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1.
BMC Public Health ; 22(1): 530, 2022 03 18.
Article in English | MEDLINE | ID: covidwho-1817203

ABSTRACT

BACKGROUND: Preventatives measures to combat the spread of COVID- 19 have introduced social isolation, loneliness and financial stress. This study aims to identify whether the COVID-19 pandemic is related to changes in suicide-related problems for help seekers on a suicide prevention helpline. METHODS: A retrospective cohort study was conducted using chat data from a suicide prevention helpline in the Netherlands. The natural language processing method BERTopic was used to detect common topics in messages from December 1, 2019 until June 1, 2020 (N = 8589). Relative topic occurrence was compared before and during the lock down starting on March 23, 2020. The observed changes in topic usage were likewise analyzed for male and female, younger and older help seekers and help seekers living alone. RESULTS: The topic of the COVID-19 pandemic saw an 808% increase in relative occurrence after the lockdown. Furthermore, the results show that help seeker increased mention of thanking the counsellor (+ 15%), and male and young help seekers were grateful for the conversation (+ 45% and + 32% respectively). Coping methods such as watching TV (- 21%) or listening to music (- 15%) saw a decreased mention. Plans for suicide (- 9%) and plans for suicide at a specific location (- 15%) also saw a decreased mention. However, plans for suicide were mentioned more frequently by help seekers over 30 years old (+ 11%) or who live alone and (+ 52%). Furthermore, male help seekers talked about contact with emergency care (+ 43%) and panic and anxiety (+ 24%) more often. Negative emotions (+ 22%) and lack of self-confidence (+ 15%) were mentioned more often by help seekers under 30, and help seekers over 30 saw an increased mention of substance abuse (+ 9%). CONCLUSION: While mentions of distraction, social interaction and plans for suicide decreased, expressions of gratefulness for the helpline increased, highlighting the importance of contact to help seekers during the lockdown. Help seekers under 30, male or who live alone, showed changes that negatively related to suicidality and should be monitored closely.


Subject(s)
COVID-19 , Suicide , Adult , Communicable Disease Control , Female , Humans , Male , Pandemics/prevention & control , Retrospective Studies , Suicide/prevention & control , Suicide/psychology
2.
Int J Environ Res Public Health ; 19(7)2022 03 29.
Article in English | MEDLINE | ID: covidwho-1785637

ABSTRACT

Individuals bereaved by suicide represent an important group in terms of postvention. While peer support groups are often accessed by those bereaved, few studies have examined their impact in terms of physical and mental health wellbeing. The aim of this study was to examine psychosocial outcomes of individuals attending suicide bereavement peer support groups in Ireland. Between August 2020 and June 2021, all members were invited to complete a survey, with new members also surveyed at three- and six-month follow-up, to examine changes in wellbeing, depressive symptoms and grief reactions. Results were analyzed using descriptive statistics and mixed linear regression models. The 75 participants were mostly female, with lower levels of overall wellbeing and a higher prevalence of depressive symptoms and suicidal ideation than the general population. Participants also reported high levels of social adjustment difficulties and grief reactions, which were more pronounced for those more recently bereaved. At follow-up (n = 28), a significant improvement in wellbeing and a reduction in grief reactions were found, adjusting for time since bereavement. Participants identified the groups as creating a safe space and providing a sense of belonging and hope. Notwithstanding the small number of participants at follow-up, these findings underline the enduring mental health challenges for those bereaved by suicide and provide further evidence for the role of peer support in postvention.


