Have more people taken their own lives because of COVID-19?

It’s become one of the burning questions of our devastating 18-month pandemic – that of mental health, and suicide.

What is the effect? How does the existential dread of an invisible killer virus and the psychological challenges of extended lockdowns contribute? Have more people taken their own lives because of COVID-19?

One group of Victorian researchers has some preliminary answers, and while they’ve established suicide didn’t increase in the COVID-stricken Australian state of Victoria until the study’s cut-off date of 31 January, 2021, it comes with a weighty caveat.

“Our work is very, very preliminary,” says Monash University’s Associate Professor Lyndal Bugeja, a co-author of the research, now published in the Australian and New Zealand Journal of Public Health.

In the period measured, the total number of suicides did not rise, despite a continuing increase in calls to helplines, and some expectation that a widespread pandemic and punishing lockdowns would see the rate go up.

State coroner Judge John Cain called earlier and even more preliminary data (in 2020) “encouraging”, and Associate Professor Bugeja admits her early research for Monash (until the end of January this year) is “surprising” – but there’s still deep worry about the effects of the pandemic on mental health.

This encompasses wider concerns about dangerous new variants of the virus itself, but also the psychological toll of lockdowns.

The importance of social connectedness

The things that affect people, according to Associate Professor Bugeja, are: “Elements of the pandemic generally, and the consequences of trying to put public health strategies in place, and the changes to people’s lives as they knew it – the ability to go to work, go to school, the impact on employment and income and their general health, their fear of becoming ill, not being able to see their families, children in lockdown, curfews.

“We’re mostly concerned about social connectedness,” she says. “Connections with others are very positive in terms of wellbeing – that’s one of the main lessons of suicide prevention research.”

The new research was led by Dr Justin Dwyer, a psychiatrist at St Vincent’s Hospital in Melbourne. The second author is his brother, Dr Jeremy Dwyer, of the Coroners Court of Victoria, and Monash’s Department of Forensic Medicine (DFM). Associate Professor Bugeja also works for DFM, as well as Monash Nursing and Midwifery.

Read more: Double trouble: How severe lockdown restrictions have taken a toll on population mental health

In terms of Australia more widely, the paper cites studies showing there was no overall change in the suicide rate in Queensland in the seven months after the state declared a public health emergency in January 2020.In New South Wales, until September 2020, the number fell.

For Victoria, the researchers looked at coronial and police data from 2015 until January last year. They conclude that while the numbers did not rise, COVID-19 “is an important background stressor that can erode one’s wellbeing, sense of agency and connectedness to others”.

The first of the 60 Victorian suicides the researchers established was COVID-19-linked occurred in early March, 2020. Those linked to the pandemic comprised 9.5% of the 634 suicides between the end of February in 2020 and the end of January this year. Females accounted for 30%, compared with 25.7% pre-COVID. Males accounted for 70%, compared with 74.3% previously.

Research reveals a trio of themes

Three strong themes emerged within the research.

Firstly, the pandemic has disturbed sense of self – meaning a person felt “individually thwarted”.

The second theme was relationships being disturbed or disrupted by loss of activities, feeling lonely working at home and isolated from others, and also strained domestic relationships.

The third theme was a disruption of relationships with institutions – welfare services, healthcare, work and home.

Read more: Bearing it in mind: Being more than just OK on RU OK? Day

“The research found that for people already experiencing a number of other distressing events in their life, the consequences of COVID can be another thing added to the range of things they’re experiencing,” Associate Professor Bugeja says.

“For some people it’s very significant. But it’s always on a spectrum. For some people the pandemic is just another factor that was present, while for other people it’s something very, very significant for them. It’s a very complex problem.

“This pandemic is unprecedented,” she says. “Very tough. People have coped in so many ways. Some people relish being at home. For some people’s mental health, it’s been wonderful for them, in some respects. There have been good outcomes, but it’s certainly very worrying for some people.”

Media, social media have fed assumptions

Associate Professor Bugeja also stresses that incorrect media reporting or social media posts have, in some cases in Victoria, led to people in the community assuming COVID-19 had already led to more suicides.

“One of the things I’ve found frustrating was people’s assumptions, being voiced in media, that the suicide rate will go up, or is up. Let’s wait until we see the numbers. Research is underway. It is not helpful for people to make those predictions.

“We need to be careful how we talk about suicide – it needs to be talked about in a preventative way, and not sensationalised. That does not help the issue at all.”

Read more: COVID-19: The significance of hope for shaping and motivating positive actions

So, given all that, how has a COVID-19 hotspot such as Melbourne coped in the way it has?

“The health workforce has contributed greatly,” says Associate Professor Bugeja. “They’ve been there to help people who are very distressed. I also wonder whether there’s been a general awareness that people will become distressed in the circumstances of a pandemic, and so family, friends and co-workers have also probably played a strong role in keeping people connected.

“People have looked out for each other, in the main.”