There is great concern that the COVID-19 pandemic and all it includes (such as social isolation, financial hardship, unemployment, and fear of infection) may increase the incidence of mental health issues and suicidality. This is especially a concern in veterans, a population already at increased risk for mental health issues and suicidality. In this population-based, prospective cohort study, analyzing data from 4069 veterans from the National Health and Resilience in Veterans Study, the authors investigated US veteran suicidality from November, 2019 (pre-pandemic) to December, 2020 (peripandemic). The data show that there was actually a DECREASE in suicidal ideation between pre- and peri-pandemic times (Figure).
Figure. Prevalence of Suicidal Ideation Between Pre-Pandemic and Peri-pandemic Times
The percent of veterans with suicidal ideation decreased from 10.6% to 7.8% over a 10-month period from November, 2019 to December, 2020.
On the other hand, 2.6% of veterans in the study reported new-onset suicidal ideation in the peri-pandemic period. Vulnerability to this new onset suicidality was associated with low social support, suicide attempt history, lifetime PTSD and/or depression, COVID-19-asssociated worsening social relationships, COVID-19 infection, and past year alcohol use disorder severity. The authors speculate that the reduction in suicidal ideation seen peri-pandemic may be due to veterans being more resilient and accustomed to challenging times, greater perceived social support, more time with family, improvements in physical health, and a sense of belonging. Both the risk and protective factors may help guide policy and responses to suicidality during a pandemic.
Nichter B et al. JAMA Psychiatry 2021; Epub ahead of print. Abstract