Subject(s)
Bereavement , Suicide , Female , Follow-Up Studies , Grief , Humans , Male , Self-Help Groups , Suicide/psychology
3.
JAMA Netw Open ; 5(4): e226250, 2022 Apr 01.
Article in English | MEDLINE | ID: covidwho-1777507

ABSTRACT

Importance: Suicide rates are rising disproportionately in rural counties, a concerning pattern as the COVID-19 pandemic has intensified suicide risk factors in these regions and exacerbated barriers to mental health care access. Although telehealth has the potential to improve access to mental health care, telehealth's effectiveness for suicide-related outcomes remains relatively unknown. Objective: To evaluate the association between the escalated distribution of the US Department of Veterans Affairs' (VA's) video-enabled tablets during the COVID-19 pandemic and rural veterans' mental health service use and suicide-related outcomes. Design, Setting, and Participants: This retrospective cohort study included rural veterans who had at least 1 VA mental health care visit in calendar year 2019 and a subcohort of patients identified by the VA as high-risk for suicide. Event studies and difference-in-differences estimation were used to compare monthly mental health service utilization for patients who received VA tablets during COVID-19 with patients who were not issued tablets over 10 months before and after tablet shipment. Statistical analysis was performed from November 2021 to February 2022. Exposure: Receipt of a video-enabled tablet. Main Outcomes and Measures: Mental health service utilization outcomes included psychotherapy visits, medication management visits, and comprehensive suicide risk evaluations (CSREs) via video and total visits across all modalities (phone, video, and in-person). We also analyzed likelihood of emergency department (ED) visit, likelihood of suicide-related ED visit, and number of VA's suicide behavior and overdose reports (SBORs). Results: The study cohort included 13 180 rural tablet recipients (11 617 [88%] men; 2161 [16%] Black; 301 [2%] Hispanic; 10 644 [80%] White; mean [SD] age, 61.2 [13.4] years) and 458 611 nonrecipients (406 545 [89%] men; 59 875 [13%] Black or African American; 16 778 [4%] Hispanic; 384 630 [83%] White; mean [SD] age, 58.0 [15.8] years). Tablets were associated with increases of 1.8 psychotherapy visits per year (monthly coefficient, 0.15; 95% CI, 0.13-0.17), 3.5 video psychotherapy visits per year (monthly coefficient, 0.29; 95% CI, 0.27-0.31), 0.7 video medication management visits per year (monthly coefficient, 0.06; 95% CI, 0.055-0.062), and 0.02 video CSREs per year (monthly coefficient, 0.002; 95% CI, 0.002-0.002). Tablets were associated with an overall 20% reduction in the likelihood of an ED visit (proportion change, -0.012; 95% CI, -0.014 to -0.010), a 36% reduction in the likelihood of suicide-related ED visit (proportion change, -0.0017; 95% CI, -0.0023 to -0.0013), and a 22% reduction in the likelihood of suicide behavior as indicated by SBORs (monthly coefficient, -0.0011; 95% CI, -0.0016 to -0.0005). These associations persisted for the subcohort of rural veterans the VA identifies as high-risk for suicide. Conclusions and Relevance: This cohort study of rural US veterans with a history of mental health care use found that receipt of a video-enabled tablet was associated with increased use of mental health care via video, increased psychotherapy visits (across all modalities), and reduced suicide behavior and ED visits. These findings suggest that the VA and other health systems should consider leveraging video-enabled tablets for improving access to mental health care via telehealth and for preventing suicides among rural residents.


Subject(s)
COVID-19 , Drug Overdose , Mental Health Services , Suicide , Veterans , COVID-19/epidemiology , Cohort Studies , Emergency Service, Hospital , Humans , Male , Middle Aged , Pandemics , Retrospective Studies , Suicide/prevention & control , Suicide/psychology , Tablets , Veterans/psychology
4.
Crisis ; 42(4): 241-246, 2021 07.
Article in English | MEDLINE | ID: covidwho-1751676
5.
PLoS One ; 17(3): e0264984, 2022.
Article in English | MEDLINE | ID: covidwho-1736517

ABSTRACT

More than 700,000 people lose their lives to suicide each year and evidence suggests that the current COVID-19 pandemic is leading to increases in risk factors for suicide and suicide-related behaviour, in particular among young people. It is widely documented that some sectors of the population are over-represented in the suicide statistics. It is also well established that the pathways that lead someone to a suicidal crisis are complex and differ across regions and sectors of the population; as such a multi-faceted approach to prevention is required. Many of us would also argue that novel approaches, that combine broad population-based strategies with individual interventions, and approaches that capitalise on new technologies and methodologies are also required. For these reasons, when bringing together this collection, we deliberately sought studies that focused upon those groups who are over-represented in the suicide statistics yet under-represented in research. We also called for studies that reported on novel approaches to suicide prevention and for studies that reflected the voices of people with lived experience of suicide, also often unheard in research efforts.


