Pandemic and Lockdown not Leading to Increased Suicides, Study Finds

A new study in Lancet Psychiatry finds that the COVID-19 pandemic has not led to increased suicide rates in middle and high-income countries.

Ashley Bobak, MS
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A new study, published in Lancet Psychiatry, examines the effect of the COVID-19 pandemic on suicide rates. After reviewing data from 21 countries, the researchers found no significant increase in suicide risk since the beginning of the pandemic, despite initial concerns that rates would increase. They urge vigilance and attendance to the long-term effects of the pandemic on mental health.

The researchers, led by Professor Jane Pirkis of the University of Melbourne, write:

“Our study is the first to examine suicides occurring in the COVID-19 context in multiple countries. It offers a broadly consistent picture, albeit from high-income and upper-middle-income countries, of suicide numbers remaining unchanged or declining in the pandemic’s early months. This picture is neither complete nor final, but serves as the best available evidence on the pandemic’s effects on suicide so far.”
A self isolating man wearing a face mask in the Covid-19 crisis. Mental health, stress and anxiety caused by the outbreak of coronavirus. Vector illustration.

The COVID-19 pandemic has had a significant impact on mental health, although researchers are still working to understand the extent of the impact. In an attempt to understand the effect of COVID-19 on suicide rates, the researchers examined currently available studies on worldwide suicide rates. However, they found insufficient evidence to offer a full understanding of how the pandemic has influenced suicide rates.

They highlight how the effect of the pandemic on suicide rates is dependent on many factors, including: “the extent of the pandemic, the public health measures instituted to control it, the capacity of existing mental health services and suicide prevention programs, and the strength of the economy and relief measures to support those whose livelihoods are affected by the pandemic.”

Additionally, other external influences on suicide, such as political unrest or economic difficulties, which could be independent of and worsened by the pandemic, will likely vary across countries.

In the current study, the researchers used real-time suicide data from 21 high-income and upper-middle-income countries. 10 of these countries provided data for the entire country, whereas 11 provided data about a specific area or areas within the country. The data was analyzed to determine whether the monthly suicide rates (which ranged from April 1st to July 31st, 2020) changed after the pandemic began.

Overall, the researchers did not find an increase in suicide risk since the beginning of the pandemic, consistent with results from other studies investigating suicide rates in high and upper-middle-income countries.

They attribute the lack of increase in suicide rates to several factors, including concerns being raised early on about the potential negative impacts of stay-at-home orders and school and business shutdowns on mental health. While self-reported experiences of depression, anxiety, and suicidal thinking increased during the time period examined, it did not appear to affect overall suicide rates in the countries included in the study.

An additional factor is the increased emphasis and accessibility of mental health treatment and services made available by some countries during the pandemic, which may have buffered against some of the damaging effects of the pandemic.

The researchers also highlight the role of community as being a potential protective factor. For example, communities made have made an effort to support individuals at-risk for mental health or other concerns, or households may have developed closer, stronger relationships through increased time together. An overall sense of togetherness as communities as a whole weathered the pandemic may have also protected against a rise in suicidality.

Countries’ provision of financial support to citizens and businesses may be another potential safeguard. However, as much of this support is now being reduced or withdrawn, the potential increases in suicide rates due to the pandemic and economic impacts of the pandemic might be yet to come, as the economic recession has been shown to be a contributor to rising suicidality.

Although no increase in suicide rates was found during the primary analysis, researchers did find significant increases in suicide risk in Vienna, Japan, and Puerto Rico when the observation period was extended from July 31st to October 31st, 2020. In addition, an increase was noted in Puerto Rico when the start date was changed from April 1st to March 1st, 2020. Potential external factors may have contributed to these outliers, such as an increase of celebrity suicides in Japan during the pandemic as well as Puerto Rico’s ongoing economic recession, which the pandemic may have further exacerbated.

The lack of inclusion of low-income or lower-middle-income countries, which account for slightly less than half of the world’s suicides (and may have been especially impacted by the pandemic) presents a major limitation of this study.

