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President Trump’s comments about the likelihood of suicide during the COVID-19 crisis distressed many mental health professionals.This story was originally published in Spanish.
Lea la versión española aquí.
President Trump’s comments about the likelihood of suicide during the COVID-19 crisis distressed many mental health professionals.
For mental health professionals, in times of crisis like those we are experiencing now, how people talk about suicide is as important as what they say about it. That is why mental-health experts were repelled by the dismissive manner Trump exhibited on March 24 when he said that if the U.S. economy remained closed and isolated, suicides would increase by thousands.
For Katherine M. Keyes, associate professor of epidemiology at the Columbia University Mailman School of Public Health, this was a terrible mistake because “it is these kinds of statements” from public figures that can lead to a real “increase in the number of suicides as people lose hope,” and these statements have no real basis.
Shortly after the president said at a Fox News town hall that suicides “probably and — I mean, definitely — would be in far greater numbers than the numbers that we’re talking about with regard to the virus,” the Associated Press ran a fact check report denying the veracity of these claims, saying there “is no evidence that suicides will rise dramatically, let alone surpass potential coronavirus deaths. Historically in a crisis, suicides tend to diminish as society pulls together for a common purpose.
“We often think about economics as driving suicide, because unemployment has such a strong correlation with suicide rates,” says Seth Abrutyn, associate professor of Sociology at the University of British Columbia, but “it isn’t as clear as ‘poor people die by suicide disproportionately more than employed people.’ In fact, poorer people are less likely to die by suicide.”
There is no evidence that suicides are increasing dramatically, all the experts consulted by City Limits said. While most suicide prevention hotlines so far indicate an increase in the number of calls, this does not necessarily indicate increased risks of suicide.
Rising anxiety
Organizations like the National Alliance on Mental Illness of New York City, NAMI-NYC, have noticed an increase in phone calls and emails to helplines since March 1, when the first case of coronavirus was detected in New York.
“Yes, the volume has increased significantly —we set an all-time high last week for the number of people contacting the NAMI HelpLine on a given day,” acknowledges Dawn Brown, director of community engagement at the National Alliance on Mental Illness, “with a 45 percent increase.”
“Of the callers who mention COVID-19,” Brown says, “more than 20 percent have reported experiencing a high level of anxiety. Among the myriad problems, callers seek support and peace of mind, seek where they can find a testing center, alternatives to access treatment, financial assistance, and information about social services in their area.”
The volume of calls, text messages, and chats with NYC Well, the city’s mental health hotline, has also increased. For its part, the New York City Department of Health and Mental Hygiene (DOHMH) has noted as a general trend that “in recent years, call volume has increased from February to March” and the department via email added that “this year’s increase is larger than previous years and is likely a result of the city promoting NYC Well for people in many communications about COVID-19. It may also be due to the stress and anxiety many individuals are feeling related to this outbreak.”
In 2019 the average number of contacts per day to the NYC Well program was 932. During the week of March 22, 2020 to March 28, 2020, the daily contact volume was in the range of 1,100 to 1,300, DOHMH says.
The American Association of Suicidology (AAS), which among other things accredits crisis centers around the country, tells City Limits that many of the nation’s crisis centers “are experiencing dramatic increases in calls.”
“Some [of these centers] are taking over their state’s hotline specific to coronavirus and COVID-19 concerns, as well as dealing with increased volume of suicide and mental health crisis calls. And many of them are totally worn out, but they’re continuing to do the work,” the organization says.
“So yes, people are worried, confused, overwhelmed, and scared, and the folks on the crisis lines are doing everything in their power to offer a little hope and solace to those in need,” responded AAS via email.
Springtime and suicides
So far, the National Suicide Prevention Lifeline and the Trevor Project, a suicide prevention and crisis intervention organization for LGBTQ young people, have not seen significant changes in call volume in New York.
