The COVID-19 pandemic and epidemiologic insights from recession-related suicide mortality

The COVID-19 pandemic has led to the initiation of large-scale quarantine measures, resulting in widespread closures of significant sectors of the worldwide economy. The International Monetary Fund predicts that the world economy will experience the worst recession since the Great Depression, labelling this the �Great Lockdown� [1]. In this context, we need to plan for deleterious mental health effects resulting from this global recession, including: job stress and insecurity, sharply rising unemployment and longer duration of unemployment, income shock, bankruptcy, rising household debt levels, marked decline in asset values, loss of savings, house repossessions, reduced healthcare resources, cuts in community and social services, strained relationships, increased social isolation, and rises in alcohol misuse [2]. In 1897, Durkheim proposed that periods of significant economic, social or political change might result in �anomic suicide� due to a lack of social integration, and a rise in concern for self-interest, as people�s material and social circumstances fall well below their previous living standards [3]. Public health measures necessitated by COVID-19 may thus drive the development of anomie, which has repercussions for social connectedness, overall mental health and specific adverse consequences such as increased suicide rates. There are emerging concerns that the COVID-19 pandemic may specifically increase suicide rates due to the combination of economic stress, social isolation, barriers to receiving mental health treatment and increased levels of national anxiety [4]. Accordingly, epidemiological data on suicide from previous significant economic recessions and depressions may help estimate the potential economic impacts of COVID-19 on suicide rates.