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Increased Risk of Suicide Due to Economic and Social Impacts of Social Distancing Measures to Address the Covid-19 Pandemic: A Forecast

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Abstract

Background. Due to the Covid-19 pandemic there have been unprecedented increases in unemployment and social isolation nationally and globally. Predicting suicide rates as a result of this pandemic can provide information about the potential mental health ramifications and supports that may be needed. This article aims to forecast the potential increased incidence of suicide due to the economic and social impacts of the social distancing measures in place to address the Covid-19 pandemic. Methods. Authors identified available evidence to develop a statistical forecast using previous estimates of the impact of unemployment and social isolation on suicide rates as well as predicted unemployment data and social isolation data. Findings. The increased rate of suicide worldwide due to increased unemployment and social isolation could be close to 50,000 individuals based on initial estimates of these collateral impacts. Interpretation. Policy, funding, and interventions to address the mental health impact of the Covid-19 pandemic is needed. The model can be applied to predict additional localized or regional effects. The efforts to stop the spread of Covid-19 can be weighed against these potential collateral mental health effects.
Increased Risk of Suicide Due to Economic and Social Impacts of Social Distancing Measures to Address the
Covid-19 Pandemic: A Forecast
Carl F. Weems PhD
Professor and Chair
Human Development and Family Studies
Co-Director, ISU Translational Research Network (UTuRN)
Iowa State University
Victor G. Carrion, MD
Professor and Vice Chair of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences,
School of Medicine, Stanford University
Bethany H. McCurdy, BS & Mikaela D. Scozzafava, MA
Research Associates, ISU Translational Research Network (UTuRN)
Human Development and Family Studies
Iowa State University
This paper in under peer review and has not yet been published and is not therefore the authoritative document of
record. Draft version April/7/2020. This paper has not been peer reviewed. Please do not copy or cite without
author's permission.
Correspondence To: Carl F. Weems, Professor and Chair, Department of Human and Family Studies, 4380 Palmer,
Iowa State University, Ames, IA 50011. E-mail: cweems@iastate.edu
Author Note: Dr Weems is supported by grants from the National Institute of Justice (2019-R2-CX-0013), the
Office on Violence Against Women (2017-SI-AX-0004), the Youth Policy Institute of Iowa, as well as contracts
with the state of Iowa (Child Support Training BOC-18-003 and Service Training FOSU-20-001; prime sponsor for
both HHS-US Department of Health & Human Services). Dr. Carrion is supported by the Lucile Packard
Foundation for Children’s Health. The content is that of the authors and the content does not necessarily reflect the
opinions, findings, and conclusions of any funding source or agency. The authors declare no conflict of interest.
Predicting Suicide 2
Abstract
Background. Due to the Covid-19 pandemic there have been unprecedented increases in unemployment and social
isolation nationally and globally. Predicting suicide rates as a result of this pandemic can provide information about
the potential mental health ramifications and supports that may be needed. This article aims to forecast the potential
increased incidence of suicide due to the economic and social impacts of the social distancing measures in place to
address the Covid-19 pandemic. Methods. Authors identified available evidence to develop a statistical forecast
using previous estimates of the impact of unemployment and social isolation on suicide rates as well as predicted
unemployment data and social isolation data. Findings. The increased rate of suicide worldwide due to increased
unemployment and social isolation could be close to 50,000 individuals based on initial estimates of these collateral
impacts. Interpretation. Policy, funding, and interventions to address the mental health impact of the Covid-19
pandemic is needed. The model can be applied to predict additional localized or regional effects. The efforts to stop
the spread of Covid-19 can be weighed against these potential collateral mental health effects. Funding. The authors
received no financial support for the research, authorship, and/or publication of this manuscript.
