Abstract
Aims: We aimed to determine whether there has been a change in the number of suicides occurring in three Australian states overall, and in age and sex subgroups, since the COVID-19 pandemic began, and to see if certain risk factors for suicide have become more prominent as likely underlying contributing factors for suicide.Method: Using real-time data from three state-based suicide registers, we ran multiple unadjusted and adjusted interrupted time series analyses to see if trends in monthly suicide counts changed after the pandemic began and whether there had been an increase in suicides where relationship breakdown, financial stressors, unemployment and homelessness were recorded.Results: Compared with the period before COVID-19, during the COVID-19 period there was no change in the number of suicides overall, or in any stratum-specific estimates except one. The exception was an increase in the number of young males who died by suicide in the COVID-19 period (adjusted RR 1.89 [95% CI 1.11–3.23]).The unadjusted analysis showed significant differences in suicide in the context of unemployment and relationship breakdown during the COVID-19 compared to the pre-COVID-19 period. Analysis showed an increase in the number of suicides occurring in the context of unemployment in the COVID-19 period (unadjusted RR 1.53 [95% CI 1.18–1.96]). In contrast, there was a decrease in the number of suicides occurring in the context of relationship breakdown in the COVID-19 period (unadjusted RR 0.82 [95% CI 0.67–0.99]). However, no significant changes were identified when the models were adjusted for possible over-dispersion, seasonality and non-linear trend.Conclusion: Although our analysis found no evidence of an overall increase in suicides after the pandemic began, the picture is complex. The identified increase in suicide in young men indicates that the impact of the pandemic is likely unevenly distributed across populations. The increase in suicides in the context of unemployment reinforces the vital need for mitigation measures during COVID-19, and for ongoing monitoring of suicide as the pandemic continues.
Highlights
The coronavirus disease 2019 (COVID-19) pandemic has had damaging health, social and economic impacts across the world
Using real-time suicide data from the iQSR, the Victorian Suicide Register (VSR) and the Tasmanian Suicide Register (TSR) that is largely drawn from police reports, we ran multiple interrupted time-series analyses (ITSA) to ascertain whether trends in monthly suicide counts changed after the pandemic began and whether there had been an increase in suicides where relationship breakdown, financial stressors, unemployment and homelessness were recorded
Compared with the pre-COVID-19 period, during the COVID-19 period there was no change in the number of suicides overall, or in any stratumspecific estimates except one
Summary
The coronavirus disease 2019 (COVID-19) pandemic has had damaging health, social and economic impacts across the world. In some countries the health impacts were predominately the large number of deaths directly resulting from COVID-19 [1]. In countries like Australia, where COVID-19 cases and deaths have been fewer, the health impacts are likely due to the consequences of social distancing and stay-at-home orders [2]. There has been considerable concern about the mental health of populations during this time, concerns that suicides might increase as a consequence of the pandemic [3,4,5]. People may be unable, or less likely to access mental health care, due to barriers associated with stayat-home directives and general fear of contracting COVID-19. Recent findings from Japan suggest this caution is warranted; after an initial reduction in suicide in that country, there was a subsequent increase [10, 11]
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