Subject(s)
Suicide/prevention & control , Suicide/psychology , Suicide/trends , Humans , Risk Factors , Suicidal Ideation
6.
J Geriatr Psychiatry Neurol ; 35(2): 237-244, 2022 03.
Article in English | MEDLINE | ID: covidwho-1731432

ABSTRACT

AIMS: The pattern of suicidality in older patients with psychiatric disorders during the COVID-19 pandemic is not clear. This study examined the prevalence of suicidality and its association with quality of life (QOL) among older clinically stable patients with psychiatric disorders during the COVID-19 pandemic. METHODS: A multicenter, cross-sectional study was conducted from May 22 to July 15, 2020, among four major tertiary psychiatric hospitals in China. Suicidality was assessed by asking 3 standardized questions. Depressive symptoms, pain, and QOL were assessed with the 9-item Patient Health Questionnaire (PHQ-9), the numeric pain rating scale (NPRS), and the World Health Organization Quality of Life Questionnaire-brief version, respectively. RESULTS: A total of 1063 clinically stable patients participated and completed the assessment. The prevalence of suicidality was 11.8% (95% CI: 9.9%-13.7%) during the COVID-19 pandemic. Multiple logistic regression analysis revealed that poor treatment adherence (P = .009, OR = 1.86, 95% CI: 1.17-2.96) and perceived illness worsening during the COVID-19 outbreak (P = .02, OR = 2.07, 95% CI: 1.15-3.73), being diagnosed with major depressive disorder (P < .001, OR = 2.79, 95% CI: 1.68-4.64), PHQ-9 total score (P < .001, OR = 1.20, 95% CI: 1.15-1.24) and NPRS total score (P = .002, OR = 1.17, 95% CI: 1.06-1.29) were associated with higher risk of suicidality. After controlling for covariates, older psychiatric patients with suicidality had lower QOL compared to those without (F(1, 1063) =16.5, P<.001). CONCLUSIONS: Suicidality was common in older patients with clinically stable psychiatric disorders during the COVID-19 pandemic. Considering its negative impact on QOL and personal suffering, routine screening and preventive suicide measures should be implemented for older psychiatric patients.


Subject(s)
COVID-19 , Depressive Disorder, Major , Mental Disorders , Suicide , Aged , COVID-19/epidemiology , Cross-Sectional Studies , Depressive Disorder, Major/epidemiology , Humans , Mental Disorders/epidemiology , Pandemics , Prevalence , Quality of Life , SARS-CoV-2 , Suicide/psychology
8.
Sci Rep ; 12(1): 2696, 2022 02 17.
Article in English | MEDLINE | ID: covidwho-1699590

ABSTRACT

COVID-19 stressors and psychological stress response are important correlates of suicide risks under the COVID-19 pandemic. This study aimed to investigate the prevalence of COVID-19 stress, its impact on mental health and associated risk factors among the general population during the outbreak of COVID-19 in July 2020 throughout Taiwan. A nationwide population-based survey was conducted using a computer-assisted telephone interview system with a stratified, proportional randomization method for the survey. The questionnaire comprised demographic variables, psychological distress assessed by the five-item Brief Symptom Rating Scale and independent psychosocial variables including COVID-19 stressors, loneliness, suicidality, and health-related self-efficacy. In total, 2094 respondents completed the survey (female 51%). The COVID-19 stress was experienced among 45.4% of the participants, with the most prevalent stressors related to daily life and job/financial concerns. Higher levels of suicidality, loneliness, and a lower level of self-efficacy had significantly higher odds of having COVID-19 stress. The structural equation model revealed that COVID-19 stress was moderately associated with psychological distress and mediated by other psychosocial risk factors. The findings call for more attention on strategies of stress management and mental health promotion for the public to prevent larger scales of psychological consequences in future waves of the COVID-19 pandemic.