In regards to how the crisis triggered by the coronavirus is affecting the mental health of New Yorkers, Keyes replied that “it will take some time to get that data.” Regina Miranda, a professor of psychology, and Ana Ortin, a research associate, both from Hunter College at CUNY, responded by e-mail that “we don’t know exactly how the risk of suicide will be impacted by COVID-19, and some of the consequences may not be seen for months or even years.”
“Research has shown talking about suicide with those who are or might be feeling suicidal is preferable to avoiding it,” said Abrutyn. “It isn’t easy, but people should know raising the subject and talking about it (and listening closely) does not make a suicidal person more suicidal or make someone not suicide suicidal.”
“Spring,” Miranda and Ortin say, is usually “a season when we see an increase in suicide attempts and increased visits to emergency departments. But as far as we know we still don’t have exact data on suicide attempts in March, or if there has been an increase compared to previous years.”
DOHMH says that as of “March 26, 2020, there has been no increase in emergency room visits for suicide-related issues since the COVID-19 outbreak in New York City.”
“In New York,” Miranda and Ortin say, “the majority of visits to emergency departments for suicide ideation, attempts, or self-harm tend to be among teenagers, more often girls. Many of these referrals to emergency departments for assessment of suicide risk come from schools. With school closings, it will be more difficult for teachers and school counselors who might have identified youth at risk and made referrals to do so.”
The suicide profile
New York City saw 565 suicides in 2017. According to Miranda and Ortin, “across the U.S., 48,344 people died by suicide in 2018, and New York state has the lowest suicide rate at just over 8 per 100,000 (compared to the national average of just over 14 per 100,000).”
Nationally, “men are at higher risk of suicide deaths than women. At the same time, women more often think about and attempt suicide. The highest risk period of life for suicide deaths tends to be in middle age, but the highest risk period for making a suicide attempt is in adolescence,” Miranda and Ortin explained.
Experts also recognized that the Latino community, as well as the immigrant community, faces specific problems such as language barriers, lack of health insurance, fear of deportation, misdiagnosis, discrepancies in access to treatment and in the quality of treatment they receive.
However, comparatively, those at greatest risk among the different groups (Asians, Blacks, Latinos and Native Americans) are Native Americans, Miranda and Ortin specify.
Experts also point out that some adolescents whose suicidal thoughts are triggered by social stressors may initially experience a buffering effect from not being in school. Yet “for those in homes with high levels of interpersonal conflict, not being able to go out or receive social support from peers may increase risk. At the same time, an increasing reliance on social media for communication will necessitate monitoring of cyberbullying. Parents should be attentive to their children’s overall signs of distress and offer support,” say Miranda and Ortin.
“Job loss, financial instability, depression, anxiety, among others, can be factors that increase the risk of suicide,” says Keyes. In addition, he acknowledged that social isolation may not help people who have been facing problems with depression or anxiety.
Currently, many mental health providers have switched to telemedicine, “which will present challenges and opportunities: challenges for low-income (usually minority) communities with limited access to the internet and technology, and opportunity because people who have difficulty traveling to see their mental health provider might be more likely to attend a telehealth session from home,” Miranda and Ortin add.
Don’t talk about suicide without talking about prevention
Another problem noted by some experts about the president’s comments is that it is never a good idea to talk about mental health and suicide without mentioning the resources available to prevent suicide. All of the experts emphasized the importance of the entire community knowing that there are professionals available to help.
The NAMI has a guide to mental health specifically for the Latino community and the NAMI helpline, (800) 950 6264, is open Monday through Friday from 10 am to 6 pm (Eastern Time).
The National Suicide Prevention Hotline shared with City Limits this link for communicating with someone who may be suicidal. 1 (800) 273 8255.
New York’s NY Well program offers a number of resources to emotionally support people whose symptoms of stress are overwhelming. There is also this link where you can find a list of support resources for those who must stay at home, as well as resources for housing, employment and unemployment, and food. 1 (888) NYC WELL
New York State’s recently created a Covid-19 emotional support helpline at 1 (844) 863 9314.
