Overall suicide rates did not increase in the majority of countries during the first 9-15 months of the COVID-19 pandemic. An international team of researchers, including some from the Bristol BRC, looked at data from 33 countries to get a better picture of how the pandemic was impacting the mental health of the global population.

Findings from the study suggest that the sharp increase in suicide deaths, predicted by some at the start of the pandemic, did not happen This was despite a documented rise in mental health problems and an increase in stress factors for suicide such as isolation, economic instability, stress, substance use or limited access to healthcare. Although, there are some signals that this might change as the pandemic continues.

Researchers looked at data from 24 high-income, six upper-middle-income and three lower-middle-income countries. In most of the countries and areas there was no evidence of an increase in the overall rate of suicide. In fact, they found some evidence to suggest that suicide rates were lower than expected although there were some signals that this might be changing as the pandemic continued.

The study team couldn’t assess how different demographic groups were affected by the pandemic because the data they needed for this type of analysis wasn’t consistently available. They conducted their analysis based only on sex and age and were unable to include factors such as ethnicity, income level or mental health status. This means that a decrease in the suicide rate for one group might have masked an increase in the suicide rate for another group.

Results were not consistent across countries or areas. Different suicide rate patterns couldn’t be explained by how specific countries had responded to the pandemic, their mortality rates, the level of economic support they offered or whether they had a national suicide prevention strategy. Although there were some suggestions that lower-middle-income countries fared less well than others.

Four in every suicide death occurs in low- and middle-income countries, however the study team accessed data from only three lower-middle-income countries and no low-income countries. This is important because, for example, suicide rates seemed to be rising in areas of India and Iran that researchers had data for. The team believe that more research is needed into the extent to which the pandemic impacted suicides in low- and lower-middle-income countries as many of them were hit hard by the pandemic and struggled to provide economic and mental health support for their populations.

Duleeka Knipe, a member of the research team, said:

“Ongoing monitoring of suicide deaths during the pandemic and beyond is critical, and particularly so for low- and middle-income countries.

“Large-scale international efforts such as this one should take place alongside more localised data collection, which can be timelier, more detailed and enable access to more contextual data.

“Monitoring should ideally not only track total suicide deaths, but also suicides for different groups because the impacts may vary by sex, age and other factors.”

Paper

Suicide numbers during the first 9-15 months of the COVID-19 pandemic compared with pre-existing trends: An interrupted time series analysis in 33 countries

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