Subject(s)
COVID-19/psychology , Loneliness/psychology , Self Efficacy , Stress, Psychological/epidemiology , Suicide/statistics & numerical data , Adolescent , Adult , Aged , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Models, Theoretical , Prevalence , Stress, Psychological/etiology , Suicide/psychology , Taiwan/epidemiology , Young Adult
9.
PLoS One ; 17(1): e0262958, 2022.
Article in English | MEDLINE | ID: covidwho-1648374

ABSTRACT

BACKGROUND: Past works have linked the COVID-19 pandemic and subsequent public health responses such as isolation, quarantine, and lockdown to increased anxiety, sleep disorders, depressive symptoms, and suicidal ideation. Only a few studies, mostly carried out in high-income countries, have investigated the association between the pandemic and suicide rate. We seek to investigate the changes in the monthly suicide rates during the COVID-19 pandemic in Nepal, compared to the pre-pandemic suicide rates. METHODS AND FINDINGS: This is a retrospective study investigating the changes in suicide rates in Nepal during the COVID-19 pandemic period (April 2020 to June 2021), compared to the pre-pandemic period (July 2017 to March 2020), adjusted for seasonality and long-term trend in the suicide rate. We performed analysis for the entire country as well as sub-sample analyses stratified by gender and provinces. A total of 24350 suicides deaths during four years of the study window were analyzed. We found an overall increase in the monthly suicide rate in Nepal with an average increase of 0.28 (CI: 0.12,0.45) suicide per 100,000 during the pandemic months. The increase in suicide rate was significant both among males (increase in rate = 0.26, CI: 0.02,0.50) and females (increase in rate = 0.30, CI: 0.18,0.43). The most striking increments in suicide rates were observed in June, July, and August 2020. The pattern of increased suicide rates faded away early on among males, but the effect was sustained for a longer duration among females. Sudurpaschim and Karnali provinces had the highest increase in suicide rates associated with the COVID-19 pandemic. CONCLUSIONS: The COVID-19 pandemic is associated with an increased suicide rate in Nepal. The findings may inform policymakers in designing appropriate public health responses to the pandemic that are considerate of the potential impact on mental health and suicide.


Subject(s)
Anxiety/psychology , COVID-19/psychology , Depression/psychology , Social Isolation/psychology , Suicidal Ideation , Suicide/psychology , Adult , Anxiety/epidemiology , COVID-19/epidemiology , Depression/epidemiology , Female , Humans , Male , Mental Health/statistics & numerical data , Nepal/epidemiology , Quarantine/psychology , Retrospective Studies , SARS-CoV-2/pathogenicity , Suicide/statistics & numerical data
10.
PLoS One ; 16(12): e0260931, 2021.
Article in English | MEDLINE | ID: covidwho-1632675

ABSTRACT

During the COVID-19 pandemic, US populations have experienced elevated rates of financial and psychological distress that could lead to increases in suicide rates. Rapid ongoing mental health monitoring is critical for early intervention, especially in regions most affected by the pandemic, yet traditional surveillance data are available only after long lags. Novel information on real-time population isolation and concerns stemming from the pandemic's social and economic impacts, via cellular mobility tracking and online search data, are potentially important interim surveillance resources. Using these measures, we employed transfer function model time-series analyses to estimate associations between daily mobility indicators (proportion of cellular devices completely at home and time spent at home) and Google Health Trends search volumes for terms pertaining to economic stress, mental health, and suicide during 2020 and 2021 both nationally and in New York City. During the first pandemic wave in early-spring 2020, over 50% of devices remained completely at home and searches for economic stressors exceeded 60,000 per 10 million. We found large concurrent associations across analyses between declining mobility and increasing searches for economic stressor terms (national proportion of devices at home: cross-correlation coefficient (CC) = 0.6 (p-value <0.001)). Nationally, we also found strong associations between declining mobility and increasing mental health and suicide-related searches (time at home: mood/anxiety CC = 0.53 (<0.001), social stressor CC = 0.51 (<0.001), suicide seeking CC = 0.37 (0.006)). Our findings suggest that pandemic-related isolation coincided with acute economic distress and may be a risk factor for poor mental health and suicidal behavior. These emergent relationships warrant ongoing attention and causal assessment given the potential for long-term psychological impact and suicide death. As US populations continue to face stress, Google search data can be used to identify possible warning signs from real-time changes in distributions of population thought patterns.