For LGBTQ youth, The Trevor Project has a crisis hotline at 1 (866) 488 7386 and Chat/Text services at TheTrevorProject.org/Help
The Samaritans also have a 24-hour suicide prevention hotline that offers help at (212) 673 3000 and this guide that offers resources and services for suicide prevention (in English).
Finally, Keyes recommended that “if you feel you are not getting the help and service you deserve, seek the advice of a mental health professional to ensure that you receive appropriate care.”
Risks and possibilities
Even for those who do not call a hotline or contemplate suicide, there can be long-term effects from something as harrowing as the COVID-19 crisis. Some will have to deal with the harmful effects of post-traumatic stress disorder (PTSD).
“These circumstances that we are experiencing now might lead to PTSD,” says Denise Varela, mental health counselor and certified national counselor. “Symptoms include flashbacks, avoidance (not wanting to hear news about it, fear of walking in front of a hospital, etc.), hypervigilance and reactivity (being ‘super alert’ and aware that ‘something is about to happen’), and cognition and mood swings (feeling sad, anxious, angry, guilty, etc.).”
There is also the possibility that some people will eventually be stronger as a result of COVID-19. At this juncture, DOHMH says, it is important “to build upon our strengths and foster resiliency, and to be aware that research shows that people who go through extremely difficult life events can experience significant positive outcomes including improved resiliency, deeper and more meaningful relationships, and awareness of personal strengths.”
20 thoughts on “Early Insights on COVID-19’s Impact on Mental Health and Suicide Risk”
So sick and tired of Trump bashing! You guys don’t miss a beat and it’s absolutely disgusting during this crisis to have to listen and deal with “Trump bashing”.
No one bashed him. Simply pointed out the way anyone talks about suicide is important. Journalists have numerous guidelines to follow to not lead to suicide contagion. Resources need to be emphasized.
Well said. I agree it sounded like consistent Trump bashing throughout this otherwise useful article. What are they teaching in journalism school. Very bad. I’m tired of hearing disparaging comments about my president.
So people listening to Trump immediately went out and committed suicide. Oh please, so I guess we should not talk about people committing suicide during this crisis….so we should just ignore the increase…you Dems are sick
I’m sure you are right, Peter. The president’s offhand reference to increased suicide rates, absent any evidence that they are likely or any resources to help people who are struggling with the other mental-health issues that actually are likely to be created by the crisis, was very helpful.
Where are the actual suicide stats for this year compared to previous years? All the rest is jawboning.
As the author states, there is no discernible increase in suicides so far. But it is early.
The suicide rate in the U.S. has surged 35% since 1999, according to a new analysis from the Centers for Disease Control and Prevention.
Suicide is the 10th-leading cause of death in the U.S., and the CDC describes suicide as “a large and growing public health problem.” The new report indicates that while the country’s suicide rate climbed from 1999 to 2018 – from 10.5 to 14.2 per 100,000 – the greatest increases have occurred since 2006. Suicide rates also have risen across most age groups, and for both males and females.
It would have been useful if in the first plans of solutions on the government level had taken more into account the stress they were going to infict on the population with the shut down.
And the shut down and social distancing was more theory than something that was practiced in the past. Sure, in the past there were quarantines but they were more complete quarantines where there was far less traffic in and out. The way the current quarantines are set up it is more like seige conditions in that there is movement in and out of a confined locations but it is regulated and not something everyone can do whenever they want.
Not surprisingly, Trump is pointing to some issue that are real but in a context that is entirely unhelpful as the professionals cited here note. Indeeded, telling people they are more likely to kill themselves is likely to cause despair which is likely to make suicide more likely.
But what to do with all the disorganization and bad planning on the part of the government. And why is Pakistan doing so much better with Covid19 than the US. Okay, S. Korea had better planning and caught the virsus early, but Pakistan?
