Suicide-Related Emergency Department Visits Before and After the COVID-19 Pandemic
Abstract
Introduction and Objective. The impact of COVID-19 on suicide rates is a significant concern given the widely recognized psychological effects that the pandemic has had on mental health. Overall, suicide trends remained relatively stable. Yet, specific age groups, races, and genders experienced an increase in suicide rates. Better understanding of suicide trends over time is critical to identify and address mental health crises exacerbated by the pandemic. This study aimed to determine whether the pandemic is associated with an increase in emergency department (ED) admissions for suicide or intentional injury. Methods. We performed secondary analyses of data from the National Hospital and Ambulatory Medical Care Survey (2018 to 2021). The frequency of ED visits due to intentional injury or suicide were compared in 2018-2019 (pre- COVID-19 pandemic onset) to those of 2020-2021 (post-COVID-19 onset). Logistic regression was used to estimate odd ratios and corresponding 95% confidence intervals. Patient’s race, sex, age, and regional differences were assessed as covariates. Results. There were 27,516 and 22,247 visits assessed in the pre- and post- COVID-19 periods, respectively. In total, 1,375 visits were due to intentional injury/suicide. No differences were found comparing the proportion of visits due to intentional injuries/suicide pre- and post-COVID-19 periods (2.6% in both) The adjusted OR (aOR) was 0.98, 95% confidence interval (CI)=0.84-1.15. The odds of suicide/ intentional injury was 53% higher in males (aOR=1.53 95%CI=1.30-1.81), in those with ages 18-44 years (aOR=7.24 95% CI=4.92-10.67) and 45-64 years (aOR=3.55, 95% CI 2.31-5.47) compared to those 65 years of older, and in Non-Hispanic Blacks compared to Non-Hispanic Whites (aOR=1.29, 95% CI=1.05-1.58). Conclusions-Implications. Using a national sample of ED visits, we found no association between pre/post COVID-19 pandemic periods and occurrence of visits due to intentional injury/suicide. Yet, targeted interventions to population subgroups with significant increases in the odds of suicide/intent of injury are needed. Further research is crucial to assess long-term impacts of COVID-19.
Keywords
Suicide, COVID-19, Mental Health, Vulnerable Populations
Presentation Type
Oral Presentation
Suicide-Related Emergency Department Visits Before and After the COVID-19 Pandemic
Introduction and Objective. The impact of COVID-19 on suicide rates is a significant concern given the widely recognized psychological effects that the pandemic has had on mental health. Overall, suicide trends remained relatively stable. Yet, specific age groups, races, and genders experienced an increase in suicide rates. Better understanding of suicide trends over time is critical to identify and address mental health crises exacerbated by the pandemic. This study aimed to determine whether the pandemic is associated with an increase in emergency department (ED) admissions for suicide or intentional injury. Methods. We performed secondary analyses of data from the National Hospital and Ambulatory Medical Care Survey (2018 to 2021). The frequency of ED visits due to intentional injury or suicide were compared in 2018-2019 (pre- COVID-19 pandemic onset) to those of 2020-2021 (post-COVID-19 onset). Logistic regression was used to estimate odd ratios and corresponding 95% confidence intervals. Patient’s race, sex, age, and regional differences were assessed as covariates. Results. There were 27,516 and 22,247 visits assessed in the pre- and post- COVID-19 periods, respectively. In total, 1,375 visits were due to intentional injury/suicide. No differences were found comparing the proportion of visits due to intentional injuries/suicide pre- and post-COVID-19 periods (2.6% in both) The adjusted OR (aOR) was 0.98, 95% confidence interval (CI)=0.84-1.15. The odds of suicide/ intentional injury was 53% higher in males (aOR=1.53 95%CI=1.30-1.81), in those with ages 18-44 years (aOR=7.24 95% CI=4.92-10.67) and 45-64 years (aOR=3.55, 95% CI 2.31-5.47) compared to those 65 years of older, and in Non-Hispanic Blacks compared to Non-Hispanic Whites (aOR=1.29, 95% CI=1.05-1.58). Conclusions-Implications. Using a national sample of ED visits, we found no association between pre/post COVID-19 pandemic periods and occurrence of visits due to intentional injury/suicide. Yet, targeted interventions to population subgroups with significant increases in the odds of suicide/intent of injury are needed. Further research is crucial to assess long-term impacts of COVID-19.