Subject(s)
COVID-19/psychology , Cell Phone/statistics & numerical data , Search Engine/statistics & numerical data , Socioeconomic Factors , Suicide/psychology , Geographic Information Systems , Humans , Mental Health/statistics & numerical data , New York City , Quarantine/statistics & numerical data , Search Engine/trends , Stress, Psychological , Time Factors , United States
11.
Int J Environ Res Public Health ; 19(2)2022 01 08.
Article in English | MEDLINE | ID: covidwho-1637414

ABSTRACT

Contemporary performance and accessibility are features that enable mobile devices to be increasingly beneficial in the context of optimizing the treatment of psychiatric disorders. Smartphones have the potential to effectively support psychotherapeutic interventions among adolescents and young adults who require them. In the present study, the use and subjective influence of a smartphone app with content from dialectical behavior therapy (DBT) was investigated among transitional age youth (TAY) with borderline personality disorder, focusing on suicidality and non-suicidal self-injury (NSSI), in a natural setting. A longitudinal qualitative approach was used by means of individual semi-structured interviews, where participants were asked about their experiences and associated emotions before and after a testing period of 30 days. A total of 13 TAY with a diagnosed borderline personality disorder between the ages of 18 and 23 were included. Six overarching themes were identified through qualitative text analysis: (1) experiences with DBT skills, (2) phenomenon of self-harm, (3) feelings connected with self-harm, (4) dealing with disorder-specific symptoms, (5) prevention of self-harm, and (6) attitude toward skills apps. In general, the provision of an app with DBT content achieved a positive response among participants. Despite a small change in the perception of suicidality and NSSI, participants could imagine its benefits by integrating their use of the app as a supportive measure for personal psychotherapy sessions.


Subject(s)
Borderline Personality Disorder , Dialectical Behavior Therapy , Mobile Applications , Self-Injurious Behavior , Suicide , Adolescent , Adult , Behavior Therapy , Borderline Personality Disorder/therapy , Humans , Self-Injurious Behavior/psychology , Self-Injurious Behavior/therapy , Suicidal Ideation , Suicide/prevention & control , Suicide/psychology , Treatment Outcome , Young Adult
13.
PLoS One ; 16(12): e0261867, 2021.
Article in English | MEDLINE | ID: covidwho-1581724

ABSTRACT

OBJECTIVE: Since the start of the COVID-19 pandemic, there have been concerns that social distancing may negatively impact mental health, particularly with regards to loneliness, depressive symptoms, and suicidality. The current study explored how aspects of social distancing, communication, and online support from October 2020 to December 2020 related to loneliness, depressive symptoms, and suicidal ideation. METHOD: Participants (n = 216) who self-identified as having mental health diagnoses were recruited and completed questionnaires online. RESULTS: Findings showed that COVID-19 related social contact, particularly electronic social contact, is associated with decreased loneliness, suicidal ideation, and depression. Online emotional support was significantly associated with decreased loneliness and depressive symptoms. Social distancing practices were not associated with increased loneliness, suicidal ideation, and depression. CONCLUSIONS: Our findings underscore the importance of leveraging electronic methods of social connection, especially among individuals who are at risk for suicide or depression.


