SPECULATION THAT THE Covid-19 pandemic – and in particular the measures implemented to stem the spread of the virus – has led to an increase in suicide deaths has persisted despite there being no evidence to support the claims.
Unfounded conjecture surrounding rising suicide rates remains common on social media in many countries, including Ireland – particularly in anti-lockdown and anti-vaccine Facebook, Telegram and WhatsApp groups.
The most recent Central Statistics Office (CSO) quarterly statistics are also being touted as evidence of a spike in suicides despite the data being largely in-line with previous, pre-2020 trends.
In the latest ‘vital statistics’ update, the CSO notes that recorded suicides were 192% higher in quarter two of 2021 than they were in Q2 of 2020.
However, the CSO has attached a major caveat to the 2020 figures, due to the fact that Covid-19 restrictions on Coroners’ Courts holding public hearings at the start of the pandemic meant the recorded number of suicides was artificially low that quarter.
In Q2 of each of the five years before the pandemic, the number of suicide deaths registered was in the range 63-120. Due to the underreporting in 2020, the number fell to just 25. In 2021 it moved back in line with previous years (73 were recorded) when the restrictions on Coroners’ Courts were relaxed.
The National Suicide Research Foundation says this indicates a return to previous levels of registered suicide deaths, not an increased level of suicide.
The independent research unit investigates the causes of suicide and self-harm in Ireland. It is a registered charity and receives the majority of its funding from the HSE.
It must also be noted that Ireland’s method for recording suicide deaths means the figures for 2020 won’t be finalised until October/ November this year and the figures for 2021 won’t be finalised until the end of 2023.
The NSRF head of research, Dr Paul Corcoran, says the foundation has picked up on inaccurate claims about rising suicide rates throughout the pandemic and noted that the unfounded online speculation can be harmful to those at risk of suicide.
“Soon after the onset of the pandemic there were many claims related to an anticipated increase in suicidal behaviour. These claims, and their reinforcement, risk impacting negatively on vulnerable members of the population.
The reliable suicide data that has emerged over the course of the pandemic has shown that most countries have seen no increase in suicide deaths and some have seen a decrease. However, an interest in making claims about possible increases in suicide has persisted.
The foundation’s chief scientist, Professor Ella Arensman, noted that some media outlets can also cause significant harm by sensationalising suicide stories and by jumping to conclusions based on incomplete statistics.
“People who are currently experiencing depression, they will not question the statements in the media.”
Arensman warned that when people in a vulnerable position see headlines indicating a link between the pandemic and a surge in suicides “they could take that for granted and it can negatively impact on their current situation. That doesn’t give hope.”
Corcoran, who is also an epidemiologist, also noted that the assertions regularly come with cherry-picked statistics.
“Interestingly, the CSO Q1 2021 data gave a figure of 36 suicides, half the number of 72 in Q1 2020. These figures could have been used to suggest that the pandemic was associated with a large decrease in suicide deaths. However, there seems to be more interest in making claims about potential increases.”
The procedures that have to be followed before a death is determined as a suicide in Ireland means that there is a time lag between a suicide occurring and it being recorded in the statistics.
The cause of death in suspected suicide cases is reached through a coroner’s inquest, which is not held until at least six weeks after the person’s death, and inquests can take several months to reach a verdict.
Registration of a suicide death happens soon after the inquest and the CSO quarterly figures represent the number of suicide deaths registered in the quarter.
Therefore, the quarterly figures strongly correlate with the number of inquests of suicide deaths that were held, not the number of suicide deaths that occurred. The deaths in question usually occurred approximately six months earlier.
This is why curbs on Coroners Courts in 2020 caused such a dramatic dip in the Q2 2020 figure.
The CSO told The Journal this impact was felt from March 2020 onwards. It noted that it provided a detailed caveat on the matter in the Q2 2020 release and also mentioned it again in the Q2 2021 release.
The CSO releases mortality data, including suicide statistics, in three different stages. First, there is the provisional stage which provides the number of deaths based on year of registration. The data remains provisional for around two years, so the statistics from Q2 2020 and 2021 are still provisional.
Next, there is an official stage which revises the numbers based on year of occurrence, and finally, the figures are revised again to include late registrations.
There are usually notable changes between provisional and official suicide figures, with the official figures almost always higher.
The official annual stats are published about 20 months after any given year’s end. Further to this around 15% of suicide deaths are registered too late to be included in these official figures.
“Unfortunately, it is necessary to wait three-four years to get a close reflection of the number of suicide deaths in Ireland,” Dr Corcoran said.
The NSRF operates the Suicide and Self-Harm Observatory (SSHO) which gathers real-time suicide and self-harm data from Cork and Kerry.
The observatory is provided with an update on suspected suicide cases in the counties every two weeks, giving it a picture of the situation long before the CSO data.
Professor Arensman said there are indications of a slight increase in self-harm in the most recent data from Cork and Kerry, with people who are not receiving the face-to-face mental health support they require suffering.
She added that this is in-line with international statistics in other high-income countries where slight increases in suicide rates have been recorded in recent months.
“For people with mild anxiety with mild depression this [online supports/telemedicine] has been shown to be sufficient. But for people with severe depression, severe anxiety, and other severe mental health conditions, we don’t yet have proven effectiveness,” Arensman said.
She added that real-time data on suspected suicides across Ireland would be hugely beneficial for intervention and prevention purposes.
While there is no evidence that the pandemic has led to an increase in suicides, organisations that provide mental health support have noticed a shift in the demand for their services, particularly at times of uncertainty regarding restrictions.
The ISPCC said it has experienced increases in contacts to Childline at particular points but the listening service has not experienced an overall increase over the duration of the pandemic to date.
“When restrictions were first announced, children and young people were among the first to be impacted. In the week in which schools were closed, our listening service experienced an increase in online contacts, calls and texts,” an ISPCC spokesperson said.
The period of March to April 2020 saw the number of visitors to Childline’s website jump by over 50% compared with the same period in 2019.
Pieta House said overall demand for Pieta’s services increased by 22% from 2020 to 2021. The number of under 18s seeking support increased by 42% last year and more than doubled on the same time the year before.
The charity was prompted to launch a recruitment campaign to find additional therapists to meet the demand.
“Our services have been needed more than ever, and an increase in the volume of therapists with specific experience to deal with our increasing younger age group became a priority for us in the summer of 2021,” a Pieta spokesperson said.
Youth organisation Spunout said there were “big spikes” in demand in October and late December 2020 that coincide with increasing Covid restrictions.
“In terms of negative effects on mental health, or an increase in the need for mental health supports, we can highlight that service demand increased for us during times of pandemic uncertainty,” a spokesperson noted.
The traffic to Spunout’s website has doubled since the start of the pandemic and its most read articles are on self harm, the effects of social media on mental health, and depression.
The Samaritans said it hasn’t seen a huge increase in demand as its service has always been very busy, carrying out approximately half a million calls per year.
“What we did notice was that calls were longer for many people as callers struggled to cope with Covid and it’s restrictions – leading to more loneliness, isolation and causing family and relationship issues,” the charity said.
The HSE provides advice on how to mind your mental health during the coronavirus outbreak on its Your Mental Health website.
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