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Abstract
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This 2020 we find ourselves, health professionals, health managers, governments and almost all the community in very unexpected and challenging circumstances as we face the COVID-19 pandemic. Millions of people around the world are infected and more than one million have died so far[1]. The pandemic is presenting many-fold impacts on economy, education and several aspects of our lives. All these impacts added to social distancing, isolation, family and other personal losses and fear of contagion have both activated and intensified mental health problems in many people, being crucial to enhance suicide prevention[2],[3]. All geographical areas are vulnerable to the pandemic and its associated impacts. However, megacities, urban agglomerations surpassing 10 million people, are environments at higher risk[4],[5]. Megacities are very susceptible to public health crises and are currently facing unprecedented challenges to reduce the spread of COVID-19 and alleviate the impacts of the pandemic[6],[7].
The pandemic in megacities could adversely affect well-recognized suicide risk factors such as increase in psychiatric disorders, unemployment, financial stressors, domestic violence and alcohol and drug abuse[2],[3],[6],[8]. Social isolation and feelings of loneliness are likely to increase during the pandemic and have been considered as risk factors of suicide during previous epidemics[9]. People at higher risk of suicide include individuals with pre-existing psychiatric disorders, with previous suicide attempt, males, female victims of intimate partner violence[6],[8],[10], people living in megacities with high prevalence of COVID-19 and individuals who have suffered the loss of relatives or friends[3]. It has been also proposed that the fear and stigma towards persons with COVID-19 may also result in an increase of suicide[11].
Recent prevalence studies show that the impact of the pandemic has resulted in an increase in anxiety, stress and depression in the general population[12] and especially among healthcare workers[13],[14] and people with pre-existing psychiatric disorders[15]. The fear of contagion, isolation, loneliness and physical distancing may exacerbate pre-existing psychiatric disorders and trigger mental health problems in the general population[3],[11]. The rise in mental disorders coupled with the already known problem of the mental health treatment gap, representing a challenge to satisfactory address this new demand for mental healthcare. Because of the quarantine, it is also expected that many people with psychiatric disorders discontinue their treatment, increasing their suicide risk. The pandemic is representing a challenge to mental health teams at both primary and speciality care levels; those have needed to reformulate their practices and developing proficiency to deliver remote assessments, consultations and interventions, wherever possible...
Language: en |