Subject(s)
COVID-19/psychology , Depression/psychology , Loneliness/psychology , Adult , COVID-19/epidemiology , Female , Humans , Male , Middle Aged , Pandemics , Physical Distancing , Risk Factors , SARS-CoV-2/pathogenicity , Social Factors , Suicidal Ideation , Suicide/psychology , Surveys and Questionnaires
14.
Am J Public Health ; 111(11): 1950-1959, 2021 11.
Article in English | MEDLINE | ID: covidwho-1538296

ABSTRACT

Objectives. To determine whether unemployment and bankruptcy rates are related to increased excess deaths during the COVID-19 recession and to examine whether the current recession-based mortality rate not only is dependent on COVID-19 but also continues the pattern of recessions, especially the Great Recession, in relation to chronic disease mortality rates and mental health disturbances (e.g., including suicide) from 2000 to 2018. Methods. This study used pooled cross-sectional time series analysis to determine the impact of unemployment and bankruptcy rates on excess deaths from February to November 2020 for US states. The study used a second pooled cross-sectional time series analysis to determine whether the COVID-19‒ era recessional mortality continues the impact of prepandemic recessions (2000-2018) on multiple causes of mortality. Results. Ten percent unemployment was associated with approximately 48[thin space]149 excess deaths, while, jointly with bankruptcies, their combined effect produced 35 700 and 144 483 excess deaths, for unemployment and bankruptcies, respectively. These health-damaging COVID-19‒recessional findings suggest a reiteration of the significantly increased major cause‒specific mortality during 2000 to 2018, mitigated by the size of the health care workforce. Conclusions. Minimization of deaths attributable to the COVID-19 recession requires ample funding for the unemployed and underemployed, especially Black and Hispanic communities, along with significant investments in the health workforce. (Am J Public Health. 2021;111(11):1950-1959. https://doi.org/10.2105/AJPH.2021.306490).


Subject(s)
Bankruptcy/statistics & numerical data , COVID-19 , Cause of Death , Economic Recession , Mortality/trends , Unemployment/statistics & numerical data , Cross-Sectional Studies , Female , Humans , Male , Suicide/psychology , United States
15.
Eur Rev Med Pharmacol Sci ; 25(20): 6397-6407, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1503071

ABSTRACT

OBJECTIVE: Coronavirus disease 2019 (COVID-19) is a pandemic and leading cause of death. Beyond the deaths directly caused by the virus and the suicides related to the psychological response to the dramatic changes as socioeconomic related to the pandemic, there might also be suicides related to the inflammatory responses of the infection. Infection induces inflammation as a cytokine storm, and there is an increasing number of studies that report a relationship between infection and suicide. MATERIALS AND METHODS: We searched the World Health Organization status report and the PubMed database for keywords (COVID-19, suicide, infection, inflammation, cytokines), and reviewed five cytokine pathways between suicide and inflammation using two meta-analyses and two observational studies starting from November 31, 2020, focusing on the relationship between suicide and inflammation by infection. First, we discussed existing evidence explaining the relationship between suicidal behaviors and inflammation. Second, we summarized the inflammatory features found in COVID-19 patients. Finally, we highlight the potential for these factors to affect the risk of suicide in COVID-19 patients. RESULTS: Patients infected with COVID-19 have high amounts of IL-1ß, IFN-γ, IP10, and MCP1, which may lead to Th1 cell response activation. Also, Th2 cytokines (e.g., IL-4 and IL-10) were increased in COVID-19 infection. In COVID-19 patients, neurological conditions, like headache, dizziness, ataxia, seizures, and others have been observed. CONCLUSIONS: COVID-19 pandemic can serve as a significant environmental factor contributing directly to increased suicide risk; the role of inflammation by an infection should not be overlooked.


Subject(s)
COVID-19/immunology , Cytokines/immunology , Suicide , COVID-19/psychology , Humans , Risk Factors , Suicide/psychology
16.
Psychiatry Res ; 301: 113998, 2021 07.
Article in English | MEDLINE | ID: covidwho-1475002

