Suicide prevention and the COVID-19 pandemic

Today’s guest bloggers are Kristen Quinlan, PhD, and Kerri Nickerson, LCSW, MPH, co-chairs of the APHA Intersectional Council Topic Committee on Suicide Prevention. Quinlan is an epidemiologist with the Suicide Prevention Resource Center and a senior research associate with the Education Development Center, and Nickerson is director of State and Community Initiatives at the Suicide Prevention Resource Center. 

Since the COVID-19 pandemic struck the U.S. early this year, researchers and practitioners in the suicide prevention field have questioned whether the secondary impacts of COVID-19 — such as increased mental health concerns, economic insecurity, a surge in firearm sales and social isolation — will impact our nation’s suicide rate. 

At the same time, protective factors — including a renewed focus on outreach to isolated populations, increased access to virtual mental health services and economic support packages — have bolstered the suicide prevention field. 

Fully understanding how COVID-19 has impacted suicide is going to take time, data and attention from a variety of sectors and settings. However, here are some important early lessons:

• COVID-19 has brought public health to the forefront of national discourse. Now, more than ever, the country is poised to recognize the need for a public health approach to suicide prevention. As a nation, we are beginning to see that everyone plays a role in supporting the physical and mental health of a community. As public health practitioners, we can help all members of our communities take action and be part of a comprehensive approach to suicide prevention.

• COVID-19 has thrown into sharp relief how inequalities impact physical and mental health. There is growing public recognition that context — specifically, inequities in income and access to health care, supportive services and education — matters in understanding physical and mental health. Context also matters in understanding suicide. Stigma, poorly designed policies related to substance misuse and mental health, unequal access to education and lack of access to culturally appropriate, evidence-based treatment all contribute to increasing suicide rates in historically disenfranchised communities. As public health practitioners, we must recognize inequalities and work to resolve them.

• COVID-19 has underscored the need for timely data to inform health-related decisionmaking. As a field, suicide prevention has faced serious delays in data access. As a result of COVID-19, public health practitioners have created new systems of real-time data collection, new data sharing and new partnerships. As public health practitioners, we can find ways to support the suicide prevention field’s efforts to capitalize on and sustain these new data supports.

• COVID-19 has generated innovation in health and behavioral health delivery systems. Telehealth and tele mental health services are increasing in popularity and are receiving some funding. Evidence-supported innovations, like following up with those who do not show up for mental health appointments or with those who are at risk of suicide, feel more feasible in a virtual health care delivery system. Communities are supporting health and mental health through innovative social connectedness programs, like community sing-alongs, teddy bear walks and virtual meet-ups. Public health practitioners and researchers would be well-served to identify ways to support and evaluate these innovations, even after the acute COVID-19 pandemic has passed. 

APHA is well-suited to promote a public health approach to suicide prevention. The Intersectional Council Workgroup on Suicide Prevention, or ISC-SP, an APHA-sponsored topical workgroup, was created to raise awareness of the intersectionality of suicide prevention with a variety of public health interest groups. 

If you or a loved one is in crisis, talk to someone immediately. Contact the Suicide Prevention Lifeline online or by calling 1-800-273-8255. A list of risk factors and warning signs for suicide is available.