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Suicide risk during Covid-19

By now Covid-19 is all everybody’s talking about, every network is swarming with discussions round the clock: television, newspapers and social media are flooded and everyone has their own opinion about it. There’s no shortage of people standing up as experts in the field and using it as their own workhorse to start or encourage a conversation that in these times is precious. This pandemic has prompted all the competent authorities to take preventive measures and to broadcast them as if they were manna to everyone, to curb the spread of the virus.

Notable social distancing interventions have been implemented to reduce direct human contact. While these steps are expected to slow down the rate of new infections, the mental health effects of the Covid-19 pandemic might be profound and suicide risk is high. Suicide is likely to become a more pressing concern as the pandemic has longer-term effects on the general population, above all on vulnerable groups.

There is some evidence that deaths by suicide increased exponentially in almost every country during the 1918–19 influenza pandemic; but it’s not necessary to go back a century to prove the veracity of the concern: most recent is, for example, the case of Hong Kong, where the severe acute respiratory syndrome (SARS) epidemic led to the death of a large number of people in 2003. The current context is different and evolving.

The likely negative effects of the pandemic on people’s mental health might be aggravated by fear, self-isolation and physical distancing. Suicide risk might be boosted because of stigma towards individuals with Covid-19 and their relatives. Those with psychiatric disorders are among the most exposed and vulnerable since they might experience worsening symptoms, others might develop new mental health diseases, especially depression, anxiety, and post-traumatic stress. These problems will be affecting the general population no holds barred, as well as people with high levels of exposure to illness caused by Covid-19, such as those who develop the virus and frontline health-care workers.

Actions should be taken to mitigate potential unintended consequences. A wide-ranging interdisciplinary operation that focuses on – and extends beyond– general mental health policies is key. Suicide prevention therefore needs urgent consideration. Some services are already developing expertise in carrying out psychiatric assessments and delivering interventions remotely. For example, some brief contact interventions (telephone-based outreach) and the Caring Letters intervention (in which letters are sent through the mail) seem to be working. These checking-up practices should be implemented more widely, even if there is a substantial probability of affecting individuals’ sensitivity and privacy since some patients may not feel comfortable with such interactions.

To avoid mistakes or overlooks, making evidence-based online resources and interventions freely available at scale could benefit population mental health. Moreover, since loss of employment and financial problems are well-recognised risk factors for suicide, governments are trying – funds allowing ­­­– to provide financial safety nets such as free food and unemployment support.

Therefore, it’s fundamental to make the best out of a bad situation and take advantage of social devices. First of all, despite its name, social distancing entails physical space between people, not social distance. Staying connected and maintaining relationships by telephone or video, especially among individuals with substantial risk factors for mental stability, is crucial.

There may be a silver lining to the current situation: history teaches that after catastrophic acts we get a new lease of life and for instance suicide rates have declined in the past period after national disasters. So, let’s hope to trigger the so-called “pulling-together effect”, whereby individuals undergoing a shared experience might support one another, strengthening social relationships.

Here you can find the European SOS number according to your home country.

By Giulia Peroni

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