Lack of official data from these countries was a barrier. However, researchers were able to find unofficial data from Tunisia, Myanmar (both lower-middle-income), and Malawi (low-income). For Malawi and Tunisia, they found disturbing increases in suicide rates – increasing by 57% in Malawi and 5% in Tunisia. In Myanmar, a 2% decrease in suicide rates was found.

Other limitations include potentially diminished quality in the data utilized due to the possible effects of COVID-19 on data collection, which could have resulted in undercounts of suicides, inability to analyze the data by demographic category, and a reliance on data focused on particular areas for 11 of the countries.

Exploring how the pandemic has impacted particular demographic groups, especially marginalized individuals, like the homeless population, is key considering that social inequalities have worsened the negative effects of COVID-19, including mental distress.

Pirkis and colleagues conclude by emphasizing the need to continue to monitor real-time data so that any increases in suicide rates can be discovered immediately. They suggest that we need to understand what protective factors helped keep suicide rates low early on in the pandemic.

Additionally, suicide rates capture just one factor of mental health, so other aspects of mental health must be explored and understood to provide adequate support. Increased effort into understanding the effect of the pandemic on lower-income countries and finding ways of communicating research findings to governments and communities in such a way that elicits understanding and policy change, as opposed to being sensationalized, is also crucial. Taking these steps could allow for an understanding and prevention of the potential long-term effects of the pandemic on suicide risk and mental health.

 

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Pirkis, J., John, A., Shin, S., DelPozo-Banos, M., Arya, V., Analuisa-Aguilar, P., Appleby, L., Arensman, L., Bantjes, J., Baran, A., Bertolote, J. M., Borges, G., et al. (2021). Suicide trends in the early months of the COVID-19 pandemic: An interrupted time-series analysis of preliminary data from 21 countries. Lancet Psychiatry. https://doi.org/10.1016/ S2215-0366(21)00117-6 (Link)

29 COMMENTS

  1. Perhaps if and when people do call the mentals for support, the mentals are more understanding that the changes the virus instigated, and resulting confusions, are a “normal response”.

    Whereas when people called or saw someone for issues before, it was blamed on them, as originating from inside of them, and so was a permanent illness or disordered.

    Because the mentals have no reference outside of what is also happening to themselves, and since they can relate to the virus changes, they are more accepting.

    They better step up their game and keep slapping the illness or disordered labels on people. I mean it would be abnormal if getting a diagnosis of a permanent illness somehow depresses a person. They should be happy to finally receive a diagnosis.

  2. “… the potential increases in suicide rates due to the pandemic and economic impacts of the pandemic might be YET TO COME [emphasis added], as the economic recession has been shown to be a contributor to rising suicidality.”

    I expect that with an increase in psychiatric drug use (especially “antidepressants’) as Big Pharma and psychiatry prey on increased levels of fear and personal loss, the rates of suicide will start to rise again. And we know that these drugs numb emotions, including empathy, which is one explanation why the number of mass shooting, once again, seems to be on the rise.

    Richard

    • I remember being honest with my NP during April of 2020 — I was on the brink of failing my honors thesis because I was so anxious from the isolation + feeling like nothing was in my control that I couldn’t even open my emails from my professors trying to help me. I would cry uncontrollably for days.

      For some reason she put me on LAMICTAL. I was so desperate I just took it. I can only imagine, as you mentioned, the wave of people becoming injured by psych meds they were given due to the pandemic. I am trying to get off my lamictal before I suffer seizures for the remainder of my life.

      • I can only imagine, as you mentioned, the wave of people becoming injured by psych meds they were given due to the pandemic.

        Or more specifically, by the lockdowns. Expect lots of “studies” and lots of disinformation. And good luck with your detox, are you familiar with http://www.survivingantidepressants.org ?

        Once we come out of collective slow-motion traumatic shock we’ll look back and piece together what has been done to us over the past year in the name of “public health,” and how our fear has been manipulated, and a lot of people will be getting very angry. Count on it.

        • Thank you for the linked website. I am first going to try the “old fashion” way of trying to convince my prescriber that there’s no reason for me to be on a seizure medication, and I don’t even have a diagnosed mood disorder. My prescriber said to me, and I quote, “Unfortunately I cannot prescribe something to fix the pandemic, or the stress is causes. Are you doing okay with your 100mg of lamictal?”