Research in Context
Evidence before this study
Along with the health devastation of the coronavirus pandemic and Covid-19 related disease, it is apparent that there
will be traumatic stress wrought by the human loss, severe stress, and global fear. The collateral economic and social
impacts are also likely to have a deep effect on the mental health of many throughout the entire world. According to
the World Health Organization, suicide accounts for approximately 800,000 deaths per year globally with 79% of
suicides occurring in low- and middle-income countries. World suicide incidence is 10·6 persons dying from suicide
per 100,000 people with an estimate of 7 for females and 13·5 for males. Being male, low socioeconomic status,
and being from low-income countries have increased rates and increased risk. In the USA, rates were 22·4 for males
and 6·1 per 100,000 for females as reported by the US Office of Disease Prevention and Health Promotion. Social
isolation/loneliness and unemployment are well established factors associated with increased risk of suicide. Due to
the Covid-19 pandemic there have been unprecedented increases in unemployment and social isolation nationally
and globally. Predicting suicide rates as a result of this pandemic can provide information about the potential mental
health ramifications and supports that may be needed.
Added value of this study
This article provides a forecast the potential increased incidence of suicide due to the economic and social impacts
of the social distancing measures in place to address the Covid-19 pandemic. Authors identified available evidence
to develop a statistical forecast using previous estimates of the impact of unemployment and social isolation on
suicide rates as well as predicted unemployment data and social isolation data. The model can be applied to predict
additional localized or regional effects. The efforts to stop the spread of Covid-19 can be weighed against these
potential collateral mental health effects.
Implications of all the available evidence
The increased rate of suicide worldwide due to increased unemployment and social isolation could be close to
50,000 individuals based on initial estimates of these collateral impacts. Policy, funding, and interventions to
address the mental health impact of the Covid-19 pandemic is needed.
Predicting Suicide 3
Increased Risk of Suicide Due to Economic and Social Impacts of the Social Distancing Measures to Address
the Covid-19 Pandemic: A Forecast
Along with the health devastation of the coronavirus pandemic and Covid-19 related disease, it is apparent that there
will be traumatic stress wrought by the human loss, severe stress, and global fear. The collateral economic and social
impacts are also likely to have a deep effect on the mental health of many throughout the entire world. The mental
health impact of the disintegration of the typical social and economic world will have effects of which the full toll
will not be fully understood for years via retrospective analysis of data to be collected. However, this paper
examines the future potential of the negative psychosocial consequences on suicide rates. The study is prompted by
the need to estimate the mental health needs in the coming months/years and recent calls to better understand the
broader implications of the efforts to stem the spread of the virus. Brooks et al.1 conducted a review of studies
examining the effects of quarantine measures and identified several psychological impacts that include post-
traumatic stress symptoms, confusion, and anger with longer quarantine duration, infection fears, frustration,
boredom, inadequate supplies, inadequate information, financial loss, and stigma contributing to psychological
stress. In addition, the Center for Disease Control (CDC)2 warns about feelings of guilt that may be associated with
not performing work or parenting duties. In this study, we examine the potential impact on USA and worldwide
suicide rates using estimates from existing research and public data, focusing on two factors which have estimates of
the initial impact of the pandemic and are also known to increase risk for suicide - social isolation/loneliness and
unemployment.
The adverse conditions precipitated by the effects of the pandemic as well as the social distancing measures threaten
positive self-evaluations among the entire population of the world in multiple ways, including the disruption of
esteem-supporting relationships (e.g., with co-workers, teachers, friends, neighbors). After disaster, adverse
conditions for positive self-evaluation exist and the context in which many individuals find themselves are thwarting
the use of strategies to maintain positive self-evaluations3,4. This may be particularly true for disadvantaged
communities and families, and in those whose identities rely on work or performance5. In terms of social
relatedness, the social distancing measures are seriously disrupting social ties and one’s ability to access not only his
or her extended community, but with family members as well. Indeed, loneliness and related mental health impacts
are a very common outcome of social distancing measures1. For example, Reynolds et al.6 found that loneliness was
reported in 38·5% (95% CI 35·5–41·5) and social isolation in 60·6% (95% CI 57·6 63·6) of a large sample
(n=1,057) of individuals quarantined during the 2003 severe acute respiratory syndrome (SARS) outbreak in
Canada.
