COVID-19, unemployment, and suicide

The COVID-19 pandemic has led to the introduction of strong restrictive measures that are having a substantial effect on the global economy, including an increase in the unemployment rate worldwide.¹ In a previous study,² we modelled the effect of unemployment on suicide on the basis of global public data from 63 countries, and we observed that suicide risk was elevated by 20–30% when associated with unemployment during 2000–11 (including the 2008 economic crisis). We have now used this model to predict the effects of the currently expected rise in the unemployment rate on suicide rates.

Close to 800 000 people die by suicide every year.³ We used our core model's estimates (intercept, sex, age group, and unemployment)² to describe the non-linear connection between unemployment and suicide. We applied the overall estimates to World Bank Open Data (ie, worldwide number in the labour force in 2019, unemployment rate [modelled estimate from the International Labour Organization] for 2019, and male and female populations in 2018 in the four age groups). Because the model predicted only 671 301 suicides with this data, instead of 800 000, we added a correction term of 0·17 to address differences in space (194 vs 63 countries) and time (2020 vs 2000). The expected number of job losses due to COVID-19 were taken from the International Labour Organization's press release from March 18, 2020,¹ reporting a decline of 24·7 million jobs as a high scenario and 5·3 million jobs lost as a low scenario. In the high scenario, the worldwide unemployment rate would increase from 4·936% to 5·644%, which would be associated with an increase in suicides of about 9570 per year. In the low scenario, the unemployment would increase to 5·088%, associated with an increase of about 2135 suicides.

According to WHO, each suicide in a population is accompanied by more than 20 suicide attempts.³ Thus, the number of mentally distressed people who might seek help from mental health services can be expected to increase in the context of the COVID-19 pandemic. Data from the economic crisis of 2008 showed that the increase in suicides preceded the actual rise in the unemployment rate.² We therefore expect an extra burden for our mental health system, and the medical community should prepare for this challenge now. Mental health providers should also raise awareness in politics and society that rising unemployment is associated with an increased number of suicides. The downsizing of the economy and the focus of the medical system on the COVID-19 pandemic can lead to unintended long-term problems for a vulnerable group on the fringes of society. It is important that various services, such as hotlines and psychiatric services, remain able to respond appropriately.