The Medical Minute: Preventing suicide during COVID-19

Social isolation. Financial worries. They’re two unfortunate realities causing great anxiety for many people during the COVID-19 pandemic. They also may raise the risk of death by suicide.

While no definitive data exists yet on suicide rates during the pandemic, the Centers for Disease Control and Prevention (CDC) conducted a study in late June on mental health, substance use and suicidal ideation in U.S. adults. The results showed elevated adverse mental health conditions associated with COVID-19. Thirty-one percent of respondents reported symptoms of anxiety or depression and 11% reported having seriously considered suicide in the 30 days prior to the study.

The results are concerning given the tie between suicide and mental health conditions such as major depressive disorders, anxiety disorders, bipolar disorder, schizophrenia and post-traumatic stress disorder. “About 90% of individuals who die by suicide have either a diagnosed or diagnosable mental health disorder,” said Dr. Ahmad Hameed, a psychiatrist at Penn State Health Milton S. Hershey Medical Center.

Suicide isn’t inevitable. It’s preventable, and individuals considering suicide want help. “A majority of the time, individuals who survived a serious suicide attempt say they were relieved that they are alive and that someone was there to listen to them and understand what they were going through,” Hameed said.

Impact of COVID-19

Helping to prevent suicide begins with understanding of the impacts of the COVID-19 pandemic on mental health. For people already prone to anxiety, the pandemic’s stressors—health concerns, potential job losses, worries about loved ones, non-stop COVID-19 news reports—can seem unbearable.

A Duke University study published in July revealed that individuals experiencing unemployment, homelessness, debt, bankruptcy or a lower income were 20 times more likely to attempt suicide.

While anxiety among adults is high, the risk for suicide crosses across demographics and affects some groups, such as military veterans, more than others. Eighty percent of people who die by suicide are men. In the June CDC study, younger adults, racial/ethnic minorities, essential workers and unpaid adult caregivers reported disproportionately worse mental health outcomes, increased substance use and elevated suicidal ideation. And a study published on Sept. 11 showed that primary school students in China experienced more depressive symptoms and made more suicide attempts after schools were closed during the pandemic.

Helping people prevent suicide

As the U.S. recognizes Suicide Prevention Awareness Month in September, “it’s time for loved ones, friends and family members to be really mindful of any potential behaviors they might see in a person with a mental health condition,” Hameed said.

Look for signs that a person’s depression, anxiety or isolation is worsening. Are they more distant? Are they able to care for themselves? Are they experiencing sudden weight loss or weight gain? Are they having trouble sleeping? Do they talk about not wanting to live? Have they made a plan to die by suicide? Has their alcohol or drug use increased? Did they recently buy a gun (more than half of people who die by suicide use a firearm)? Are they getting their affairs in order?

People who recognize warning signs can then assist individuals at risk for suicide by following these four steps:

• Ask if they are struggling with their emotions or considering suicide.
• Listen to their concerns without judgment.
• Validate their feelings.
• Help. Guide them to the right professional resources.

Options include bringing a loved one to a psychiatrist, therapist, primary care provider or emergency department. People considering suicide can also speak with a counselor for free 24/7 by calling the National Suicide Prevention Lifeline at 1-800-273-8255. Press 1 to reach the Veterans Crisis Line. Or host a free lifeline chat. In addition, the CDC offers these tips on coping with COVID-19-related stress.

“People really do want help,” Hameed said. “All we have to do is ensure that the help is readily available.”

Related content:

• The Medical Minute: Suicide: A Public Health Crisis
• Ask Us Anything About… Suicide

The Medical Minute is a weekly health news feature produced by Penn State Health. Articles feature the expertise of faculty, physicians and staff, and are designed to offer timely, relevant health information of interest to a broad audience.