And the media is contradictory and confusing. But sure it does make sense to try and calm people down so that people don’t despair when things aren’t that bad. But the disjunct between what is going on, what Trump says, and that the media reports is problematic.
That censoring is so heavy seems obvious. But what to do? Clearly, there is always hope. No matter how bad something this, there is hope. But if the government created most of the problems and all the solutions that the government offers are making things worse, then what to do?
Yes, the shut down created a whole lot of stress, financial crisis, and etc. and personally speaking I’m not seeing that it really controlled the spread of Covid19 since the US is doing so badly in comparison to other countries, and again especially like countries like Pakistan. What is Pakistan doing right that the US is doing wrong and why don’t we have media coverage on that? And it is really strange and a-typical for a disease to have zero mortality for those under 9. That it does, as well as the better situation of countries like Pakistan, suggests that lack of cleanliness might create immunity in some way.
And yet instead of that, we have Trump inciting people to greater fear and frustration.
I appreciate that suicide rates go down in times of national crisis such as war. But isn’t this a different type of crisis? I have always been under the impression that suicide has a strong correlation to unemployment. I believe 1 in 3 people who commit suicide are unemployed. Current unemployment rates are more similar to the Great Depression than World War II. I am fearful that when we look back on this we will find that more people under 50 died by related causes than did by the virus itself. I’m hoping that our media‘s hysteria isn’t stifling a better government response. Let’s stop making this a political issue.
I have suffered with depression for most of my life and have learned to manage my symptoms very well until recently. However the recent lack of choice to spend time at home, along with other requirements has triggered my PTSD symptoms, which makes it harder to manage the depression.
The last few days I have been finding more and more reasons why life in this “new normal” is not worth my efforts anymore. As my choices decrease I lose hope and when I no longer can find hope for a life worth living I will seriously consider suicide and it will be too late to reach out for help. When I get there I don’t want help. I have been through this before and always managed to find a way through and past the worst times. The question is can I do it one more time? I don’t know.
Stay positive, stay strong. Things are beginning to open up again. We will re-emerge from this stronger. There is a lot to see and live.
Wendy, I believe you can do it. Do you have someone to talk to? I hope we experience some relief soon.
I came here for information – facts, figures. All I found was endoctrination and political attacks. Don’t waste your time trying to convince people that you are talking from a scientific point of view.
Trump alerted for a real problem (often forgotten and hidden due to shame) and you choose to attack him – and actually try to shift the blame to him, just in case he is right.
Instead of recognizing how the lock down is devastating for people with mental health issues and can potentially cause huge spikes in suicides, you try to convince us that people will commit suicide because of Trump’s words.
No hope? He is the one trying to end the lock down and thus giving people some hope, while Democrats and CNN are saying we will have to live like this until everyone is vaccinated…
These are really crazy, crazy times we are living in.
Stay positive, stay strong. Things are beginning to open up again. We will re-emerge from this stronger. There is a lot to see and live.
Yep. Let’s now quarantine the 95-98% people who are healthy, INSTEAD of protecting those at risk by modifying our behavior as responsible citizens. Guess we will do this for every single flu outbreak, norovirus outbreaks…that’s right! We cannot allow our little ones to go to barbaric germ factories called schools! The communist party has certainly won this roung.
Influenza usually kills about 1,700 people in a year in New York City.
COVID-19 has killed more than 20,000 since mid-March.
It is possible this is a different situation.
It was very nice article and informative on Anxiety and mental health, And how to tackle this situation during tough times of Covid-19.
Trump nailed it! He is a wise man.
I can only speak for the hospital I work as an RN, and what I’ve seen personally would blow your mind. The suicide attempts/mental health crisis in teens and young adults has drastically increased. It already was a problem, but now is even worse. The long term psychological effects from trauma are going to be way worse than any viral disease.
National stats seem to reflect a huge increase as well.
It was a great piece of writing and informative about anxiety and mental health. how to manage this problem in the difficult moments of Covid-19. Keep your head up, keep going. Things are opening up.