Impact of the COVID-19 pandemic on suicidal attempts and death rates: a systematic review

Background The COVID-19 pandemic has exacerbated the risk factors associated with suicidal behavior and thus, prioritizing its prevention is recommended. Methods This study systematically reviewed the global evidence on the incidence of suicide/suicidal attempts and the trend in suicidal rates during the COVID-19 pandemic. Cross-sectional and cohort studies investigating the outcomes of suicidal death and suicidal attempts at any setting during the COVID-19 pandemic were searched in Medline, Embase, and PsycINFO databases for papers published from December 2019 to May 2021. Results Out of 1052 studies18 studies with 12,746 suicidal attempts and 33,345 suicidal deaths were included in the final analysis. The mental health impact of social distancing, COVID-19 quarantine, and financial crises due to loss of employment were associated risk factors with suicide and/or suicidal attempts during the COVID-19 pandemic. Six common thematic recommendations for preventing suicidal deaths and suicidal attempts were identified. Conclusions Unexpected behavior changes during the COVID-19 pandemic may have contributed to the increasing trend of suicidal attempts reported. Domestic conflicts and violence, financial loss, anxiety and depression, and pre-existing mental health condition/s should be considered in preventing suicidal attempts and deaths secondary to the COVID 19 pandemic. Early detection and timely intervention for individuals with suicidal behavior is crucial and collated recommendations in the current study can be utilized for those preventive interventions. More systematic suicide risk screening process should be introduced who are at risk, along with an evidence base prevention approach.

Automated summary

The COVID-19 pandemic has increased the risk factors for suicidal behavior, and this study systematically reviewed global evidence on the incidence and trends of suicide and suicidal attempts during the pandemic. The mental health impact of social distancing, quarantine, and financial crises were identified as associated risk factors. Six common recommendations for preventing suicide were identified. Considering domestic conflicts and violence, financial loss, anxiety and depression, and pre-existing mental health conditions is important in preventing suicide during the COVID-19 pandemic. Early detection and timely intervention are crucial, and the recommendations from this study can be utilized for preventive interventions.