As the world continues to struggle against the coronavirus, and the U.S. is hit with a record number of cases, a new paper in the journal Brain, Behavior, and Immunity points to a troubling trend of global COVID-19 suicides. Using cases of COVID-19-related suicides in the U.S., Italy, Britain, Germany, Saudi Arabia, India, and Bangladesh, the authors highlight four major risk factors:
1. Social Distancing and Isolation. Globally, COVID-19 fears have created serious emotional distress. The isolation created by social distancing orders has been upsetting for many and may intensify existing mental health conditions, including depression and suicidality. The authors detail cases from India, the U.S., Saudi Arabia, and Britain, in which COVID-19 isolation likely contributed to death by suicide. In one case, for example, a Chinese student studying in a Saudi Arabian university died by suicide. The student had been isolated in hospital quarantine due to suspected coronavirus infection.
2. Economic Recession Stemming from COVID-19 Lockdowns. The COVID-19 epidemic has precipitated a global economic crisis, which will likely intensify the risk of suicides related to unemployment and economic distress. The authors argue that uncertainty, feelings of hopelessness, and a sense of worthlessness may increase suicide rates. In Germany, for example, a finance minister died by suicide near Frankfurt in late March 2020. He reportedly felt despair over the economic impacts of the coronavirus pandemic.
3. Healthcare Professionals’ Stress and Trauma. Globally, there is evidence that healthcare providers are at increased risk for mental ill-health during the coronavirus epidemic. Stressors include extreme stress, fear of illness, a sense of helplessness, and trauma related to witnessing patients die alone. All of this will likely increase the risk of suicide among healthcare professionals, the authors argue. In Britain, for example, an intensive care nurse died by suicide in a London hospital. Her death occurred while she was caring for COVID-19 patients, eight of whom had died.
4. Stigma and Discrimination. Mistreatment due to COVID-19 stigma, the authors argue, may explain emerging cases of suicide around the world. In India, for example, a man died by suicide after “facing social boycott and religious discrimination” related to his neighbors’ suspicion that he might have COVID-19. In Bangladesh, another man died by suicide after being isolated by his neighbors due to his coronavirus diagnosis.
To address the risks of COVID-19 related suicide, the authors suggest a series of actions. For everyone, these include:
- Limiting exposure to COVID-19 news, and relying on only trustworthy news sources.
- Finding ways to connect socially and limit isolation, while adhering to social distancing.
- Engaging in mindfulness and other mental health-promoting exercises.
- Monitoring loved ones, and ensuring that those struggling feel supported and loved.
For health professionals specifically, recommendations include:
- Expanding the availability and accessibility of tele-counseling.
- Increasing mental health support for medical professionals fighting COVID-19.
Despite the likely efficacy of such actions, the authors caution, more needs to be done. Globally, the race is on for vaccines for SARS-CoV-2 and antivirals to treat COVID-19. Similar work must develop psychological and social interventions to prevent the mental health damages being wrought by COVID-19, the authors argue. We are just beginning to see these psychological harms develop, but the need for mental health care will likely extend far into the future.
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Thakur, V., & Jain, A. (2020). COVID 2019-suicides: A global psychological pandemic. Brain, behavior, and immunity. doi: 10.1016/j.bbi.2020.04.062