In addition to social isolation, US jobless claims exceeded 3,200,000 on March 21, 2020 according to the US
Department of Labor7, which was over 3 million more newly unemployed for each of the two prior weeks as well as
the same week one year ago. This number jumped to well over 6 million on April 2nd 7. According to International
Labour Organization8 estimates the pandemic could result in 24·7 million jobs lost worldwide. Their analysis
indicates that this may be a worst-case scenario for global unemployment with estimates of a “low” unemployment
scenario of 5·3 million (already surpassed by the US alone) and “mid” scenario of 13 million jobs lost 8. Supporting
relationships at the family, neighborhood, church, school, and work have been interrupted - threatening the amount
or the stability of contact with social ties, financial resources, and a sense of meaning 3,4,5. Reasoning from these
considerations on social isolation and employment loss, there is a need to examine the potential for these effects to
impact the overall death rate via suicide. Using two well established factors associated with suicide, namely social
isolation and unemployment, allows for a somewhat conservative estimate of one of the most severe mental health
impacts.
According to the World Health Organization (WHO) 8, suicide accounts for approximately 800,000 deaths per year
globally with 79% of suicides occurring in low- and middle-income countries in 2016. Suicide accounted for 1·4%
of all deaths worldwide, making it the 18th leading cause of death in 2016. World suicide incidence is 10·6 persons
dying from suicide per 100,000 people with an estimate of 7 for females and 13·5 for males9. Being male, low
socioeconomic status, and being from low-income countries have increased rates and increased risk8. In the USA,
rates were 22·4 for males and 6·1 per 100,000 for females as reported by the US Office of Disease Prevention and
Health Promotion10.
In terms of increased risk of suicide associated with unemployment, review of the literature and analysis by Gunnell
and Chang11 suggests a consistent association that has been well established for some time. In terms of risk
Predicting Suicide 4
estimates, Kposowa12 used a cohort analysis of social factors predicting suicide in the US National Longitudinal
Mortality Study. The sample was 471,922 individuals 15 years and above at the beginning of the study, of whom
545 had committed suicide. Unemployed men were twice (2·12, 95% CI = 1·16–3·88) as likely to commit suicide as
those employed with unemployed women 3.8 times more likely to kill themselves as their employed counterparts
(3·85, CI 1·4510·2).
It’s also long been understood that social isolation increases risk of suicide13. A recent review by Calati14 suggests
that the objective condition (e.g., living alone) and the subjective feeling of being alone (i.e., loneliness) are strongly
associated with suicidal outcomes with these associations found transculturally. In terms of estimates of increased
risk, Stickley and Koyanagi15 used the US National Longitudinal Mortality Study with data from 7403 persons.
Attempted suicide was dichotomous: “Have you ever made an attempt to take your life, by taking an overdose of
tablets or in some other way?”. Loneliness was assessed by subjectively asking if they felt ‘lonely and isolated from
other people’ in the past two weeks with 4 options: very much, sometimes, not often, and not at all. Odds ratio
controlling for age, sex, educational qualifications, ethnicity, marital status, wealth, employment status, alcohol
dependence, social support, physical health conditions, stressful life events, and common mental disorders for those
in the very much loneliness category was45.
In addition to unemployment and loneliness, the pandemic is expected to impact negative mental health outcomes in
multiple ways, and these are also predictive of suicide. Common reactions to the stress of the disaster like pandemic
are substance abuse, mood disorders, anxiety and post-traumatic stress. A meta-analysis of this literature by
Yoshimasu16 reports that substance-related disorders [OR = 5·24; 95% CI = 3·30–8·31] and mood disorders [OR =
13·42; 95% CI = 8·0522·37] are associated with suicidal risk. Lin et al.17 reported that depressed mood increased
suicide risk by a factor of 2·11 (adjusted risk ratio).
Drawing from the theoretical considerations above and data on the increased risk for suicide engendered by mental
health problems, unemployment, and social isolation, each of which are increasing in incidence as a result of the
pandemic, this paper calculates the potential increases in death associated with the Covid-19 pandemic due to
suicide.
Method
A literature search identified estimates for developing a statistical model to predict increased suicide rates.
Data from the WHO and US Office of Disease Prevention and Health Promotion were used to estimate existing
suicide rates. World suicide incidence is 10·6 persons dying from suicide per 100,000 people with estimates being
7 000077) for females and 13·5 (.000135) for males9. In the USA, existing rates were estimated as 22·4 for
males000224) and 6·1 000061) for females per 100,0009.
