COVID-19 and Suicidal Behaviour The International COVID Suicide Prevention Research Collaboration (ICSPRC)

COVID-19 & Suicidal Behaviour: The International COVID Suicide Prevention Research Collaboration (ICSPRC)

It’s now over 2 years since the onset of the COVID-19 pandemic. Almost 6 million people have lost their lives and 400 million people have been diagnosed with COVID around the globe. The last few months have seen a new wave of infections with the omicron variant of the virus once again putting populations and health systems under strain. Vaccine roll-out programmes have helped reduce case fatality from infection, but there are huge international inequalities in access to the vaccine.

With the help of IASP, the International COVID Suicide Prevention Research Collaboration (ICSPRC) was established in early 2020. We now have over 150 members drawn from 42 countries in all regions of the world. It’s been fantastic to see the willingness of colleagues to share early data and experiences about how best to reduce the risk of suicide during these challenging times.

The suicide research community has not been idle during the pandemic, a quick check of our Living Review searches and screening shows that over 800 papers on the impact of the pandemic on suicide and suicidal behaviour have been published to date.

Impact of COVID-19 on suicide rates worldwide

Despite widespread evidence from across the globe about the adverse impact of the pandemic – and its associated public health protection measures – on population mental health, suicide rates in most countries appear, to date, to have been little affected. Indeed, as Professor Jane Pirkis and colleagues’ recent Lancet Psychiatry paper showed us, many countries experienced falls in suicide rates in the first few months of the pandemic. There have been exceptions to this pattern, with suicide rate rises reported in Japan throughout the pandemic, particularly amongst females. More recently rises have been reported from India, Nepal and Hungary. So it is important we all remain vigilant and share lessons learnt about how to prevent suicide in these challenging times.

Jane and the team are currently updating their synthesis of international suicide trend data. They have pulled together age, sex and method-specific suicide rates from 34 different countries (25 high income, 6 upper middle income, and 3 lower middle income) up to December 2020. Data from some countries are available up to June 2021. A huge thanks to all involved, but particularly Profs Ann John and Matt Spittal and our team of ECRs (Sangsoo Shin, Marcos DelPozo-Banos, Vikas Arya). They have a fantastic group of nearly 100 collaborators who have helped them source data from around the world and are currently working with them to finalise a journal article.

Prof Ann John is now leading a second analysis which is looking at any changes in suicide methods that may have occurred alongside the pandemic. The group is keen to maintain this international suicide surveillance initiative and to source new data from low and middle-income countries which have so far been under-represented in the analysis. They are particularly interested in identifying data from Africa. Please get in touch if you have relevant data.

Impact of COVID-19 pandemic on self-harm

Louis Appleby, Rory O’Connor and Maddeline Mooney are leading an initiative to identify international data on trends in self-harm/suicide attempts during the pandemic. A huge thanks to everyone who responded to the recent call for information on the data they have access to and particularly to Maddeline for pulling this all together. The team have identified national-level data on ED attendance for self-harm for 6 countries, with subnational data available for a further 10 countries. Hospitalisation and other administrative data on self-harm were reported for an additional 6 countries. The main gaps in reported data relate to Africa.

Reflecting on the first year of the pandemic

The most recent ICSPRC output is Dr Mark Sinyor and colleagues’ reflections on the first year of the pandemic. They speculate that an explanation for suicide rates not rising early in the pandemic may be that the collective trauma felt by all groups in the population “normalised” distress leading to a sense that “we’re all in this together”; families and communities came together to support one another. As the pandemic subsides we need to be mindful that some people, perhaps particularly those with pre-existing mental illness and other vulnerabilities, may feel left behind by the recovery. Mark reminds us that we need to continue to make policymakers and others aware of the importance of:

a) mitigating the negative effects of economic recession/unemployment;
b) minimising the long-term harm to educational and career prospects of young people;
c) ensuring there is timely access to high-quality mental health and suicide prevention interventions;
d) public health and media messaging emphasizing healthy coping, emotional resilience and avoiding presentation of suicide as an inevitable or common reaction to the pandemic and
e) promoting social cohesion especially in places and at times when social discord/division may be emerging

Webinar programme

One of the successes of the ICSPRC initiative has been its monthly webinar programme. This has helped researchers and policymakers around the world keep up to date with the latest data on the impact of the pandemic and share experiences about prevention initiatives. In an exciting collaboration between IASP and IASR (the International Academy for Suicide Research) we aim to continue the webinar programme, but gradually shift its focus away from COVID as the pandemic subsides. The new initiative will be led by Professors Lai-Fong Chan (IASP Board member, Malaysia) and Holly Wilcox (IASR President-elect, USA) who are pulling together an internationally representative steering group to run the programme long term.

Workshop at European Symposium on Suicide and Suicidal Behaviour, Copenhagen (24-27 August 2022) 

We’re planning to host a pre-conference workshop at the European Symposium on Suicide and Suicidal Behaviour in Copenhagen on the 24th of August 1 PM-4 PM. This will be an opportunity to update people on the latest research into the impact of the pandemic on suicide and suicidal behaviour and exchange ideas about the next steps with the collaboration.

We’re also hoping to hear about clinical developments/learning arising from the pandemic. Please get in touch with me if you have any experiences you’re able to share with the group.

We’re hugely grateful for the brilliant support the IASP team (Jackie Etches and Wendy Cliff) have provided to the programme. 

David Gunnell
Chair of ICSPRC Steering Group


Links to ISPRC resources:
Dr Duleeka Knipe and colleagues advise to journal editors and publishing houses on safer reporting and publishing.
See: https://www.bmj.com/content/372/bmj.n351 and YouTube video: https://youtu.be/gozDLnnuo7A

A COVID-19 Suicide Research Study Register. We encourage all researchers working on COVID-19 related studies of suicide and suicidal behaviour to share detail to facilitate collaboration.

An editorial in Crisis, led by Thomas Niederkrotenthaler, summarising research considerations in relation to COVID-19: https://econtent.hogrefe.com/doi/full/10.1027/0227-5910/a000731

Advice on questions/survey tools relevant to suicide prevention research in relation to COVID-19: https://iasp.info/wp-content/uploads/ICSPRC_COVID_advice_on_questions.pdf

Mark Sinyor’s editorial/comment piece in Archives of Suicide Research reflecting on the impact of COVID-19 on suicide risk one year into the pandemic: https://www.tandfonline.com/doi/full/10.1080/13811118.2021.1955784

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