Researchers say suicide prevention should be part of COVID-19 response plans

Secondary consequences of the novel coronavirus (COVID-19), such as economic stress, social isolation, and barriers to mental health treatment, may increase the risk of suicide, according to a new commentary by Mark Reger, PhD, of the University of Washington in Seattle, published in the journal JAMA Psychiatry.

Suicide rates have been on the rise in the United States over the last two decades, with the latest data from 2018 showing the highest suicide rate since 1941. Social distancing interventions have been implemented to reduce the rate of COVID-19 infections but the potential for adverse outcomes on suicide risk is high, the authors said.

Additionally, research shows healthcare professionals are at an increased risk for suicide, an at-risk group that is now serving in the front lines against COVID-19. A national discussion is emerging about healthcare workers’ concerns about infection, exposure of family members, sick colleagues, shortages of necessary personal protective equipment, overwhelmed facilities, and work stress. This special population deserves support and prevention services, the authors said.

It is important to consider changes in a variety of economic, psychosocial, and health-associated risk factors, according to the commentary. Actions could be taken to mitigate potential unintended consequences on suicide prevention efforts, which also represent a national public health priority.

The authors make the following recommendations as suicide prevention opportunities: 

Physical Distance, Not Social Distance

Efforts can be made to stay connected and maintain meaningful relationships by telephone or video, especially among individuals with substantial risk factors for suicide. Social media solutions can be explored to facilitate these goals.

Tele-Mental Health

There is national momentum to increase the use of telehealth in response to COVID-19. Unfortunately, tele-mental health treatments for individuals with suicidal ideation have lagged far behind the telehealth field. Research, culture change, and potentially even legislative protections are needed to facilitate delivery of suicide prevention treatments to individuals who will otherwise receive nothing.

Increase Access to Mental Healthcare

As COVID-19 precautions develop in healthcare settings, it is essential to consider the management of individuals with mental health crises. Screening and prevention procedures for COVID-19 that might reduce access to care could include screening for mental health crises. Also, rather than sending a patient with a child home, alternative treatment settings could be considered, according to the paper.

Distance-Based Suicide Prevention

There are evidence-based suicide prevention interventions that were designed to be delivered remotely. For example, some brief contact interventions such as telephone-based outreach and the Caring Letters intervention have reduced suicide rates in randomized clinical trials. Follow-up contact may be especially important for individuals who are positive for COVID-19 and have suicide risk factors, the authors said.

Media Reporting

Because of suicide contagion, media reports on this topic should follow reporting guidelines and include the National Suicide Prevention Lifeline (1-800-273-TALK(8255)). The hotline remains open.

Editor's note: If you or someone you know is considering suicide, call the National Suicide Prevention Hotline at 1-800-273-8255. Click here for more information and ongoing COVID-19 updates for integrative healthcare professionals.