          The Zoloft is next after that. I am lucky to be on “low” doses of both, but I’m sick of being on them because I know what they’ll do to me long term.

        • oldhead, I think there are some “waking up” to what has been done to them. There is a slow-motion thing about it. Even in a nearby county to me, the parents are getting very angry over their children having to wear masks at school, especially for how long a school day is for a child. However, the school board says that they can’t do anything until the governor changes his orders. But, then, the pressure will be upon people. now get your vaccine, so the masks can come off for everyone, but especially the little children in the school. Still, there are those who may never wake up, but stay asleep and in denial forever. All of this seems so similar to how people process their dependence on drugs and alcohol and that includes the evil psych drugs. Rationalization, rationalization, rationalization with a little cognitive dissonance thrown in for good measure. Thank you.

        • Let’s be very clear and candid on the question of “Lockdowns” and Covid 19.

          1) Lockdowns were absolutely necessary AND saved tens of thousands of lives. In fact, if the Trumps administration had not been in COMPLETE DENIAL, AND had clearly and uniformly implemented ‘Lockdowns” in a decisive way (with a clear mask policy), at least two hundred thousand lives would have been saved in the U.S. We could have actually moved AWAY from “Lockdowns” many months sooner IF there had been political leadership based on real science. Where this was carried out in the world more correctly, there was a DRAMATIC decrease in Covid deaths, AND their society only shutdown for a short period.

          2) The ONLY REASON we can now move away from “Lockdowns,” as one method of controlling the Covid 19 pandemic, is because of the huge success of the Covid 19 vaccines. The vaccines have been overwhelmingly safe and effective, AND are THE SOLE REASON why we are now closer to herd immunity. (And yes, I would probably NOT take the J&J vaccine unless it was the only vaccine option available.)

          3) Yes, it was reasonable and rational to have serious distrust of Big Pharma when it comes to drug production and vaccines. BUT this same class of people are also vulnerable to dying from Covid 19 AND had enormous self interest (in addition to making big profits) in developing safe and effective vaccines. AND I believe most of these people actually took the vaccines along with their family members.

          4) I find it very difficult to take seriously those people writing comments about Covid 19 at MIA who were dead wrong on several key life and death issues related to this deadly virus. It was necessary during this pandemic to correctly sum up and apply scientific principles in real time. Some people had more difficulty doing this than others, and so far have not summed up their mistaken analysis.

          5) Some people writing here said Covid would disappear last Fall, Then they spread links to articles that said it would disappear by April of this year. Some of these same people discouraged people from taking the Covid vaccines. Again, the vaccines ARE the sole reason why Covid is in serious decline in the U.S.

          6) Yes, “Lockdowns” and “MasK policies” clearly “divide into two,” and have some negative and harmful aspects, ESPECIALLY when applied incorrectly. Yes, we undermine belief in science and the Covid vaccines when vaccinated people are not allowed to go maskless, and when people are wearing masks outdoors etc.

          7) Yes, “Lockdowns” were applied far too long in school systems, and this has created harm for many young people. There was enough evidence early on that schools could be opened in safer ways due to the differences in how Covid affects young people. There were many school systems in some parts of the country that successfully applied safe methods of staying open.

          8) Covid is not over for many people in the world (India dropped its guard and is paying a huge price in recent death tolls), and those people promoting “Anti-Vaxx” propaganda, and/or, not getting the vaccine, are actually preventing us (the whole world) from achieving human herd immunity. Covid 19 is real and must still be taken seriously. At the same time, we must sum up, criticize, and AVOID all the errors of over reaction and the related unscientifically based excessive control measures being unevenly applied throughout the country.

          Richard

          • Posting as moderator:

            I am approving this post, as it does not specifically violate the Posting Guidelines. However, I am concerned that this will re-create the dive into off-topic interpersonal hostility, as it has done twice before. Richard has posted his view of things, others are welcome to post their view of things, but it is essential that this not deteriorate into an us-vs-them, “You are wrong and I am right” kind of discussion. I ask for your cooperation in keeping this a safe environment for all views to be expressed. I will be keeping a close eye and will intervene swiftly if I see this conversation deteriorating into personalized attacks.