Unemployment
Estimates for unemployment were taken from the US jobless claims which hit 3,283,000 on March 21, 2020 and
over 6 million on April 2nd 7; reported were over 3 million more unemployed. The US workforce is 47% female7. To
provide a conservative estimate for those effected, we used the April 2nd number of 6 million additional7
unemployed as the theoretical population impacted in the US. According to International Labour Organization8
estimates, the pandemic could result in 24·7 million jobs lost, with a “low” unemployment scenario of 5·3 million
and “mid” scenario of 13 million jobs lost. Given these numbers, a conservative estimate for those effected, the
theoretical population impacted for women and men of 10 million individuals, was used with the gender distribution
of 38·96% of the workforce being female18. Estimates for the increased risk of suicide for unemployment were taken
from Kposowa12 predicting suicide in the US National Longitudinal Mortality Study. For unemployed men, the risk
ratio of 12 was used and for unemployed women, the risk ratio was 3·8.
Social Isolation
Estimates for the number affected by increased social isolation were taken from public reports of stay at home
orders for the USA on March 25th, which was estimated to be 50% of the US population. As of March 25th, 15 states
and 30 municipalities had ordered 166 million people to stay home, according to data compiled by Regan et al.19
using US Census population estimates. For the world, the estimate of increased movement restriction was estimated
Predicting Suicide 5
at 6 billion people. As noted, Reynolds et al.6 estimated loneliness in 38·5% and social isolation 60·6% of those
quarantined. As a conservative estimate of 10% of those effected by stay at home orders as of March 25th was used
as a theoretical population of those impacted by loneliness in the US which would be 16·6 million of whom 50·8%
are female, according to the US Census Bureau20 as of 2019. For the world, we used an estimate of 5% or 130
million for the worldwide theoretical population of those effected by loneliness of whom there is a total population
ratio of 1·01 males to every 1 female21.
Estimates for suicide risk associated with social isolation and loneliness were estimated from two sources - the
Stickley & Koyanagi15 analysis of the US National Longitudinal Mortality with odds ratios for suicide attempts for
those in the most severe loneliness category ranged from 3·45 (lifetime suicide attempt) to 17·37 (past 12-month
suicide attempt), however these were not broken down by sex and the data for calculating relative risk was not
available. Kposowa12 predicting suicide in the US National Longitudinal Mortality Study also reported relative risk
ratios for those living alone with estimates ranging from 1·4 to 1·55 for males and 1·93 to 2·4 for females. Taken
together, our models used an estimate of 1·5 for males and 2·0 for females.
Mental Health
The statistical models added a negative mental health multiplier. Drawing from the broader literature and data in Lin
et al.17 reporting that depressed mood may increase suicide risk by a factor of 11, this number was used in the
models as a mental health multiplier. This addresses the fact that our model cannot estimate those who both lost
their job and became severely lonely and cannot estimate incidence of mental disorder impacts on the general
population resulting from the pandemic.
Statistical model
The estimate was based on the following: The estimate of existing incidence establishes the baseline number of
individuals that increased risk will exacerbate. The estimated increased risk is the multiplier that either
unemployment or loneliness adds to the estimate of additional cases of suicide. The estimate of those affected is the
theoretical population of those impacted by the risk factors of unemployment or loneliness. The mental health
multiplier is added to the equation to acknowledge the additional risk added by the increased risk associated with
mood disorders and substance abuse and is theoretically a conservative estimate for all the various mental health
factors that may increase risk among the theoretical population of those affected by unemployment and loneliness,
while recognizing error in the estimates of the population impacted. Thus the equation was: Estimate of existing
incidence * Estimate of Increased Risk (Risk Ratio) * Estimated number of Those Effected * Mental health
multiplier 2·11 = Number of Suicides. These analyses were stratified by sex differences in base rates, risk estimates
and workforce and population estimates. Base rates (existing incidence times the theoretical number effected) are
then subtracted from these totals to give an estimate of the increased rate. Data were calculated in MS Excel and the
spreadsheet is available in the online supplement.
