Governments urged to act now to prevent coronavirus suicide risk

Governments need to give ‘urgent consideration’ to their public health response to prevent any possible impact of the coronavirus pandemic on the number of suicides, experts warn.

There is growing concern about the far-reaching impact COVID-19 may have on people’s mental health across the globe, with the consequences likely to be present for longer and peak later than the actual pandemic.

Forty-two researchers from around the world, including Professor David Gunnell from the University of Bristol (who is the NIHR Bristol BRC Mental Health theme co-lead), have formed the International COVID-19 Suicide Prevention Research Collaboration.

Writing in The Lancet Psychiatry, they say an increase in suicides is not inevitable – provided preventive action is taken imminently.

Examples of interventions include developing clear care pathways for people who are suicidal, remote or digital assessments for people under mental health care, staff training to support new ways of working, support for helplines, providing easily accessible help for those who have lost a loved one to the virus, the provision of financial safety nets and labour market programmes, and dissemination of evidence-based online interventions.

In their comment for The Lancet Psychiatry, the authors write:

“Suicide is likely to become a more pressing concern as the pandemic spreads and has longer-term effects on the general population, the economy and vulnerable groups.

“Preventing suicide therefore needs urgent consideration. The response must capitalise on, but extend beyond, general mental health policies and practices.”

Those with psychiatric disorders might experience worsening symptoms and others might develop new mental health problems, especially depression, anxiety and post-traumatic stress.

Loss of employment and financial worries may contribute to feelings of hopelessness. In addition to providing financial safety nets in the short-term, researchers highlight that active labour market programmes will be ‘crucial’ in the long-term.

As domestic violence cases increase, academics recommend public health responses must ensure that those facing domestic violence are supported and that safe drinking messages are communicated.

The global group of experts conclude in The Lancet Psychiatry:

“These are unprecedented times. The pandemic will cause distress and leave many vulnerable. Mental health consequences are likely to be present for longer and peak later than the actual pandemic.

“However, research evidence and the experience of national strategies provide a strong basis for suicide prevention. We should be prepared to take the actions highlighted here, backed by vigilance and international collaboration.”

Additional efforts may be required in some lower income countries with fewer public health resources and inadequate welfare support. Other concerns in these countries include the social effects of banning religious gatherings and funerals, domestic violence, and vulnerable migrant workers.

The International COVID-19 Suicide Prevention Research Collaboration also reiterate how irresponsible media reporting of suicide can encourage further suicides. Journalists should ensure that reporting follows existing and COVID-19-specific guidelines [PDF].

Professor David Gunnell established the International COVID-19 Suicide Prevention Research Collaboration. He said:

“It is hard to predict what impact the pandemic will have on suicide rates, but given the range of concerns, it is important to be prepared and take steps to mitigate risk as far as possible.”

Professor Louis Appleby, co-author and Chair of England’s National Suicide Prevention Strategy Advisory Group said:

“We don’t know that suicide rates will rise. We do know there will be people who feel more distressed or isolated. That some with mental illness will worry about disruption to the care they rely on. A comprehensive response, from economic policy to frontline services, is needed.”