Abstract During the COVID-19 pandemic, individuals’ mental health faced substantial challenges. This study aims to provide a comprehensive examination of the pandemic’s impact on suicide rates in Austria, with a particular focus on variations by gender, region, and age. The study employs a regression discontinuity in time design and an interrupted time series analysis, utilising monthly death records from January 2015 to December 2021. To account for seasonal variations and potential underreporting of suicides, harmonic Fourier terms are incorporated into the analysis, and both suicides with intended self-harm and self-harm with undetermined intent are included. While existing research offers valuable insights into the impact of the pandemic on suicidal behaviour, it does not yet allow for specific conclusions to be drawn for Austria. In contrast to the methods typically employed in previous research on other countries, this approach enables a comprehensive examination of the temporal effects surrounding the implementation and lifting of pandemic-related measures. The study reveals a significant negative trend in Austria’s suicide rates before the start of the pandemic and more suicides than expected after its onset. In particular, the number of suicides among men aged 64-85 and women in the age groups 0-19, 20-34, and 65-84 was significantly higher than expected. Conversely, the data indicated a positive impact among women aged 35-64. This study contributes to understanding the impact of the pandemic on suicide rates in Austria. It demonstrates that, even within the same country, the impact can differ by gender, age, and region, thereby supporting the need for subgroup analysis. It also highlights that potential underreporting of suicides may result in an underestimation of the impact of the pandemic on suicides in previously conducted studies. Understanding these nuances is crucial for suicide prevention and informing policy decisions to improve health system resilience. Key messages • The study found higher than expected suicide rates in Austria during the COVID-19 pandemic, especially among men aged 64-85 and women aged 0-19, 20-34, and 65-84. • The underreporting of suicides may result in an underestimation of the impact of COVID-19 on suicides in previously conducted studies.
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