Results
Unemployment
Results of the estimates for unemployment are presented in Table 1 and these are broken down by gender. US
suicide incidence stratified by gender, times the increased risk estimate by gender, times the mental health
multiplier, times the theoretical number impacted and then subtracting out the base rate estimate suggest the USA
may see over 3,800 additional suicides and that the world may see as more than 5,100 additional due to
unemployment.
Loneliness
Results of the estimates for loneliness are also presented in Table 1and these are broken down by gender. US suicide
incidence stratified by gender, times increased risk estimate, times the mental health multiplier, times the theoretical
number impacted and then subtracting out the base rate estimate suggests the USA may see over 5,600 additional
suicides and that the world may see as more than 35,000 additional suicides due to loneliness/isolation.
Predicting Suicide 6
Discussion
The results of the estimations suggest that overall more than 49,000 additional suicides could be seen based on
conservative estimates of those impacted by initial effects on employment and social isolation. The estimated
numbers could be compounded by the expected limited work force and resources to address mental health.
Governments may consider establishing funding sources throughout the forecast of the pandemic in order to procure
needed operations of all systems providing mental health care. Brooks et al.1 suggests that in situations where
physical isolation/distancing is required the goals might be to do so for no longer than required, provide a clear
rationale for the efforts, and provide information ensuring sufficient supplies are available. They also suggest that
appealing to a sense of altruism about the benefits of quarantine to the wider society may also help.
The dire warning of this data is one we hope will not come to fruition. This is one theoretical predictions the authors
hope will not be worn out by future analysis. However, this paper provides a contribution by drawing attention to the
future mental health needs and is a prompt for proactive measures. Important to note though not explored thoroughly
here is the psychological effect of social stigma that may precipitate suicide in individuals with a viral infection.
Theories of stigma suggest that stigmatization significantly influences its targets’ mental health22,23. Previously,
research has found associations between suicide and social stigma in patients diagnosed with HIV/AIDS24 and
Ebola25. Little is known about health effects of social stigmatization regarding viral infections and requires further
exploration.
In terms of the archival contribution of this paper, our estimates of the number of individuals impacted, while based
on the available data, are liable to wide variation if we revise them down words we could have as few as 5,000
additional suicide and revise them upwards we could easily see 100,000 more cases worldwide. This fact shows both
the power of intervention to prevent the loss of life, and also points to the utility of the model developed for
regional, state or other country wide efforts. That is, the model developed here is probably more accurate for the
USA estimates. Yet, the model can be applied at regional, state, country levels where and when more specific data
emerges. Analyzing the data by regional, state, or country planners may supply more localized estimates for mental
health preparedness efforts. Similar models might be developed for predicting the increased incidence of substance
abuse and mental disorders.
Identifying the results of previous quarantine efforts is also beneficial to understand what to anticipate after a
pandemic. A positive impact can result from marketing campaigns highlighting the benefits of being responsive
together through physical distancing while maintaining social and emotional connectedness. Hawryluck et al.26
suggested that distress among those quarantined during the SARS epidemic in Toronto might have been lessened by
thorough education, detailing and reinforcing the importance of quarantine, while also providing outreach to
increase individuals’ stress management. These efforts can be led by any organization, their government, or different
communities. The media and health organizations provided the majority of information about disease control
measures to quarantined individuals in Toronto26. Employers might also allow time for adaptation and grief of loss
while providing supportive resources and innovative approaches that allow individuals the capability of continuing
to contribute to their work-related mission and efforts.
In partnership with national leadership, health systems should probably attend not only to acute care, but take
preventive measures, such as the implementation of loan forgiveness programs, reduce the cost of postgraduate
training, shorten the duration of training, and other approaches that incentivize individuals to seek a career in mental
health. This may take rethinking current disaster aid funding from a short term to longer term focus27. Building the
work force, the employers and the health care of tomorrow requires utilizing this time as an opportunity to be free
from traditional constraints and evolve into a society that is more adaptive to current and future needs. Above all, let
us not avoid reality, let us approach it. The goal of this article is to face the problem head on and develop
intervention measures that can ameliorate this pandemics impact on health.
Author contributions:
CFW conceptualized the ideas for this article with help from VGC. CFW, BHM, and MDS conducted literature
searches. CFW wrote the first draft of the manuscript. VGC, BHM, and MDS contributed to the writing after the
first draft. BHM and MDS verified data, figures, and analysis from the first draft.
