Abstract
Background: The COVID-19 pandemic has caused morbidity and mortality, as well as, widespread disruption to people's lives and livelihoods around the world. Given the health and economic threats posed by the pandemic to the global community, there are concerns that rates of suicide and suicidal behaviour may rise during and in its aftermath. Our living systematic review (LSR) focuses on suicide prevention in relation to COVID-19, with this iteration synthesising relevant evidence up to June 7 th 2020. Method: Automated daily searches feed into a web-based database with screening and data extraction functionalities. Eligibility criteria include incidence/prevalence of suicidal behaviour, exposure-outcome relationships and effects of interventions in relation to the COVID-19 pandemic. Outcomes of interest are suicide, self-harm or attempted suicide and suicidal thoughts. No restrictions are placed on language or study type, except for single-person case reports. Results: Searches identified 2070 articles, 29 (28 studies) met our inclusion criteria, of which 14 articles were research letters or pre-prints awaiting peer review. All articles reported observational data: 12 cross-sectional; eight case series; five modelling; and three service utilisation studies. No studies reported on changes in rates of suicidal behaviour. Case series were largely drawn from news reporting in low/middle income countries and factors associated with suicide included fear of infection, social isolation and economic concerns. Conclusions: A marked improvement in the quality of design, methods, and reporting in future studies is needed. There is thus far no clear evidence of an increase in suicide, self-harm, suicidal behaviour, or suicidal thoughts associated with the pandemic. However, suicide data are challenging to collect in real time and economic effects are evolving. Our LSR will provide a regular synthesis of the most up-to-date research evidence to guide public health and clinical policy to mitigate the impact of COVID-19 on suicide. PROSPERO registration: CRD42020183326 01/05/2020.
Highlights
The COVID-19 pandemic is causing widespread societal disruption and loss of life globally
There are concerns about the impact of the pandemic on population mental health (Holmes et al, 2020). These stem from the impact of the virus itself on people infected, as well as front-line workers caring for them (Kisely et al, 2020), and on population mental health from the public health measures that have been implemented to minimise the spread of the virus – in particular physical distancing, leading to social isolation, disruption of businesses, services and education and threats to peoples’ livelihoods
Aim The overarching aim of the review is to identify and appraise any newly published evidence from around the world that assesses the impact of the COVID-19 pandemic on suicide deaths, suicidal behaviours, self-harm and suicidal thoughts, or that assesses the effectiveness of strategies to reduce the risk of suicide deaths, suicidal behaviours, self-harm and suicidal thoughts, resulting from the COVID-19 pandemic
Summary
The COVID-19 pandemic is causing widespread societal disruption and loss of life globally. There are concerns about the impact of the pandemic on population mental health (Holmes et al, 2020) These stem from the impact of the virus itself on people infected, as well as front-line workers caring for them (Kisely et al, 2020), and on population mental health from the public health measures that have been implemented to minimise the spread of the virus – in particular physical distancing, leading to social isolation, disruption of businesses, services and education and threats to peoples’ livelihoods. There are concerns that suicide and self-harm rates may rise during and in the aftermath of the pandemic (Gunnell et al, 2020; Reger et al, 2020). Given the health and economic threats posed by the pandemic to the global community, there are concerns that rates of suicide and suicidal behaviour may rise during and in its aftermath. Outcomes of interest are suicide, self-harm or attempted version 2 (update)
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