Suicide attempt and intentional self-harm during the earlier phase of the COVID-19 pandemic in Washtenaw County, Michigan

J Epidemiol Community Health. 2021 Oct;75(10):963-969. doi: 10.1136/jech-2020-215333. Epub 2021 Mar 29.

Abstract

Objective: Determine the early impact of the COVID-19 pandemic on emergency department (ED) encounters for suicide attempt and intentional self-harm at a regional tertiary academic medical centre in Washtenaw County, Michigan, which is one of the wealthier and more diverse counties in the state.

Methods: Interrupted time series analysis of daily ED encounters from October 2015 through October 2020 for suicide attempt and intentional self-harm (subject n=3002; 62% female; 78% Caucasian) using an autoregressive integrated moving average modelling approach.

Results: There were 39.9% (95% CI 22.9% to 53.1%) fewer ED encounters for suicide attempt and intentional self-harm during the first 7 months of the COVID-19 pandemic (ie, on or after 10 March 2020, when the first cases of COVID-19 were identified in Michigan).

Conclusions: Fewer individuals sought emergency care for suicide-related behaviour during the earlier phase of the COVID-19 pandemic than expected when compared to prior years. This suggests initial outbreaks of COVID-19 and state of emergency executive orders did not increase suicide-related behaviour in the short term. More work is needed to determine long-term impacts of the COVID-19 pandemic on suicide-related behaviour and whether there are high-risk groups.

Keywords: clinical epidemiology; social epidemiology; suicide; time-series.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • COVID-19* / epidemiology
  • COVID-19* / psychology
  • Emergency Service, Hospital / statistics & numerical data
  • Female
  • Humans
  • Interrupted Time Series Analysis
  • Male
  • Michigan / epidemiology
  • Middle Aged
  • Pandemics*
  • Self-Injurious Behavior* / epidemiology
  • Suicide, Attempted* / statistics & numerical data
  • Young Adult