            Thanks for your help!

            Steve

          • Count me out. I for one am no longer going to be be provoked by the standard narrative or its permutations, I have better things to do. Some of us have been repeatedly insulted and even threatened on MIA in the past for mentioning basic truths about the COVID/lockdown scenario, and it serves no purpose to further contribute to such an atmosphere. Those who have been paying attention will notice that some of my (and others’) past observations on this quasi-dystopian situation in which we have been enmeshed for over a year are starting to be borne out. However there are sufficient platforms for such discussions and MIA is clearly not one, nor do I think Steve should be expected to transmute the predictable hysterical cacophany into something resembling reasoned discourse. So I’ll sit this one out. I do have one request of Steve however: should anyone refer to “the science,” please make sure they cite the specific study or studies to which they refer. Thank you.

  3. Officially recorded suicides have not increased in the United States (in fact they dropped slightly in 2020), but deaths due to “intentional and unintentional injury” have skyrocketed. How many of these were people driven to rage or despair due to the socioeconomic costs of the lockdown?

    There were also ten thousand “covid deaths” with “intentional or unintentional injury” listed as a contributing factor on the death certificate. How many of these were actually suicides re-coded as deaths due to the covid?

    https://patrickdhahn.medium.com/covid-19-and-suicide-can-the-official-death-toll-be-believed-5b6ffa1294ba

  4. This study is comical. Unless one can interview a dead corpse, or one found a suicide note explaining pandemic or lockdown as the sole reason, there is no way of knowing. Additionally, the researchers admit to using reported data and that these data can be unverifiable. Poor research. Poor study. Poor science. Entirely theoretical. Research and statistics can be misleading. Be skeptical of any research and statistics.

    • There were days that I felt like a “dead corpse.” Oh, those were those days, I was taking those drugs as in the grips of Big Pharma and the psychiatrists, etc. (Co-Conspirators.) But, let me see…they messed with my “menstrual cycle.” Some women of child-bearing age have complained of this with the “vaccines.” Oh yes, I was only concerned with one result, the “maintenance of my symptoms.” Some have accused public health officials and some governmental officials of being concerned with one result- variations on the theme of “covid” despite other looming problems. Oh, yes and their was this constant haranguing of how bad I was; how sick I was, even since my birth and toddler days, etc. I guess, in their minds, I was born sick. Maybe it was cold and snowy on the night I was born and my mother ate a very large dinner prior to labor and birth. She also ate a dozen or more donuts the night before. But, then, some have accused the media, public health, some government officials of similar haranguing of how bad a person is; in that if one does not do this and that; they could kill “grandma!” Sounds like a good trade-off to me—the sordid world of psychiatry now fully exposed during “covid.” I feel saved from something but I am not sure what. How is “isolation station” for a six year old, a twelve year old, a sixty year old, a ninety year old? How is each day for someone who must feel like they are living through the dinosaur extinction after that asteroid collided with the earth millions of years ago? I was just wondering if all this is worth it? In my viewpoint, it really isn’t “political” in my viewpoint, but it sure does smack of the “psychological”. Thank you.

  5. Go for it Rebel! Figures lie and liars figure.

    Tell the Las Vegas School District it’s no problem, when they had to reopen specifically to prevent more suicides by youth, which has been a repeated occurrence nationwide.

    Ignore the man behind the curtain. It’s just Fauci.

  6. I have read a number of articles about teens and even middle schoolers committing suicide and leaving notes or telling loved ones it was because of the lockdown beforehand. Yet there are no more suicides than usual since March of last year.

    Glory be! The suicides for other causes must have dropped. As the writer has noted suicides can also be from political unrest, economic problems, and domestic abuse. Ergo we can assume all three of these factors are no longer the problems they once were.

    Thank you, Lancet Psychiatry. I won’t forget this report in the future.

    • Covid lockdowns don’t occur in a vacuum. The suicide effects of lockdowns are partially dependent on other factors. If a kid is bullied at school the lockdown could have reduced their suicide rate. Likewise if a kid is bullied at home a lockdown could have increased their suicide rate.

