The impact of the COVID-19 pandemic on self-harm and suicidal behaviour
Abstract
Background: The COVID-19 pandemic has caused morbidity and mortality, as well as, widespread disruption to people’s lives and livelihoods around the world. Given the health and economic threats posed by the pandemic to the global community, there are concerns that rates of suicide and suicidal behaviour may rise during and in its aftermath. Our living systematic review (LSR) focuses on suicide prevention in relation to COVID-19, with this iteration synthesising relevant evidence up to June 7th 2020.
Method: Automated daily searches feed into a web-based database with screening and data extraction functionalities. Eligibility criteria include incidence/prevalence of suicidal behaviour, exposure-outcome relationships and effects of interventions in relation to the COVID-19 pandemic. Outcomes of interest are suicide, self-harm or attempted suicide and suicidal thoughts. No restrictions are placed on language or study type, except for single-person case reports.
Results: Searches identified 2070 articles, 29 (28 studies) met our inclusion criteria, of which 14 articles were research letters or pre-prints awaiting peer review. All articles reported observational data: 12 cross-sectional; eight case series; five modelling; and three service utilisation studies. No studies reported on changes in rates of suicidal behaviour. Case series were largely drawn from news reporting in low/middle income countries and factors associated with suicide included fear of infection, social isolation and economic concerns.
Conclusions: A marked improvement in the quality of design, methods, and reporting in future studies is needed. There is thus far no clear evidence of an increase in suicide, self-harm, suicidal behaviour, or suicidal thoughts associated with the pandemic. However, suicide data are challenging to collect in real time and economic effects are evolving. Our LSR will provide a regular synthesis of the most up-to-date research evidence to guide public health and clinical policy to mitigate the impact of COVID-19 on suicide.
Author
Corresponding author: Ann JohnCompeting interests: DG: member of the Department of Health and Social Care (England) National Suicide Prevention Strategy Advisory Group. DG has grants from the National Institute for Health Research (NIHR) outside the submitted work and is a member of Samaritans Policy and Research Committee and Movember’s Global Advisory Committee. AJ: chair of the National Advisory Group on Suicide and Self-harm Prevention to Welsh Government and is national lead on suicide prevention for Public Health Wales. She reports grants from Medical Research Council (MRC) and MQ KH: member of the Department of Health and Social Care (England) National Suicide Prevention Strategy Advisory Group. He reports grants for DHSC and the Global Challenges Research Fund. NK: member of the Department of Health and Social Care (England) National Suicide Prevention Strategy Advisory Group and sits on committees for the National Institute for Health and Care Excellence to develop clinical guidelines for depression and self-harm. He reports grants outside the submitted work from NIHR, DHSC, and the Health Care Quality Improvement Partnership.Grant information: This work was supported by Swansea University and the University of Bristol.
DG, BKO, JPTH are supported by the NIHR Bristol Biomedical Research Centre [IS-BRC-1215-20011].
JPTH and EE are suported by the NIHR Applied Research Collaboration West.
LAMcG is by the NIHR through a NIHR Doctoral Research Fellowship [DRF-2018-11-ST2-048].
LS is supported by the NIHR through a NIHR Systematic Reviews Fellowship [RM-SR-2017-09-028].
AJ and CO are supported by the Swansea University Cochrane Satellite for Suicide and Self-Harm Prevention.
AJ is supported by the National Centre for Mental Health [HCRW-CA04]
NK and RW are supported by the NIHR Greater Manchester Patient Safety Translational Research Centre [PSTRC-2016-003].
The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Copyright: © 2020 John A et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.How to cite: John A, Okolie C, Eyles E et al. The impact of the COVID-19 pandemic on self-harm and suicidal behaviour: a living systematic review [version 1; peer review: awaiting peer review]. F1000Research 2020, 9:1097 (https://doi.org/10.12688/f1000research.25522.1)