Increased rates of suicide ideation and attempts in rural dwellers following the SARS‐CoV‐2 pandemic

Abstract

Purpose Those factors identified to increase the risk of suicide in rural dwellers were exacerbated by the SARS‐CoV‐2 pandemic, specifically economic factors, substance use, access to health care, and access to lethal weapons. Because the effects of SARS‐CoV‐2 on suicide ideation and attempts in rural populations have not been fully characterized in published literature, this study compares: (1) the rates of suicide ideation and attempts between the 6 months affected by SARS‐CoV‐2 to same months of the preceding year (3/18/2020‐9/18/20; 3/18/2019‐9/18/19), (2) demographics (ie, age, sex, residence, race, and ethnicity), and (3) the locations in which the encounters were billed (inpatient, outpatient, and emergency department). Methods Deidentified claims data associated with patient encounters billed for Suicide Ideation and Suicide Attempt were grouped based on time period and analyzed using descriptive statistics, incidence rate ratio (IRR), 2‐sample t ‐test, chi‐square test of association, or Fisher's exact test. Findings Suicidal ideation encounters increased in the 6 months post‐SARS‐CoV‐2 when compared to the 6 months of the prior year ( IRR = 1.19; P < .001). Males ( IRR = 1.27, P < .001), those residing rural areas ( IRR = 1.22, P = .01), and Black, non‐Hispanic ( IRR = 1.24, P = .024) were found to have increased rates of suicide ideation post‐SARS‐Cov‐2. In adults, White, non‐Hispanics ( IRR = 1.16; P < .001) had increased rates of post‐SARS‐CoV‐2. In the pediatric subset, those who were aged 14‐17 ( IRR = 1.50; P < .001), resided in rural areas ( IRR = 1.61, P = .009), and idenitifed as Hispanic ( IRR = 1.89; P = .037) or Black, non‐Hispanic ( IRR = 1.61, P = .009) had increased rates post‐SARS‐CoV‐2. Conclusions Our study identified rural dwellers to be at increased risk for suicide ideation.

Suicide before and during the COVID-19 Pandemic: A Systematic Review with Meta-Analysis

“…There were 37 studies with 55 samples (30 non-clinical and 25 clinical samples, respectively) included for the analysis of suicidal ideation. Specifically, several studies contributed more than one sample due to multiple peri-pandemic data collection [ 9 , 65 , 70 , 75 , 106 , 108 ] or subsets of participants [ 75 , 103 , 111 ]. With an average risk of bias score of 7.5 (range = 4–9), the majority of included studies had adequate size and information for their sample, and they employed appropriate sampling and statistical methods.…”

“… Forest plot for suicide attempt of studies [ 16 , 65 , 67 , 69 , 70 , 71 , 73 , 92 , 94 , 95 , 96 , 101 , 103 , 104 , 105 , 106 , 107 , 109 , 110 , 111 ] conducted in the clinical setting (Prismatic colored as red refers to the pooled estimate). …”

Demographic and clinical profile of adolescents suicide attempters admitted to an emergency department during the COVID-19 pandemic – a retrospective cohort study using hospital information system

“…Salt et al. ( 23 ) identified any change in the incidence of suicidal attempts within any demographic subgroup of U.S. pediatric sample in the 6 months post‐SARS‐CoV‐2 when compared to the 6 months of the prior year, most likely due to group size limitations. However, they found an increase in incidence of suicidal ideation among adolescents aged 14–17, and those residing rural areas.…”