#Socialdistancing may have the unintended consequence of increasing the risk of #suicide
By Ruben Castaneda,
This article is based on reporting that features expert sources.
#SocialDistancing and #Suicide Risk
STRESS CAUSED BY widespread #socialdistancing to blunt the spread of the #coronavirus may be creating the unintended consequence of increasing the risk of #suicide in the general population, according to new research published in JAMA Psychiatry.
The study – “#Suicide Mortality and #Coronavirus Disease 2019 – A Perfect Storm?” – identifies a raft of reasons why #socialdistancing may be increasing the risk of #suicide even as it helps stop the spread of #coronavirus. More than 95% of the U.S. population is under a state or local order to stay at home except for necessary errands, like going to the grocery store or to an urgent medical appointment.
“Secondary consequences of #socialdistancing may increase the risk of #suicide,” researchers wrote. “It is important to consider changes in a variety of economic, psycho-social, and health-associated risk factors.”
The study noted that the possible increased risk of #suicide is occurring at a time when the #suicide rate in the U.S. is already on the rise. Since 1999, the #suicide rate in the U.S. has risen by 35%, according to a recent analysis by the #CentersforDiseaseControlandPrevention. #Suicide is the 10th leading cause of death in the U.S.
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Researchers for the JAMA Psychiatry study identified these increased risk factors for #suicide during the #coronavirus crisis:
- Economic #stress.
- Social #isolation.
- Decreased access to community and religious support.
- Barriers to #mentalhealth treatment.
- Illness and medical problems.
- National #anxiety.
- Firearm sales.
1. Economic #stress. In addition to killing tens of thousands of U.S. residents, the #coronavirus crisis has crashed the U.S. economy. As of early April, more than 17 million Americans had filed for unemployment benefits, and the stock market suffered deep losses, though it has recovered somewhat. The closure of schools has led some parents and guardians to take time off work. Economic downturns are usually associated with higher #suicide rates compared with periods of relative prosperity, researchers note.
“Economic downturns are usually associated with higher #suicide rates compared with periods of relative prosperity,” according to the study. “Existing research suggests that sustained economic #stress could be associated with higher U.S. #suicide rates in the future.”
2. Social #isolation. The very tactic that health experts say is saving lives – social (or physical) isolation – may be increasing the #suicide risk for some people. “Leading theories of #suicide emphasize the key role that social connections play in #suicideprevention,” researchers wrote. “Individuals experiencing #suicidalideation may lack connections to other people and often disconnect from others as #suiciderisk rises.”
3. Decreased access to community and religious support. Attending weekly religious services has been associated with a five-fold lower #suicide rate compared to people who don’t attend, according to the study. Tens of millions of people who regularly attended religious services can no longer do so. Community centers that served as social gathering spots are also closed. “The effects of closing churches and community centers may further contribute to social #isolation and hence #suicide,” researchers wrote.
4. Barriers to #mentalhealth treatment. The #pandemic is making it harder for some people to access #mentalhealth treatment. For example, health care facilities are adding screening questions for #COVID-19, the disease caused by the #coronavirus, at entry points. Some facilities don’t allow children and other relatives in without an appointment. This could create a barrier to #mentalhealth treatment during a time when school is canceled for many children.
“Moreover, overcrowded emergency departments may negatively affect services for survivors of #suicide attempts,” according to the study. “Reduced access to #mentalhealthcare could negatively affect patients with #suicidalideation.”
5. Illness and medical problems. The exacerbation of physical health problems could increase the #suicide risk for some people, particularly older individuals, researchers wrote. For older people, health problems are associated with #suicide, the study says. To show the psychological #stress the pandemic is causing, researchers quoted one patient who had been experiencing #COVID-19 symptoms. “I feel like (you) sent me home to die,” the patient said.
6. National #anxiety. It’s possible that around-the-clock news coverage of the #coronavirus crisis could be acting as an “additional stressor, especially for individuals with preexisting #mentalhealthproblems,” the study says. The effects of national #anxiety on individuals’ #depression, #anxiety and substance use deserves more study, researchers wrote.
7. Firearm sales. A number of news agencies have reported a surge in gun sales during the #coronavirus pandemic, the study notes. “Firearms are the most common method of #suicide in the U.S., and firearm ownership or access and unsafe storage are associated with elevated #suicide risk,” researchers wrote.
