Like many, I have seen popular media outlets report the speculation that suicide rates have or will increase because of COVID-19 and COVID-related factors. Many of us in the suicide prevention field have been watching the data available closely for any signal that points to whether this is true or not.
There aren’t easy answers to this question, and this is mainly due to the complexity of suicide, the lack of complete data, the varying impacts of the pandemic, and the dynamic relationship between mental health, life stressors and suicide risk.
It’s human nature to look for simple explanations for complex occurrences, especially in times of uncertainty. We want to know what causes the things that make us afraid or concerned, in order to have a sense of predictability and control, and in an attempt to avoid or prevent them. Just as with many things, simple responses rarely convey the complexity of human interactions and behaviors; that is certainly the case with suicide.
We may not understand for some time to what extent COVID-19 impacted suicide rates in 2020 and 2021. Suicide mortality data always takes time to collect and analyze in a meaningful way: we currently only have complete-year national data from the CDC for 2019. We know far more about COVID-19 mortality than we do for suicide mortality for the same time period. Many of us in suicide prevention have worked hard and advocated for improved suicide data surveillance, which helps us to better understand how often suicide occurs, where it is happening and who we are losing. While we have certainly made progress, there is more work to be done to be able to track suicide deaths and suicide-related outcomes in the way we track COVID hospitalizations and mortality. And we should remember that suicide deaths aren’t the only indicator of how people are impacted—suicidal thoughts, behaviors and attempts are important to acknowledge and understand, and the data we have on these is, at best, incomplete.
There is some promising preliminary data from 24 countries and multiple states in the U.S. that suggest that suicide rates during the early months of the pandemic did not rise, and in some cases, may have decreased. While this is good news to some degree, we should be cautious to overinterpret this. We do not yet know if this was the case for all Americans, and there is some early data to suggest that this decrease may not be the case for all racial/ethnic groups or age groups. The pandemic co-occurred in a year of ongoing civil unrest and tremendous losses. Mental health and suicide risk do not occur in a vacuum. Systemic racism, violence, economic and overall health disparities can all have an impact on mental health and suicide.
So, what can we say with confidence about suicide during this time?
- Suicide is multi-faceted and no one ends his or her own life for a single reason. So, we can be pretty sure that COVID-19 by itself does not cause suicide, though for some, it may increase their risk. Just like there are many factors that can have a positive or negative effect on our health in other areas (like stress and exercise on cardiac health, for example), the reasons a given individual dies by suicide have a lot to do with their individual risk factors and life stressors. The interaction between risk factors and life stressors is a dynamic one and intersects with environmental factors as well.
- While we are all experiencing the pandemic, we are not all having the same experience of the pandemic. It’s worth reminding ourselves (and others) that Black, Indigenous and Hispanic Communities in particular have been disproportionately impacted by COVID-19. This pandemic has further revealed the societal inequities based in race that have an ongoing impact on health, including mental health. We need to actively work to deliver culturally-competent mental health care and be prepared to address race-based societal inequities in society as part of overall suicide prevention efforts.
- Suicide prevention efforts have not stopped during COVID-19 and much of the work has adapted accordingly, giving us reason to be hopeful that our work in suicide prevention has helped many during COVID-19. We won’t know for sure for some time, but we have reason to be hopeful. The pandemic has raised awareness of the fact that we all have mental health, and can proactively take steps to manage it – which is a good thing. Americans are accessing mental health services via telehealth like never before in our nation’s history. The National Suicide Prevention Lifeline, the Crisis Text Line, and SAMHSA’s Disaster mental health line have all continued to be in operation, as well as a number of COVID-19 support lines at the state level to support those in crisis.
- What you do today can help prevent suicides during COVID-19.
Ask those you are concerned about whether they have had thoughts of suicide during this time, and help them connect to the help they need. Talk openly about mental health and coping. (You can download our #RealConvo Guides for practical tips on talking about suicide and mental health.) Research tells us that open communication with caring individuals can significantly and positively change the outcome for individuals at risk. Put the crisis numbers in your phone in case you or someone you know needs them, and share them widely. Check in on those who may be isolated and lonely, and invite others to check in on you to support your own mental health, as well. We all have a role to play in suicide prevention, and our efforts matter, especially now.
You can learn more about suicide, and what you can do to help save lives, at afsp.org.
If you are in crisis, please call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255); contact the Crisis Text Line by texting TALK to 741741; or contact SAMHSA’s Disaster Distress Helpline at 1-800-985-5990.