This story discusses suicide. If you or someone you know is at risk of suicide please call the U.S. National Suicide Prevention Lifeline at 800-273-8255, text TALK to 741741 or go to SpeakingOfSuicide.com/resources for additional resources.
Staying at home and avoiding others is the best way to slow the spread of COVID-19, but it’s awful for mental health. A new opinion paper in JAMA Psychiatry examines how public health best practices during the coronavirus pandemic could lead to an increased risk of suicide.
“Human connection is really good for people and isolation is bad for people,” Dr. Ken Duckworth, the medical director of the National Alliance on Mental Illness (NAMI), who did not participate in paper, told TODAY. “No social interaction will harm mental health, and less connection … is going to cause additional stress for people.”
The paper looks at the coronavirus pandemic and compared it to other national disasters, such as the terrorist attacks on September 11, 2001. Generally, after a traumatic event, suicide rates lower for a brief period of time. But the coronavirus pandemic is different. It comes on the heels of a two-decade increase in suicide rates in the U.S. This, added to a dearth of social connections and a high-stress situation, causes mental health professionals to worry.
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“Some of the interventions that are being implemented to slow the pandemic are the types of interventions that might put someone who is already anxious or depressed or abusing substances at greater risk,” Dr. Maria Oquendo, chair of psychiatry at Perelman School of Medicine at the University of Pennsylvania in Philadelphia, who wasn’t involved in the paper, told TODAY. “Somebody who is already suffering from any kind of psychiatric condition … is going to have a heightened anxiety response.”
After national tragedies, the number of people experiencing mental health conditions rises. The experts worry that this could contribute to increased risk of suicide for months and years to come.
“We know that there are increases in cases of depression, increases in cases of post-traumatic stress disorder and increases in cases of anxiety disorders,” Oquendo explained. “These conditions do increase the risk for suicidal behavior."
What’s more, recent evidence suggests gun purchasing is greater than ever during the pandemic, which also worries experts.
“You have less connection and an increase in access to weapons,” Duckworth said.
People struggling with substance abuse also have less access to public meetings, like Alcoholics Anonymous, while being alone and facing stressors that make using attractive.
“Addiction is going to be a vulnerability for some people,” Duckworth said.
All of these factors combined could contribute to even higher rates of death by suicide.
“The paper is wise to sound the alarm,” Duckworth said.
How to recognize someone in crisis
Friends and family can still help loved ones at greater risk for mental health complications from afar. Phone or video calls can help people understand whether someone is struggling by considering two metrics of mental health.
“Function and safety are the two North stars in mental health. So in this crisis (people should consider): Do you get out of bed? Do you have structure in the day? Do you shower and get dressed? If you have work, can you do it? These are the functional questions,” Duckworth said.
When it comes to safety people should worry if someone is thinking about harming themselves, engaging in self-harm, drinking or using drugs more, or has a plan to die by suicide. If someone is unsafe they might need immediate intervention.
Getting help from a distance
As social distancing became the norm, most mental health professionals quickly switched to offering teletherapy and telepsychiatry.
“Telepsychiatry can have outcomes that are just as good as being seen in person. We’re very fortunate in a way that most of the information that we need to help someone with a psychiatric diagnosis can be conveyed verbally,” Oquendo said.
At the beginning of the pandemic Oquendo said fewer people were seeking help at emergency rooms and psychiatric hospitals as they likely feared being exposed to COVID-19. Though now people seem to be seeking crisis mental health intervention if needed, and they should seek emergency care if they're a danger to themselves or others. If people need resources they also can contact the U.S. Suicide Prevention Lifeline.
Experts stress that people can support friends and family with mental health conditions by just calling or video chatting.
“The video communications go a very long way in terms of feeling connected,” Oquendo said. “Of course you can’t give someone a hug over a video call but you certainly can make an empathic connection and have meaningful conversations.”