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6 results

  • Has the COVID-19 pandemic influenced suicide rates differentially according to socioeconomic indices and ethnicity? More evidence is needed globally

  • Roger T. Webb, Ann John, Duleeka Knipe, Lana Bojanić, Dana Dekel, Emily Eyles, Amanda Marchant, Faraz Mughal, Jane Pirkis, Lena Schmidt, David Gunnell
  • Journal:
    Epidemiology and Psychiatric Sciences / Volume 31 / 2022
    Published online by Cambridge University Press:
    11 October 2022, e72
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  • The COVID-19 pandemic has harmed many people's mental health globally. Whilst the evidence generated thus far from high-income countries regarding the pandemic's impact on suicide rates is generally reassuring, we know little about its influence on this outcome in lower- and middle-income countries or among marginalised and disadvantaged people. There are some signals for concern regarding the pandemic's potentially unequal impact on suicide rates, with some of the affected demographic subgroups and regions being at elevated risk before the pandemic began. However, the evidence-base for this topic is currently sparse, and studies conducted to date have generally not taken account of pre-pandemic temporal trends. The collection of accurate, complete and comparable data on suicide rate trends in ethnic minority and low-income groups should be prioritised. The vulnerability of low-income groups will likely be exacerbated further by the current energy supply and cost-of-living crises in many countries. It is therefore crucial that reassuring messaging highlighting the stability of suicide rates during the pandemic does not lead to complacency among policymakers.

  • The impact of the COVID-19 pandemic on presentations to health services following self-harm: systematic review

  • Sarah Steeg, Ann John, David J. Gunnell, Nav Kapur, Dana Dekel, Lena Schmidt, Duleeka Knipe, Ella Arensman, Keith Hawton, Julian P. T. Higgins, Emily Eyles, Catherine Macleod-Hall, Luke A. McGuiness, Roger T. Webb
  • Journal:
    The British Journal of Psychiatry / Volume 221 / Issue 4 / October 2022
    Published online by Cambridge University Press:
    11 July 2022, pp. 603-612
    Print publication:
    October 2022
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  • Background

    Evidence on the impact of the pandemic on healthcare presentations for self-harm has accumulated rapidly. However, existing reviews do not include studies published beyond 2020.

    Aims

    To systematically review evidence on presentations to health services following self-harm during the COVID-19 pandemic.

    Method

    A comprehensive search of databases (WHO COVID-19 database; Medline; medRxiv; Scopus; PsyRxiv; SocArXiv; bioRxiv; COVID-19 Open Research Dataset, PubMed) was conducted. Studies published from 1 January 2020 to 7 September 2021 were included. Study quality was assessed with a critical appraisal tool.

    Results

    Fifty-one studies were included: 57% (29/51) were rated as ‘low’ quality, 31% (16/51) as ‘moderate’ and 12% (6/51) as ‘high-moderate’. Most evidence (84%, 43/51) was from high-income countries. A total of 47% (24/51) of studies reported reductions in presentation frequency, including all six rated as high-moderate quality, which reported reductions of 17–56%. Settings treating higher lethality self-harm were overrepresented among studies reporting increased demand. Two of the three higher-quality studies including study observation months from 2021 reported reductions in self-harm presentations. Evidence from 2021 suggests increased numbers of presentations among adolescents, particularly girls.

    Conclusions

    Sustained reductions in numbers of self-harm presentations were seen into the first half of 2021, although this evidence is based on a relatively small number of higher-quality studies. Evidence from low- and middle-income countries is lacking. Increased numbers of presentations among adolescents, particularly girls, into 2021 is concerning. Findings may reflect changes in thresholds for help-seeking, use of alternative sources of support and variable effects of the pandemic across groups.