Predicting Suicide 7
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Predicting Suicide 8
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Table 1 Estimates of Increased Suicide Risk Due to Covid-19 Collateral Effects on Unemployment and Loneliness/Social Isolation
Estimate
of Existing
Incidence
Estimate
Increased
Risk (Risk
Ratio)
Theoretical
Number of
Those
Impacted
Mental
Health
Multiple
Suicide
N Subtotal Minus
Base rate
Increase
Subtotals
Unemployment
Males
2·2
3,180,000
2.11
3,306·59
712·32
Females
85
2,820,000
2.11
1,397·40
172·02
4,703.99
3,819·65
Males
2·2
6,140,000
11
3,847·75
828·90
Females
85
3,860,000
11
2,414·47
297·22
6,262.22
5,136·10
Loneliness
Males
1·5
8,167,200
11
5,790·22
1,829·45
Females
2
8,432,800
11
2,170·77
514·40
7,960.99
5,617·14
Males
1·5
65,650,000
11
28,050·60
8,862·75
Females
2
64,350,000
11
20,909·89
4,954·95
48,960.49
35,142·79
Total
Increase
Total =
67,887·70
18,172·01
49,715·68
... Moreover, loneliness and unemployment, which were worsened due to the pandemic, have already been well-acknowledged in the literature as factors for increased risk of suicide (Weems, Carrion, McCurdy, & Scozzafava, 2020). Based on these two factors and on data from world suicide rates, Weems et al. predict an increase of almost 50,000 deaths above the expected number because of the pandemic´s side effects. ...
... The following data demonstrate the relevance of socioeconomic vulnerability to suicide risk: in 2016, 79% of suicides occurred in low-and middle-income countries, which represents the highest percentage of suicide mortality in the world (World Health Organization [WHO], 2019). Some specific characteristics, such as being male, low socioeconomic status, and low-income countries, increase risks, and raise suicide rates (Weems et al., 2020). Historically, increased suicide rates have been observed during periods of economic crisis (Durkheim, 1897(Durkheim, /1987Panayi, 2020). ...
... Campaigns that emphasize the benefits of voluntary physical distancing, maintaining social and emotional connections are suggested as strategies that cause a positive impact. Moreover, we can indicate preventive measures such as implementing of debt and loan forgiveness programs, reducing postgraduate programs fees, reducing training programs' length and other approaches to encourage individuals to pursue a career in mental health (Weems et al., 2020). Regarding the latter, the literature suggests that governments implement national programs that include preparation to face epidemics and pandemics to improve the responses of institutions and health professionals to these situations (Ornell et al., 2020;Shah et al., 2020;Zheng, 2020). ...
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Several studies have documented the pivotal role of social support as a protective factor against parenting stress. However, the association between those variables in the covid-19 pandemic situation has yet to be understood. The present study examines the type of support associated with parenting stress during the Covid-19 pandemic. Furthermore, we also aim to identify the most important source of support for parents. An online survey provided quantitative data from 334 participants. They are 16.5% father (n = 55) and 83.5% mother (n = 279) who have children aged 2-18 years. The Indonesian version of the Social Support Questionnaire and Parenting Stress Scale was used to measure social support and parenting stress during the Covid-19 pandemic. The findings show that social support has a significant negative association with parenting stress. In terms of type, companionship support is significantly associated with parenting stress. The prominent support figure for fathers is their spouses, while the family became mothers' primary source of support. The findings can contribute to a better understanding of the support needed by parents during the covid-19 pandemic.
... De uma maneira geral, esta medida acarretou consequências na vida das pessoas e exigiu um maior isolamento e permanência das mesmas dentro de casa (Nanotkar et al., 2020). Foi notório o impacto que teve no funcionamento social, prevendo-se diversos impactos económicos e sociais colaterais (e.g., desemprego, diminuição de rendimentos, solidão), para além de consequências na saúde mental (Weems et al., 2020). Paralelamente, exigiu também grandes alterações a nível pessoal, decorrentes nomeadamente do encerramento de muitos contextos de participação social e do evitamento de convívios com amigos e familiares (Ammar et al., 2020). ...