ABSTRACT

COVID-19, and efforts to mitigate its spread, are creating extensive mental health problems. Experts have speculated the mental, economic, behavioral, and psychosocial problems linked to the COVID-19 pandemic may lead to a rise in suicide behavior. However, a quantitative synthesis is needed to reach an overall conclusion regarding the pandemic-suicide link. In the most comprehensive test of the COVID-19-suicidality link to date, we meta-analyzed data from 308,596 participants across 54 studies. Our results suggested increased event rates for suicide ideation (10.81%), suicide attempts (4.68%), and self-harm (9.63%) during the COVID-19 pandemic when considered against event rates from pre-pandemic studies. Moderation analysis indicated younger people, women, and individuals from democratic countries are most susceptible to suicide ideation during the COVID-19 pandemic. Policymakers and helping professionals are advised that suicide behaviors are alarmingly common during the COVID-19 pandemic and vary based upon age, gender, and geopolitics. Strong protections from governments (e.g., implementing best practices in suicide prevention) are urgently needed to reduce suicide behaviors during the COVID-19 pandemic.


Subject(s)
COVID-19/psychology , Suicidal Ideation , Suicide, Attempted/psychology , Suicide/prevention & control , COVID-19/epidemiology , Female , Humans , Male , Pandemics , SARS-CoV-2 , Self-Injurious Behavior/psychology , Suicide/psychology , Suicide, Attempted/statistics & numerical data
17.
Public Health Res Pract ; 31(3)2021 Sep 08.
Article in English | MEDLINE | ID: covidwho-1471205

ABSTRACT

Emerging evidence, based on the synthesis of reports from past infectious disease-related public health emergencies, supports an association between previous pandemics and a heightened risk of suicide or suicide-related behaviours and outcomes. Anxiety associated with pandemic media reporting appears to be one critical contributing factor. Social isolation, loneliness, and the disconnect that can result from public health strategies during global pandemics also appear to increase suicide risk in vulnerable individuals. Innovative suicide risk assessment and prevention strategies are needed to recognise and adapt to the negative impacts of pandemics on population mental health.


Subject(s)
COVID-19/epidemiology , Pandemics , Suicide/prevention & control , Suicide/statistics & numerical data , Anxiety/epidemiology , Anxiety/psychology , COVID-19/psychology , Humans , Loneliness/psychology , Mental Health , Public Health , Risk Assessment/methods , SARS-CoV-2 , Social Isolation/psychology , Suicide/psychology
18.
Workplace Health Saf ; 69(2): 92, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1406688

ABSTRACT

Suicide prevention begins with understanding depression and mental health protection.


Subject(s)
Depression/diagnosis , Occupational Health Nursing/methods , Suicide/prevention & control , COVID-19/psychology , Depression/psychology , Humans , Suicide/psychology
19.
Asia Pac Psychiatry ; 13(3): e12482, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1352415

ABSTRACT

INTRODUCTION: Suicide prevention during Covid 19 has become a global priority because the current pandemic has led to societal difficulties threatening the fabric of our lifestyle with increased morbidity and mortality. Modelling studies published since the COVID 19 pandemic was declared in March 2020 estimate that suicide rates will increase by anywhere between 1% to 145% globally in response to the pandemic and action needs to be taken. METHODS: A narrative literature review on high quality evidence sources limited to human studies and publications written in English language only has been used to examine the relationship of COVID 19 and existing mental illness or history of mental illness, suicide prevention strategies and changes in overall suicide rates. RESULTS: A total of 39 papers are summarised and grouped using the headings aetiological factors, proposed interventions to increase access and national policies to provide a framework for suicide prevention during pandemics such as COVID 19. This review indicates that 1) investing in active labour market programmes will result in a decreased suicide rate during times of high unemployment 2) People in low paid and casual jobs require specific support because they are most financially vulnerable during a pandemic related crisis 3) Women require specific support during a pandemic because of the type of employment they have and because they often carry a greater proportion of the domestic burden and are at increased risk of domestic violence during lockdown and crisis 4) Mental health and substance misuse services need to be appropriately funded and prioritised during and post pandemic, due to the associated increase in substance misuse during a pandemic causing worsening mental health and increased risk of suicide 5) National Suicide Prevention Strategies should be developed by all countries and should anticipate response to a range of disasters, including a pandemic 6) Suicide prevention is everybody's business and National Suicide Prevention Strategies should adopt a whole-systems approach including mental health services, primary care, social care, NGO's and other community stakeholders 7) Suicide is preventable 8) It is essential to prioritise suicide prevention strategies in the COVID and post-COVID period to ensure that lives are saved. DISCUSSION: Increase in suicide is not inevitable and suicide prevention during pandemics and post COVID 19 pandemics requires a collaborative whole system approach. We require real time data to inform dynamic action planning.


