Suicide Deaths during the Stay-at-Home Advisory in Massachusetts

Abstract

Many believe that shelter-in-place or stay-at-home policies might cause an increase in so-called deaths of despair. While increases in psychiatric stressors during the COVID-19 pandemic are anticipated, whether suicide rates changed during stay-at-home periods has not been described. This was an observational cohort study that assembled suicide death data for persons aged 10 years or older from the Massachusetts Department of Health Registry of Vital Records and Statistics from January 2015 through May 2020. Using autoregressive integrated moving average (ARIMA) and seasonal ARIMA to analyze suicide deaths in Massachusetts, we compared the observed number of suicide deaths in Massachusetts during the stay-at-home period (March through May, 2020) in Massachusetts to the projected number of expected deaths. To be conservative, we also accounted for the deaths still pending final cause determination The incident rate for suicide deaths in Massachusetts was 0.67 per 100,000 person-month (95% CI 0.56-0.79) versus 0.81 per 100,000 person-month (95% CI 0.69-0.94) during the 2019 corresponding period (incident rate ratio of 0.83; 95% CI 0.66-1.03). The addition of the 57 deaths pending cause determination occurring from March through May 2020 and the 33 cases still pending determination from the 2019 corresponding period did not change these findings. The observed number of suicide deaths during the stay-at-home period did not deviate from ARIMA projected expectations using either preliminary data or an alternate scenario in which deaths pending investigation (exceeding the average remaining number of deaths still pending investigation which occurred during the corresponding 2015-2019 period) were ascribed to suicide. Decedent age and sex demographics were unchanged during the pandemic period compared to 2015-2019. The stable rates of suicide deaths during the stay-at-home advisory in Massachusetts parallel findings following ecological disasters. As the pandemic persists, uncertainty about its scope and economic impact may increase. However, our data are reassuring that an increase in suicide deaths in Massachusetts during the stay-at-home advisory period did not occur.

Suicides in the COVID-19 Pandemic — Are We Well Informed Regarding Current Risks and Future Prospects?

“…Suicide frequency in St. Petersburg per 100,000 female population in the first 7 months in 2020 in comparison to corresponding period average in 2016-2019 0 38 Consortium Psychiatricum | 2021 | Volume 2 | Issue 1 EDITORIAL due to social integration and strengthening of the invisible links that make societies more united in the face of a danger to the whole population. 11Our results are consistent with these studies that find or predict a drop in suicide incidence in the acute phase of a crisis [12][13][14]. We have used a blunt method of evaluation of suicide incidence change known as excess mortality -comparison between incidence during the fixed period (i.e., April) in four to five previous years and in the index year, and covering adjusted periods.April is the best period from this point of view, since government containment measures had just been introduced, and they were rather harsh and severe (described by some authors as Draconian).18 This can provide further explanations for the drop in the number of suicides.…”

“…In support of this, several reports from different countries shortly after the announcement of the COVID-19 pandemic, have presented data that show that the number of suicide attempts and suicides did not increase, on the contrary, they seemed to go down during the introduction of "stay at home" orders. [12][13][14] While this immediate effect may be understood…”

Thirty-day suicidal thoughts and behaviours in the Spanish adult general population during the first wave of the Spain COVID-19 pandemic

“…Studies from other countries suggest that suicide rates either remained unchanged during the first wave of the pandemic (e.g. Greece, Vandoros et al ., 2020 ; the US, Faust et al ., 2021 ; Australia, Coroners Court of Victoria, 2020 ; China, Qi et al ., 2020 ) or decreased (e.g. Norway, Qin and Mehlum 2020 ; the UK, Office for National Statistics, 2020 ; Germany, Radeloff et al ., 2021 ; Peru, Calderon-Anyosa and Kaufman 2021 ).…”

Suicide during the COVID-19 pandemic in Japan

“…However, existing studies use readily available and convenient data that could easily generate biased insights; many studies rely on some measures of suicidality rather than suicide mortality 19-24 and most of them compare suicidal behaviours using snapshot data during the pandemic without pre-pandemic baseline samples 19,20,22,23 . Even when studies use real suicide mortality, some rely on data that cover non-representative sub-samples 25-27 , while others compare the whole suicide or suicidality trend before and during the pandemic, which might capture common time trend, seasonality, or temporal time shocks across individuals 25-31 (we discuss why these time-series analysis and before-after comparison can be problematic in the Method section).…”