Suicide prevention during the COVID-19 outbreak
Authors: Anat Brunstein Klomek
Journal: The Lancet Psychiatry (2020)

Publications on mental health and psychosocial considerations during the COVID-19 outbreak1Inter-Agency Standing CommitteeInterim briefing note addressing mental health and psychosocial aspects of COVID-19 outbreak (developed by the IASC's reference group on mental health and psychosocial support).https://interagencystandingcommittee.org/other/interim-briefing-note-addressing-mental-health-and-psychosocial-aspects-covid-19-outbreakDate: March 17, 2020Date accessed: March 24, 2020Google Scholar, 2WHOMental health and psychosocial considerations during COVID-19 outbreak.https://www.who.int/docs/default-source/coronaviruse/mental-health-considerations.pdfDate: March 12, 2020Date accessed: March 24, 2020Google Scholar and on the psychological effects of quarantine3Brooks S Webster R Smith L et al.The psychological impact of quarantine and how to reduce it: rapid review of the evidence.Lancet. 2020; 395: 912-920Summary Full Text Full Text PDF PubMed Scopus (9812) Google Scholar 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 depression2WHOMental health and psychosocial considerations during COVID-19 outbreak.https://www.who.int/docs/default-source/coronaviruse/mental-health-considerations.pdfDate: March 12, 2020Date accessed: March 24, 2020Google Scholar and severe psychiatric conditions,1Inter-Agency Standing CommitteeInterim briefing note addressing mental health and psychosocial aspects of COVID-19 outbreak (developed by the IASC's reference group on mental health and psychosocial support).https://interagencystandingcommittee.org/other/interim-briefing-note-addressing-mental-health-and-psychosocial-aspects-covid-19-outbreakDate: March 17, 2020Date accessed: March 24, 2020Google Scholar 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.4Chan S Chiu F Lam C Leung P Conwell Y Elderly suicide and the 2003 SARS epidemic in Hong Kong.Int J Geriatr Psychiatry. 2006; 21: 113-118Crossref PubMed Scopus (175) Google Scholar 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.5Stanley B Brown G Safety planning intervention: a brief intervention to mitigate suicide risk.Cogn Behav Pract. 2012; 19: 256-264Crossref Scopus (722) Google Scholar 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. I declare no competing interests.