Suicide prevention during the COVID-19 outbreak

Publications on mental health and psychosocial considerations during the COVID-19 outbreak1, 2 and on the psychological effects of quarantine³ provide important information and recommendations. These are important publications that should be translated to the field for all three levels of suicide prevention: primary, secondary, and tertiary. These publications include sections on urgent mental health issues such as depression² and severe psychiatric conditions,¹ but directly addressing specific recommendations for suicide prevention is needed.

The COVID-19 outbreak is emotionally challenging for everyone, especially for individuals who are already at risk (eg, those suffering from depression). During and following the COVID-19 outbreak and the outcomes of isolation and quarantine, we might see an increase in suicide ideation and behaviour among at-risk populations.⁴ Whether this increase will be in the short or long term (or both) remains unclear, but the mental health community should be prepared and can use this challenging period to advance suicide prevention. First, people are currently more able than in the past to talk about depression, anxiety, and suicide ideation. It appears that sharing experiences of negative emotions carries less stigma than it used to. Moreover, death has become a topic that all ages can more readily talk about, and it might be easier for people and mental health providers to ask directly about suicide risk. Second, people now understand the importance of social support in times of crises and tend to agree that it saves lives. Finally, people at risk for suicide can now get psychological help online, which might be more accessible for various reasons (eg, because of reduced stigma and removal of transportation or time barriers). The medical community needs to make sure that online providers can assess suicide risk and provide specific suicide prevention interventions.⁵ Mental health providers should now directly convey to every patient that in any case of severe crises, they should not hurt themselves. It has always been our priority as mental health providers to reinforce to our patients that there is always hope and that there are several solutions to any problem. The challenge of the COVID-19 outbreak might bring with it an opportunity to advance the field of suicide prevention and thus to save lives. These suicide prevention efforts should be integrated into the overall reaction programme for dealing with the COVID-19 crisis.