        • Yes! I hated school! And, there was never so much joy in my heart except when I heard the words, “Snow Day” on the radio or tv news. However, since, the “lockdowns/school closure” now many school districts want to get rid of “snow days” and go to “remote learning.” Of course, many school districts were forcing “make-up days” on their students, in order to comply with “mandated days/hours” in the classroom. But, another point is to be made, even though you may not like something, when it is taken away and unavailable, we seem to want that more. This applies seemingly to all ages. I never wanted toilet paper as much until last year. Luckily, I had enough to get through until the shortage eased a little. And now, in the southeast, it is the gas shortage due to Colonial Pipelines shutting down. And, the more they tell the public not to “hoard” it, the more they do. This is “human nature.” The noise of these “officials” is partially the result of “psychology.” “Psychology/Psychiatry” as it “practiced today” is about as far apart from “human nature” as the end of the universe is to Earth; but, so is education, medicine, etc. etc. etc. Thank you.

  7. Has Mad In America completely sold out?? To be parroting a study from a psychiatry journal blows my mind. Don’t you think Lancet has a vested interest here? Seems like a conflict of interest that you all are endorsing this study. As a licensed psychotherapist this has NOT been my experience in working in the mental health field this past year. Nor the doctors and nurses as colleagues who are reporting that ERs have seen a significant increase in suicide attempts this past year. Super disappointed in MIA for selling out.

    • The first thing that crossed my mind was not the accuracy of the claim about suicides not being related to the lockdowns (which also increased transmission by forcing people inside to share infected air). The claim is ridiculous on its face. What I wondered about more was the motivation for this attempt to deny the obvious, and whose interests this serves.

    • “The data was analyzed to determine whether the monthly suicide rates (which ranged from April 1st to July 31st, 2020) changed after the pandemic began.”

      I agree that ANY conclusions on this question (that is, “no increase in suicides during the pandemic”) is, at best, extremely misleading. This is especially true since it only examined a 4 month period early in the pandemic. And of course, they (the scientific and psychiatric establishment) would NEVER want to analyze the potential causal effects of increased psych drugging on suicides and social violence in society.

      Oldhead says: “The first thing that crossed my mind was not the accuracy of the claim about suicides not being related to the lockdowns (which also increased transmission by forcing people inside to share infected air)….”

      When someone examines the overall psychological effects of the pandemic, they are NOT just looking at the issue of “lockdowns.” There are several other issues related to fear and anxiety about contracting Covid, AND, especially trauma regarding the loss of loved ones to the disease. We are now approaching 600 thousand deaths in the U.S.

      And there is simply NO EVIDENCE that “lockdowns….increased transmission by forcing people inside to share infected air…” What agenda does this unscientific and unsubstantiated statement serve???

      It is very clear when looking at the near disappearance of the flu in this country over this past year, that mask wearing and decreased social contact related to “lockdowns” LOWERED THE TRANSMISSION of any, and ALL, diseases.

      Any FAIR analysis of “Lockdowns” (see my above comment) would conclude that they had both positive and negative aspects in trying to fight against a very REAL and dangerous pandemic threat to humanity.

      Richard

  8. I am not writing this post to increase the ire of anyone, only to bring this, what I think is the real issue. I think, the real issue is that we have absolutely no idea what effect masks, social distancing, locking people out of jobs, school closures and remote learning etc. will due to generations of people, especially children, but people of all ages included. This has been an experiment in progress and those who were the “guinea pigs” were not able to sign consent forms. Actions by various governmental and other entities on the advice of public health officials and others never done before have been enacted. We have to ask ourselves what is it really worth it? We are beginning to see the earliest effects in that employers are having difficult times in finding any applicants for their now available jobs. It seems there may be many contributing factors; one mentioned is the increased unemployment payments. I think that may be only one factor that is being entertained at present. Whatever happens, any conclusions as to success and/or failure seem tenuous. Any intelligent, thinking person would realize that the jury is still out and questions remain, but, each day we learn a little more how these fairly extreme measures have affected people of all ages. The future may bring changes that many have not even considered. Thank you.

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