While people can expect suicide rates to increase during a global crisis such as the COVID-19 pandemic, a University of Michigan study suggests that the onset of the pandemic and the state of emergencies probably did not increase suicide-related behaviors in the first few months of the outbreak.
The report, led by UM researchers Rachel Bergmans and Peter Larson, found emergency room visits related to suicide attempts and self-harm fell 40% in the first eight months of Michigan’s lockdown. Their results are published in the Journal of Epidemiology and Community Health.
The study compared emergency room reports of suicide attempts and intentional self-harm at a hospital in Washtenaw County, Mich., During the first 8 months of the COVID-19 pandemic. Researchers used what’s called a time series analysis to examine what happened to suicide attempts and self-harm patterns before and after the COVID-19 pandemic.
They compared the rate of suicide attempts and self-harm from October 1, 2015 to March 9, 2020 to rates from March 10, 2020 to October 31, 2020 and found that the average daily emergency room visits due to suicidal behavior increased from 8.6 visits per day to 5.5 per day.
Bergmans, a researcher at the Survey Research Center at the UM Institute for Social Research, says a stronger social structure may be behind the decline in these visits.
“More research is needed to confirm why there has been a decrease, but the earlier phase of the pandemic was accompanied by many changes at the community and individual level, including changes in unemployment. These types of factors can increase the risk of suicide, ”she said. “However, it is possible that things like the financial aid from stimulus checks, the moratorium on eviction and the support for student loans that people receive may have protected themselves against some of these other effects.”
The specific method used by Bergmans and Larson, called the autoregressive integrated moving average modeling approach, also took into account the seasonal variations in suicide rates, which are highest in spring and fall.
“The models are designed to be informative, but the reality can sometimes differ from predictions,” said Larson, a researcher at the Survey Research Center of the Institute for Social Research and a lecturer in the School of Public Health at UM. . “I think the COVID-19 crisis is unique among the crises we have experienced over the past decades, so we should expect the mental health response to be somewhat unique as well.”
Although the researchers focused on a Michigan hospital, they say other regions are also reporting decreases in suicide deaths. Their data also appears to be consistent with data from other hospital systems across the country. In Japan, suicide mortality was 20% lower in April 2020 compared to April 2019 – however, suicide rates in Japan began to rise after the government stopped being proactive about coronavirus measures, the researchers said.
There were a total of 3,002 individuals in the study data – 62% female and 78% white, with a median age of 26.4 years. There were 10,753 emergency room visits during the study period, including 1,438 after the start of the pandemic.
The analysis shows that the number of emergency room visits remained constant until March 17, 2020, at an average number of 8.6 per day. After March 17, they fell to 5.5 per day. Although ED visits for attempted suicide and self-harm overall decreased, there were differences between groups.
Suicide-related behaviors among men have increased compared to women. The proportion of patient encounters decreased among people of Asian descent compared to whites and among married versus unmarried patients. The rate of suicide attempts and self-harm among those aged 18 to 65 has increased compared to those under the age of 18, while the typical suicide-related behavior is higher among those under the age of 18.
Bergmans and Larson suspect that this may be due to the fact that school closures reduced exposure to psychological stressors in schools – and that young people had fewer opportunities for suicidal behavior while their parents were working from home.
The researchers say one of the limitations of their study lies in the different ways people sought care during the pandemic, such as telemedicine.
“This is a small study looking at one type of mental health outcome in a hospital system. Our results are certainly consistent with other places, but I think this is really just the beginning of the process. type of work that needs to be done, ”said Bergmans mentioned. “It also highlights the need for a better understanding of how different populations have been affected. We are really interested in exploring potential health disparities, as COVID-19 has not treated all communities of the same way.”