, email) have shown higher uptake during the periods of lockdowns. Quantitative-qualitative data triangulation showed that youth and populations who were disproportionally negatively affected by unstable economic conditions and underemployment made more frequent contacts. Providers emphasized that increased demand could be viewed positively as a successful outcome of public health messaging; however, greater capacity is needed to better serve higher demand. CONCLUSIONS: COVID-19, related interventions, and measures of control were associated with an increase in contacts to helplines. However, the extent of the demand increases was lower than observed internationally. Moreover, in Aotearoa/New Zealand the reasons for increases in demand were often beyond the COVID-19 pandemic and measures of control.

4.
Lancet Psychiatry ; 8(7): 579-588, 2021 07.
Article in English | MEDLINE | ID: covidwho-1683800

ABSTRACT

BACKGROUND: The COVID-19 pandemic is having profound mental health consequences for many people. Concerns have been expressed that, at their most extreme, these consequences could manifest as increased suicide rates. We aimed to assess the early effect of the COVID-19 pandemic on suicide rates around the world. METHODS: We sourced real-time suicide data from countries or areas within countries through a systematic internet search and recourse to our networks and the published literature. Between Sept 1 and Nov 1, 2020, we searched 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 sources. Data were included from a given country or area if they came from an official government source and were available at a monthly level from at least Jan 1, 2019, to July 31, 2020. Our internet searches were restricted to countries with more than 3 million residents for pragmatic reasons, but we relaxed this rule for countries identified through the literature and our networks. Areas within countries could also be included with populations of less than 3 million. We used an interrupted time-series analysis to model the trend in monthly suicides before COVID-19 (from at least Jan 1, 2019, to March 31, 2020) in each country or area within a country, comparing the expected number of suicides derived from the model with the observed number of suicides in the early months of the pandemic (from April 1 to July 31, 2020, in the primary analysis). FINDINGS: We sourced data from 21 countries (16 high-income and five upper-middle-income countries), including whole-country data in ten countries and data for various areas in 11 countries). Rate ratios (RRs) and 95% CIs based on the observed versus expected numbers of suicides showed no evidence of a significant increase in risk of suicide since the pandemic began in any country or area. There was statistical evidence of a decrease in suicide compared with the expected number in 12 countries or areas: 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, USA (0·90 [0·85-0·95]); Illinois (Cook County), USA (0·79 [0·67-0·93]); Texas (four counties), USA (0·82 [0·68-0·98]); and Ecuador (0·74 [0·67-0·82]). INTERPRETATION: This is the first study to examine suicides occurring in the context of the COVID-19 pandemic in multiple countries. In high-income and upper-middle-income countries, suicide numbers have remained largely unchanged or declined in the early months of the pandemic compared with the expected levels based on the pre-pandemic period. We need to remain vigilant and be poised to respond if the situation changes as the longer-term mental health and economic effects of the pandemic unfold. FUNDING: None.


Subject(s)
COVID-19/complications , Global Health , Models, Statistical , Suicide/statistics & numerical data , Developed Countries/statistics & numerical data , Humans
5.
Lancet Psychiatry ; 8(7): 579-588, 2021 07.
Article in English | MEDLINE | ID: covidwho-1284642

ABSTRACT

BACKGROUND: The COVID-19 pandemic is having profound mental health consequences for many people. Concerns have been expressed that, at their most extreme, these consequences could manifest as increased suicide rates. We aimed to assess the early effect of the COVID-19 pandemic on suicide rates around the world. METHODS: We sourced real-time suicide data from countries or areas within countries through a systematic internet search and recourse to our networks and the published literature. Between Sept 1 and Nov 1, 2020, we searched 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 sources. Data were included from a given country or area if they came from an official government source and were available at a monthly level from at least Jan 1, 2019, to July 31, 2020. Our internet searches were restricted to countries with more than 3 million residents for pragmatic reasons, but we relaxed this rule for countries identified through the literature and our networks. Areas within countries could also be included with populations of less than 3 million. We used an interrupted time-series analysis to model the trend in monthly suicides before COVID-19 (from at least Jan 1, 2019, to March 31, 2020) in each country or area within a country, comparing the expected number of suicides derived from the model with the observed number of suicides in the early months of the pandemic (from April 1 to July 31, 2020, in the primary analysis). FINDINGS: We sourced data from 21 countries (16 high-income and five upper-middle-income countries), including whole-country data in ten countries and data for various areas in 11 countries). Rate ratios (RRs) and 95% CIs based on the observed versus expected numbers of suicides showed no evidence of a significant increase in risk of suicide since the pandemic began in any country or area. There was statistical evidence of a decrease in suicide compared with the expected number in 12 countries or areas: 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, USA (0·90 [0·85-0·95]); Illinois (Cook County), USA (0·79 [0·67-0·93]); Texas (four counties), USA (0·82 [0·68-0·98]); and Ecuador (0·74 [0·67-0·82]). INTERPRETATION: This is the first study to examine suicides occurring in the context of the COVID-19 pandemic in multiple countries. In high-income and upper-middle-income countries, suicide numbers have remained largely unchanged or declined in the early months of the pandemic compared with the expected levels based on the pre-pandemic period. We need to remain vigilant and be poised to respond if the situation changes as the longer-term mental health and economic effects of the pandemic unfold. FUNDING: None.


Subject(s)
COVID-19/complications , Global Health , Models, Statistical , Suicide/statistics & numerical data , Developed Countries/statistics & numerical data , Humans
6.
Child Adolesc Ment Health ; 26(1): 83-85, 2021 02.
Article in English | MEDLINE | ID: covidwho-1081607

ABSTRACT

There is increasing concern about the prevalence of depression and self-harm among children adolescents in many countries. Governments who commission and fund psychological interventions to address these difficulties want to know what is effective. The techniques available for synthesising gold standard evidence are increasingly sophisticated, but there are many criticisms of being completely reliant on this approach. A precautionary approach, where public policy decision-makers acknowledge that where the evidence is limited, the benefits of certain interventions are thought to outweigh the risks, including the risk of doing nothing. This later element may be particularly important in the domain of depression and self-harm, as both are associated with elevated risk of death by suicide.


Subject(s)
Self-Injurious Behavior , Suicide , Adolescent , Child , Depression/epidemiology , Humans , Public Policy , Self-Injurious Behavior/epidemiology , Self-Injurious Behavior/prevention & control , Suicide/prevention & control
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