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Journal Article

Citation

John A, Pirkis J, Gunnell D, Appleby L, Morrissey J. BMJ 2020; 371: m4352.

Copyright

(Copyright © 2020, BMJ Publishing Group)

DOI

10.1136/bmj.m4352

PMID

33184048

Abstract

As many countries face new stay-at-home restrictions to curb the spread of covid-19, there are concerns that rates of suicide may increase--or have already increased.12 Several factors underpin these concerns, including a deterioration in population mental health,3 a higher prevalence of reported thoughts and behaviours of self-harmamong people with covid-19,4 problems accessing mental health services,4 and evidence suggesting that previous epidemics such as SARS (2003) were associated with a rise in deaths by suicide.5

Widely reported studies modelling the effect of the covid-19 pandemic on suicide rates predicted increases ranging from 1% to 145%,6 largely reflecting variation in underlying assumptions. Particular emphasis has been given to the effect of the pandemic on children and young people. Numerous surveys have highlighted that their mental health has been disproportionately affected, relative to older adults,37 and some suggest an increase in suicidal thoughts and self-harm.8

Supposition, however, is no replacement for evidence. Timely data on rates of suicide are vital, and for some months we have been tracking and reviewing relevant studies for a living systematic review.6 The first version in June found no robust epidemiological studies with suicide as an outcome, but several studies reporting suicide trends have emerged more recently. Overall, the literature on the effect of covid-19 on suicide should be interpreted with caution. Most of the available publications are preprints, letters (neither is peer reviewed),91011 or commentaries using news reports of deaths by suicide as the data source.12

Nevertheless, a reasonably consistent picture is beginning to emerge from high income countries. Reports suggest either no rise in suicide rates (Massachusetts, USA11; Victoria, Australia13; England14) or a fall (Japan,9 Norway15) in the early months of the pandemic. The picture is much less clear in low income countries, where the safety nets available in better resourced settings may be lacking. News reports of police data from Nepal suggest a rise in suicides,12 whereas an analysis of data from Peru suggests the opposite.10

Any change in the risk of suicide associated with covid-19 is likely to be...


Language: en

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