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Suicide Prevention in the COVID-19 EraTransforming Threat Into Opportunity

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME
Abstract

Importance  Suicide, a leading cause of death with devastating emotional and societal costs, is a generally preventable cause of death and a critical global public health issue. The coronavirus disease 2019 (COVID-19) pandemic may increase the risk of population suicide through its effects on a number of well-established suicide risk factors.

Observations  Prior to the pandemic, many countries were engaging in suicide prevention strategies, and although the overall global burden of suicide deaths has increased, some national efforts were beginning to see positive results. Additionally, the gap between mental health needs and services has been increasing in many nations. With the added physical and mental health, social, and economic burdens imposed by the pandemic, many populations worldwide may experience increased suicide risk. Data and recent events during the first 6 months of the pandemic reveal specific effects on suicide risk. However, increases in suicide rates are not a foregone conclusion even with the negative effects of the pandemic. In fact, emerging suicide data from several countries show no evidence of an increase in suicide during the pandemic thus far. There are actionable steps that policy makers, health care leaders, and organizational leaders can take to mitigate suicide risk during and after the pandemic.

Conclusions and Relevance  COVID-19 presents a new and urgent opportunity to focus political will, federal investments, and global community on the vital imperative of suicide prevention. Suicide prevention in the COVID-19 era requires addressing not only pandemic-specific suicide risk factors, but also prepandemic risk factors. This Special Communication provides prioritized, evidence-based strategies for clinicians and health care delivery systems, along with national and local policy and educational initiatives tailored to the COVID-19 environment. If implemented to scale, these interventions could significantly mitigate the pandemic’s negative effects on suicide risk.

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Article Information

Corresponding Author: Christine Moutier, MD, American Foundation for Suicide Prevention, 199 Water St, 11th Floor, New York, NY 10038 (cmoutier@afsp.org).

Accepted for Publication: October 2, 2020.

Published Online: October 16, 2020. doi:10.1001/jamapsychiatry.2020.3746

Conflict of Interest Disclosures: Dr Moutier reports grants to their institution from Otsuka Pharmaceutical, Pfizer, Netflix, Viacom/CBS, US Department of Veterans Affairs, New York City Police Department, and NBCUniversal outside the submitted work.

Additional Contributions: I thank Laura B. Dunn, MD (Stanford University), for her thoughtful feedback on a draft of this manuscript. Dr Dunn was not compensated for this work.

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