... Do ponto de vista da saúde pública, portanto, o distanciamento social e os lockdowns são intervenções bem-sucedidas para mitigar o contágio de doenças transmissíveis por via aérea (HUREMOVIĆ, 2019b;KANG et al., 2020). Entretanto, a partir de outras perspectivas, ele pode ser catastrófico, sendo o aumento da violência doméstica, o desemprego, a fome e a privação social alguns dos aspectos que merecem não apenas atenção, mas demandam intervenção do poder público (MAZZA et al., 2020;PRADO;FREITAS, 2020;REGER et al., 2020;WEEMS et al., 2020). ...
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RESUMO A saúde mental dos estudantes de pós-graduação tem se tornado objeto de preocupação nos últimos anos em razão de crescente sofrimento psíquico reportado pelos estudantes. O contexto de crise da pandemia da Covid-19 pode intensificar as dificuldades que já vinham sendo enfrentadas e ainda trazer novos desafios. Este trabalho objetiva discutir dados sobre a saúde mental de estudantes de pós-graduação e como a pandemia da Covid-19 pode intensificar as dificuldades que já vinham sendo enfrentadas. Por meio de uma revisão narrativa da literatura, alguns dados de saúde mental de estudantes são discutidos em relação à estrutura da pós-graduação brasileira, e posteriormente articulados com o contexto pandêmico. Como resultado da revisão, observa-se que fatores institucionais e de infraestrutura da pós-graduação, insegurança socioeconômica, incerteza quanto ao futuro profissional, cobrança por produtividade, e qualidade da relação entre orientador e orientando destacam-se como pontos de atenção em relação à saúde mental desses estudantes.
... In a recent paper, Weems et al. estimated the increased rate of suicide worldwide to be close to 50,000 individuals as a result of increased unemployment and social isolation brought by containment measures and recommended to weigh the efforts to stop the spread of COVID-19 against these potential collateral mental health effects. [33] This increase in suicide risk is likely to affect the elderly particularly as pointed out by Yip et al. in previous research conducted in SARS-related older adult suicide victims. [34] The suicide motives were mainly associated with stress over fears of being a burden to their families, social disengagement, mental stress and anxiety related to fear of getting sick and dying, fear of losing people, fear of unpredictable shortages, and economic disaster at the time of the SARS epidemic. ...
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On March 12, 2020, with more than 20,000 confirmed cases and almost 1000 deaths in the European Region, the World Health Organization classified the COVID-19 outbreak as a pandemic. As of August 15, 2020, there are 21.5 million confirmed cases of COVID-19 and over 766,000 deaths from the virus, worldwide. Most governments have imposed quarantine measures of varied degrees of strictness on their populations in attempts to stall the spread of the infection in their communities. However, the isolation may have inflicted long-term psychological injury to the general population and, in particular, to at-risk groups such as the elderly, the mentally ill, children, and frontline healthcare staff. In this article, we offer the most up-to-date review of the effects of COVID-19 confinement on all the disorders listed in the Diagnostic and Statistical Manual of Mental Disorders. We make data-driven predictions of the impact of COVID-19 confinement on mental health outcomes and discuss the potential role of telemedicine and virtual reality in mental health screening, diagnosis, treatment, and monitoring, thus improving the above outcomes in such a difficult time.
... In a recent paper, Weems et al. estimated the increased rate of suicide worldwide to be close to 50,000 individuals as a result of increased unemployment and social isolation brought by containment measures and recommended to weigh the efforts to stop the spread of COVID-19 against these potential collateral mental health effects. [33] This increase in suicide risk is likely to affect the elderly particularly as pointed out by Yip et al. in previous research conducted in SARS-related older adult suicide victims. [34] The suicide motives were mainly associated with stress over fears of being a burden to their families, social disengagement, mental stress and anxiety related to fear of getting sick and dying, fear of losing people, fear of unpredictable shortages, and economic disaster at the time of the SARS epidemic. ...
