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Introduction: In March 2020, the first coronavirus disease 2019 (COVID-19) cases were reported in New York and a stay-at-home order was enacted soon after. Social isolation combined with pandemic-related stressors profoundly affected mental health. We hypothesize that there was an increase in violent suicide attempt during the COVID-19 pandemic lockdown compared to previous years. Methods: We queried our institutional trauma registry for total number of trauma activations and identified adult patients with International Classification of Diseases-10 diagnosis of intentional self-harm. We compared incidence during the lockdown to corresponding time periods from previous years. Demographic and injury characteristics were compared, as were outcomes such as mortality. Results: We observe a significant uptrend in patients requiring trauma intervention after suicide attempts from July 2019 through July 2020 (r = 0.8, P < 0.001) despite a significant downtrend in trauma volume at our institution during the same period (r = [FIGURE DASH]0.7, P = 0.003). Although not statistically significant, patients attempting violent suicide during lockdown were more likely to have preexisting psychiatric diagnoses, to live alone, to have injury severity score >9, and to require surgical intervention. Three COVID-period patients died in the emergency room compared to zero in the comparison group. Conclusion: Our data show a rise in violent suicide attempts during the pandemic lockdown despite an overall decrease in trauma volume. The ramifications of a stay-at-home order seem to have the most profound impact on individuals with preexisting mental health disease. Early establishment of mental health outreach programs may mitigate the reverberating psychosocial consequences of a pandemic.

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INNOVATIONSM arginalized groups, defined as those individuals who experience limited access to health care resources due to social structures and identities, experience a higher frequency of traumatic injury and are more likely to report negative experiences in the health care setting (Baah et al., 2019;Dicker et al., 2021).Black males aged 15-44 years are at risk for recidivism of violent trauma (Richardson et al., 2016), with subsequent violent injuries more likely the result of penetrating injuries (Kao et al., 2019), and each successive event more likely to be lethal (Nygaard et al., 2017).Trauma center staff are prone to compassion fatigue and patient blaming, resulting in poor patient interactions and outcomes, particularly for marginalized groups (Dicker et al., 2021). The health care community should understand the experiences of marginalized people to address their health disparities and promote health equity. Understanding the vulnerabilities of these populations and their social determinants of health could improve the care of marginalized patients (Baah et al., 2019).The project development began after a witnessed patient encounter in which a patient's family expressed concerns regarding the influence of race on the outcomes of care. This experience caused a level of discomfort for the providers, making them unsure of how to