Suicide Prevention During COVID-19
Xiomara Rivera • August 12, 2022
Suicide and the Pandemic
- Suicide is a behavior. It is a choice which emerges from a variety of environmental and personal factors.
- Immutable factors include family history of suicide, terminal illness, etc.
- Factors that can be addressed include social isolation, poverty, access to lethal means, and mental illness
- Suicide is a powerful, but COVID-19 brief impulse
- Majority of cases occur within an hour between decision and suicide attempt. This shows that individuals use they have. Firearm safety can play a huge role in the prevention of suicide.
COVID-19
- Pandemic spread globally in early 2020 bringing severe illness and death, lockdown, economic job losses, isolation, grief, fear, and reduced access to care and supports.
- Firearm sales rocketed in 2020, yet remains to be one of the largest and most well defined risks for suicide.
38% of firearm owners reporter their mental health gotten a little or a lot worse in the past month
Firearm Safety
- During a mental health crisis in the household, it is doubly important to remove the weapon from the house.
- Throughout at-risk periods, guns must be removed, pills locked up, and depending on a risk assessment, the patient taken to an emergency room.
- Families play a large role in enacting these plans, including holding/locking away weapons and medications.
- Safe storage options: cable lock, trigger lock, lock box, safe, disassembled gun, smart gun
Extreme Risk Protection Order (ERPO)
- Swanson et al (2017) found that CT's version of the law saved one life for every 10.6 guns seized, proving ERPO to be effective.
- Reduced firearms suicides by 7.5% over 10 years, without an increase in suicides by other means.
- Can be filed by family, cohabitant, romantic partner, police, or clinician (physician, psychologist, mental health worker, state health officer)
Integrating Policy, Programs, and Practices to Reducing Suicide
Suicide Prevention via a Systems Approach
- The implementation of 9 mental health service recommendations in England and Wales and suicide rates. A cross sectional and before-and-after observational study.
- It was found that services that implemented at least 7-9 of the recommendations had a significantly lower suicide rate.
9 mental health service recommendations:
- Inpatient psych unit safety
- Assertive outreach team
- 24/7 crisis team
- 7-day follow-up
- Written policy on non-adherence
- Dual diagnosis treatment
- Criminal justice sharing
- Debriefing and family contact after suicide
- Front-line clinical staff trained in management of suicide risk for at least 3 years
Legislation and Policy Approaches
- Improve access to affordable, effective mental health care
- Strengthen chain of care for suicidal individuals
- Enable billing for the services of community health workers
- Integrate primary care and community mental health care
- Reduce access to lethal means
- Embed evidence-based approaches in educational programs (teacher colleges, medical school/residency, mental health professional training, journalism schools, etc.)
- Expedite access to data to be used for action
School-Based Skill-Building Approaches
- From a public health perspective, schools are an ideal place to provide mental health and wellness services to students through early identification of those at-risk, providing prevention programming, mental health services, referring to community-based providers, and supporting the entire school community in the aftermath of suicide.
- Several states, including Maryland, are using the federal pandemic relief further to address the mental health impacts of the COVID pandemic.
- These programs build skills and can demystify/destigmatize mental health care.