March 16, 2022

Statistics Show Reduction in Lives Lost to Suicide in 2020, Continued Need for Research and Prevention

Most of us will agree that 2020 was a year unlike anything we had experienced, as the world shut down in the face of a pandemic threat that was confusing, invasive, and ever-evolving. As we became more isolated and anxious, it was heartening to see open conversations about mental health and widespread recommendations for supportive lifestyle choices such as adequate sleep, exercise, and time in the outdoors. We also heard frequent expert warnings about potential increases in mental health disturbances, crises, and suicide. Now the mortality statistics are out, and additional research is underway.

Surprising to some is that lives lost to suicide in 2020, as reported by the Centers for Disease Control and Prevention (CDC), showed a decrease of 3% from 2019. That said, nearly 46,000 lives were ended too soon.

In those aged 10-64, suicide remained a top 10 cause of death, and for those 10-34, again ranked second only to accidents. Suicide rates declined by 8% among females and 2% among males, particularly in large metropolitan areas. However, demographic disparities revealed increasing rates in those aged 25-34, Hispanic males, and non-Hispanic multi-racial females. Suicide rates remained high in rural areas, with the mountain states and Alaska continuing to show the highest rates. Additional insights are highlighted in this NPR piece.

Even as suicide rates declined in 2019 and again in 2020, concerns about the long term effects of COVID-19 on mental health and suicide rates are considerable. As the CDC highlights in their report, data from prior disasters indicate that rates often stabilize or decline within a crisis period, only to rise afterwards as the longterm effects on those affected take hold. 

Suspected Suicide Attempts showed Increases

Additional research has shown an increase in suicidal thoughts and attempts in youth visits to Emergency Departments. While this may reflect increased distress, these numbers also suggest a possible (positive) increase in help seeking behavior. This study indicated that suspected suicide attempt visits increased substantially through the pandemic, most notably in girls ages 12-17.

As a result of concerns surrounding America’s youth, in November a consortium declared a National Emergency in Child and Adolescent Mental Health.  Recently the American Academy of Pediatrics (AAP) and American Foundation for Suicide Prevention (AFSP), in collaboration with experts from the National Institute of Mental Health (NIMH), published the Blueprint for Youth Suicide Prevention to aid pediatric health professionals in approaches to suicide screening and prevention.

Infection Raises Risk of Later Psychiatric Concerns

Furthermore, studies of those who experienced a COVID-19 infection reflect increased risk for psychiatric and neurological complications, which, in turn, can raise risks for suicide. Complication risks were increased in those with severe cases.

An article in Science highlighted a study in U.S. Veterans that reflected psychiatric concerns evident a year after initial infection. The researchers found that “survivors of COVID-19 were 46% more likely than pandemic-era controls to have been diagnosed with any of 14 neuropsychiatric disorders. These included depression, suicidal thoughts, anxiety, sleep disturbance, opioid use disorder, and neurocognitive decline or “brain fog.”” Here too, those who had been hospitalized for COVID-19 experienced the highest rates of these disorders. 

The pandemic may provide increased impetus and opportunity for science to better understand the effects of physical illness on our mental health, since these connections are still poorly understood. As the Science article reports, “Neuroimmunologist Cecilie Bay-Richter of Aarhus University notes that just how infection could damage mental health is unclear. She says animal studies will be needed “to be able to truly disentangle the direct, biological causes from the indirect causes” of long-term neuropsychiatric conditions.”

As the CDC highlights, suicide is preventable. The agency promotes a comprehensive approach and evidence-based strategies. At JKBF, we believe investigation of the effects of the biology (e.g. immune, inflammatory, cardiac, neurological systems), as well as the psychology, of the pandemic may help to provide insights into factors that have been mostly overlooked with respect to mental health and suicide prevention. While we need screening and behavioral health referrals as outlined in the Blueprint mentioned above, investigation and understanding of biological influences may provide these primary and behavioral health care providers with a broader range of assessment and treatment tools.

Perhaps, future investigations of the virus that took so many lives can lead to insights and appreciation of mind-body connections that will save lives and reducing suffering in the future.