While the ongoing pandemic poses a number of challenges to preventing #suicide, there are opportunities to improve such efforts, according to the study.
#Suicideprevention strategies include:
- Emphasizing physical distance, not social distance.
- Telemedicine for #mentalhealth.
- Increased access to #mentalhealthcare.
- Distance-based #suicideprevention.
- #Suicideprevention resources.
1. Physical distance, not social distance. “Despite its name, #socialdistancing requires physical space between people, not social distance,” the study says. “When we connect, we survive,” explains Shauna Springer, the chief psychologist at the forthcoming Stella Center, which will be dedicated to treating people with trauma-related symptoms. Springer’s based in Walnut Creek, California.
Instead of urging “#socialdistancing” or even “physical distancing” which tells people what to do, we might do better to show them ways to “connect from a distance.” “To put this into practice, we can make a list of the people we care about and put a reminder in our phone to send a note of encouragement once a day on a rotating basis,” Springer says. “In addition to telling the people we trust how we are really doing, we can give others a safe space to talk about the range of their thoughts and feelings.”
2. Telemedicine for #mentalhealth. While there’s national momentum to increase the use of telehealth services in response to the #COVID-19 crisis, such treatment for people with #suicidalideation has lagged behind, according to the study. Disparities in access to computers and high-speed internet in different communities need to be addressed.
3. Increased access to #mentalhealthcare. #COVID-19 screening procedures might reduce access to #mentalhealthcare by way of canceled appointments. Such procedures instead could include screening for #mentalhealth crises, researchers wrote. This could be done by using administrative staff members to conduct #COVID-19 symptom screening. “Also, rather than sending a patient with a child home, alternative treatment settings could be considered (e.g., a private space outside),” according to the study.
With the closure of schools and the need to balance home and work responsibilities, skilled providers may have less availability due to their own pressing needs. “For this reason, it is important to think broadly and get creative,” Springer says. “Peer support is a wonderful way to get additional emotional care during this time of crisis.”
Support Group Central offers virtual support groups on numerous #mentalhealth conditions – either free or at low cost. A second resource is #NationalAllianceforMentalIllness (#NAMI) which hosts online communities where people exchange support and encouragement.
4. Distance-based #suicideprevention. There are evidence-based #suicideprevention interventions that were designed to be delivered remotely, the study says. Research suggests that telephone calls and letters have reduced #suicide rates. Following up (with individuals who may be in crisis and considering #suicide) may be especially important for people who test positive for #COVID-19 and have #suicideriskfactors.
Some houses of worship are seeking to create connections by sending out letters and cards to congregation members on their mailing lists to reach out to people who may feel isolated, says Linda Snell, a licensed clinical social worker and a therapist based in San Juan Capistrano, California. She works for New Method Wellness, a dual-diagnosis treatment center that treats people with substance misuse issues in addition to a variety of #mentalhealth conditions.
Research suggests that one’s ability to experience feeling noticed or cared for can make a difference in the life of someone who feels alone. “The difference is a connection is established through this gesture. Feeling isolated is akin to feeling lost and/or not being seen, forgotten,” Snell says. “Receiving a card is an indication of being found, it’s like saying to someone, ‘I see you. You matter.'”[
5. #Suicideprevention resources. It’s helpful for the press to follow best practices guidelines for reporting on #suicide and provide information about resources, the study says.
On its website, #SuicideAwareness Voices of Education provides tips for the press on reporting on #suicides during the #pandemic.
The tips include:
- Consider the journalistic value of reporting on a #suicide and its value to the audience. Will it educate, inform, provide clarity around the issue and help prevent other #suicides?
- If you do report on a #suicide, make sure the story is accurate, fair and treatment-positive. Don’t engage in assessing blame, and be clear that in the majority of cases, #suicide can be prevented with the proper care.
- Unless there’s direct evidence – like a note – don’t speculate that a #suicide is linked to the #pandemic. #Suicide is multi-faceted. When possible, report on any other factors that might have contributed to the #suicide.
- Because it’s impossible to know exactly why someone committed suicide, limit speculation, especially immediately.
- Include the #NationalSuicidePreventionLifeline (1-800-273-TALK).
- Include the Crisis Text Line, a free national texting service for people in crisis that operates around the clock. Text “hello” to 741741.
Ruben Castaneda, Staff Writer