Subject(s)
COVID-19/psychology , Mental Disorders , Mental Health , Suicide , COVID-19/epidemiology , Global Health , Humans , Mental Disorders/diagnosis , Mental Disorders/epidemiology , Preventive Health Services , SARS-CoV-2 , Social Determinants of Health , Social Isolation/psychology , Suicide/prevention & control , Suicide/psychology , Suicide/statistics & numerical data
20.
Lancet Psychiatry ; 8(10): 892-900, 2021 10.
Article in English | MEDLINE | ID: covidwho-1331335

ABSTRACT

BACKGROUND: There is widespread concern over the impact of public health measures, such as lockdowns, associated with COVID-19 on mental health, including suicide. High-quality evidence from low-income and middle-income countries, where the burden of suicide and self-harm is greatest, is scarce. We aimed to determine the effect of the pandemic on hospital presentations for self-poisoning. METHODS: In this interrupted time-series analysis, we established a new self-poisoning register at the tertiary care Teaching Hospital Peradeniya in Sri Lanka, a lower-middle-income country. Using a standard extraction sheet, data were gathered for all patients admitted to the Toxicology Unit with self-poisoning between Jan 1, 2019, and Aug 31, 2020. Only patients classified by the treating clinician as having intentionally self-poisoned were included. Data on date of admission, age or date of birth, sex, and poisoning method were collected. No data on ethnicity were available. We used interrupted time-series analysis to calculate weekly hospital admissions for self-poisoning before (Jan 1, 2019-March 19, 2020) and during (March 20-Aug 31, 2020) the pandemic, overall and by age (age <25 years vs ≥25 years) and sex. Individuals with missing date of admission were excluded from the main analysis. FINDINGS: Between Jan 1, 2019, and Aug 31, 2020, 1401 individuals (584 [41·7%] males, 761 [54·3%] females, and 56 [4·0%] of unknown sex) presented to the hospital with self-poisoning and had date of admission data. A 32% (95% CI 12-48) reduction in hospital presentations for self-poisoning in the pandemic period compared with pre-pandemic trends was observed (rate ratio 0·68, 95% CI 0·52-0·88; p=0·0032). We found no evidence that the impact of the pandemic differed by sex (rate ratio 0·64, 95% CI 0·44-0·94, for females vs 0·85, 0·57-1·26, for males; pinteraction=0·43) or age (0·64, 0·44-0·93, for patients aged <25 years vs 0·81, 0·57-1·16, for patients aged ≥25 years; pinteraction=0·077). INTERPRETATION: This is the first study from a lower-middle-income country to estimate the impact of the pandemic on self-harm (non-fatal) accounting for underlying trends. If the fall in hospital presentations during the pandemic reflects a reduction in the medical treatment of people who have self-poisoned, rather than a true fall in incidence, then public health messages should emphasise the importance of seeking help early. FUNDING: Elizabeth Blackwell Institute University of Bristol, Wellcome Trust, and Centre for Pesticide Suicide Prevention. TRANSLATIONS: For the Sinhalese and Tamil translations of the abstract see Supplementary Materials section.


Subject(s)
COVID-19/psychology , Hospitalization/statistics & numerical data , Poisoning/psychology , Self-Injurious Behavior/psychology , Adult , COVID-19/complications , COVID-19/diagnosis , COVID-19/epidemiology , Cost of Illness , Developing Countries/statistics & numerical data , Female , Hospitalization/trends , Humans , Incidence , Interrupted Time Series Analysis/methods , Male , Poisoning/epidemiology , SARS-CoV-2/genetics , Self-Injurious Behavior/epidemiology , Sri Lanka/epidemiology , Suicide/prevention & control , Suicide/psychology
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