What do we know about coronavirus and suicide risk?
Because of the time it takes to register suicides, it’s too early to know the effect of the pandemic on suicide rates, and it is important to remember that a rise in suicide rates is not inevitable. Fortunately, evidence from the National Confidential Inquiry (NCISH) and the University of Manchester suggests suicide rates during the first national lockdown in England have not been impacted in the way that many of us were concerned about.
However, the effects of the pandemic are being disproportionately felt by the most vulnerable people in society and are exacerbating factors we know are related to suicide.
For instance, coronavirus is having a profound effect on the economy. We know that, during the previous recession, suicide rates have risen, and those who are hardest hit by economic downturn are also those who are at greatest risk of suicide – ie, middle-aged men (see our report Dying from Inequality).
What are we seeing through our services?
In the nine months since social distancing restrictions began in March we provided emotional support to our callers over 1,700,000 times. As in previous years, one in four of these conversations has been with someone who is expressing suicidal thoughts or behaviours.
Common themes where callers express suicidal feelings included feeling isolated, hopeless about the future and trapped (eg, “not seeing the end to this”). We know certain psychological factors are related to suicide risk – and have been affected since the restrictions kicked in:
- Negative thoughts about the future
Callers are expressing uncertainty, fear and concerns about what the future holds. This has become increasingly common - during November and December three in four volunteers we surveyed said that callers frequently discussed feeling negative about the future. These thoughts are often linked to economic worries (eg, worry about job loss and missing out on opportunities due to the pandemic).
- Coping/reduced resilience
Callers are talking to us about a reduced ability to cope as a result of the ongoing restrictions, with their usual ways of coping (accessing community support, or meeting with friends) having been diminished or unavailable. Concerns about this are reported more frequently and causing more distress as time goes on, as well as times when restrictions are stricter or more changeable.
Since the restrictions began, callers’ have expressed a sense of loss in various of ways, from loss of income or routine, to loss of social contact, or mental health support and services. Sometimes, loss is coming from multiple angles all at once, which is particularly difficult for people to cope with.
Some callers have been struggling with the extra time alone and at home. This can lead to ‘overthinking’ or having cyclical thought processes. In some instances, this related to previous traumatic experiences or memories that had re-emerged during lockdown. During November and December, 2 in 3 volunteers we surveyed said that this was a frequent feature of calls.
- Feeling like a burden
Some callers speak to us about feeling like a burden to families and friends. Our volunteers tell us that this concern is becoming more common as the restrictions continue. During November and December, 1 in 3 volunteers told us that callers frequently discussed this with them. Worries about being a burden seem to be especially common among callers with mental health conditions, those who discuss self-harm, male callers and frontline workers in the NHS.
Callers seem ground down now, and more gloomy. They don't see any end in sight, and feel like they have no hope of things being better…. There's a sense of real depression and in some cases significant suicidal thoughts creeping in.
Samaritans listening volunteer
What are we seeing through our research?
We are collaborating with the Suicidal Behaviour Research Lab at The University of Glasgow and Scottish Association for Mental Health to understand the impact the coronavirus pandemic is having on key psychological factors related to suicide risk.
The first three waves of the nationally representative survey (running from 31 March to 11 May) of 3,000 people across the UK found that:
- 8% were experiencing suicidal thoughts at the beginning of the first national lockdown, increasing to nearly 10% by mid-May.
- Women, young people (18-29 years), those from more socially disadvantaged backgrounds, and those with pre-existing mental health problems had worse outcomes across nearly all psychological outcomes
- One in four had symptoms of moderate or severe depression at the beginning of lockdown and this remained steady through the first 6 weeks of lockdown.
- Feelings of entrapment and defeat (key psychological risk factors for suicidal thoughts) reduced as the six week period went on.
- Levels of loneliness and social support remained stable throughout the first six weeks of the lockdown.
Findings from three additional waves carried out between the end of May and autumn 2020 will be published in the coming months.