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Full-text available
On March 12, 2020, with more than 20,000 confirmed cases and almost 1000 deaths in the European Region, the World Health Organization classified the COVID-19 outbreak as a pandemic. As of August 15, 2020, there are 21.5 million confirmed cases of COVID-19 and over 766,000 deaths from the virus, worldwide. Most governments have imposed quarantine measures of varied degrees of strictness on their populations in attempts to stall the spread of the infection in their communities. However, the isolation may have inflicted long-term psychological injury to the general population and, in particular, to at-risk groups such as the elderly, the mentally ill, children, and frontline healthcare staff. In this article, we offer the most up-to-date review of the effects of COVID-19 confinement on all the disorders listed in the Diagnostic and Statistical Manual of Mental Disorders. We make data-driven predictions of the impact of COVID-19 confinement on mental health outcomes and discuss the potential role of telemedicine and virtual reality in mental health screening, diagnosis, treatment, and monitoring, thus improving the above outcomes in such a difficult time.
... COVID-19 has further led to an increased risk for people developing depression worldwide, due to containment measures such as confinement to one's home with "shelter-in-place" and community shutdown orders lasting for months [3,4]. As a result of these containment measures and their subsequent negative consequences on individuals, such as social isolation and increased rates of unemployment, there have been estimates that potentially 50,000 more individuals could commit suicide worldwide [5]. ...
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Helping People Overcome Suicidal Thoughts, Urges and Behaviour draws together practical and effective approaches to help individuals at risk of suicide. The book provides a framework and outlines skills for anyone working with adults who present with suicidal thoughts or intent. Part 1 introduces a basic understanding of our knowledge about suicide and UK policy; Part 2 outlines the research into the treatment of suicidality and the general principles for working in the safest possible way. Part 3 outlines ten key psychological skills in the context of evidence-based best practice. The book also discusses the role of health and social care professionals in the prevention of suicide in the context of Covid-19. The book will be a valuable addition to the resources of professionals including psychotherapists, nurses, social workers, occupational therapists, prison and probation officers, drug and alcohol workers, general practitioners and support staff in any health or social care context.
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The December, 2019 coronavirus disease outbreak has seen many countries ask people who have potentially come into contact with the infection to isolate themselves at home or in a dedicated quarantine facility. Decisions on how to apply quarantine should be based on the best available evidence. We did a Review of the psychological impact of quarantine using three electronic databases. Of 3166 papers found, 24 are included in this Review. Most reviewed studies reported negative psychological effects including post-traumatic stress symptoms, confusion, and anger. Stressors included longer quarantine duration, infection fears, frustration, boredom, inadequate supplies, inadequate information, financial loss, and stigma. Some researchers have suggested long-lasting effects. In situations where quarantine is deemed necessary, officials should quarantine individuals for no longer than required, provide clear rationale for quarantine and information about protocols, and ensure sufficient supplies are provided. Appeals to altruism by reminding the public about the benefits of quarantine to wider society can be favourable.
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Background Social isolation is one of the main risk factors associated with suicidal outcomes. The aim of this narrative review was to provide an overview on the link between social isolation and suicidal thoughts and behaviors. Methods We used the PubMed database to identify relevant articles published until April 13, 2018. We focused on: a) systematic reviews, meta-analyses, and narrative reviews; b) original observational studies with large samples (N≥500); and c) qualitative studies. We included all relevant suicidal outcomes: suicidal ideation (SI), suicidal planning, non-suicidal self-injury, deliberate self-harm, suicide attempt (SA), and suicide. Results The main social constructs associated with suicidal outcomes were marital status (being single, separated, divorced, or widowed) and living alone, social isolation, loneliness, alienation, and belongingness. We included 40 original observational studies, the majority of them performed on adolescents and/or young adults (k=23, 57.5%). Both the objective condition (e.g., living alone) and the subjective feeling of being alone (i.e., loneliness) were strongly associated with suicidal outcomes, in particular with SA and SI. However, loneliness, which was investigated in most studies (k=24, 60%), had a major impact on both SI and SA. These associations were transculturally consistent. Limitations Confounding factors can limit the weight of the results obtained in observational studies. Conclusions Data from the observational studies suggest that both objective social isolation and the subjective feeling of loneliness should be incorporated in the risk assessment of suicide. Interventional studies targeting social isolation for suicide prevention are needed.
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