Pandemic Tied to Higher Suicide Rate in Blacks, Lowered Rate in Whites: Study
The coronavirus pandemic has exacerbated racial divides in health care in numerous ways, and a new study reveals yet another: Suicides among Black people doubled during COVID-19 lockdowns, while suicides in white individuals were cut in half during the same period.
"In past pandemics, there has been noted rises in suicide, and the COVID-19 pandemic seemed like the perfect storm for suicide given its economic impact, the fear of illness, increased stress and reduced access to care," explained study author Dr. Paul Sasha Nestadt. He's an assistant professor of psychiatry at the Johns Hopkins School of Medicine, in Baltimore.
But this wasn't the case with the coronavirus pandemic, at least not among the Marylanders followed in this study. "There were no increase in suicides in general as we expected, but we did see suicides in Blacks almost double," Nestadt said.
The findings, which were published online Dec. 16 in JAMA Psychiatry, suggest that the Black community may have been particularly hard hit by the pandemic and its economic consequences.
"Infection and fatality rates are higher among Black people, and we know that there are huge disparities in access to care, including mental health care," Nestadt said.
This is a recipe for bad outcomes. "When someone is struck hard by things around the pandemic and they can't get access to good mental health care, they are in the most danger," he explained.
"We are all in the same storm, but we are in different boats," Nestadt said. "Many people were able to hunker down and be with their family and could afford child care, but some people were just getting by to start with and did not have the reserve or cushion to do this."
It's possible that white people may have had more resources, he noted. "They may be more likely to have jobs that allow working from home, may have been able to attain child care, and based on fatality rates may have been less likely to have lost a family member to COVID. They also had easier access to mental health care," Nestadt said.
For the study, the researchers looked at suicides in Maryland across three distinct time periods throughout the pandemic. From March 5 to May 7, the height of COVID-19-related shutdowns in Maryland, suicides among Black people doubled, but suicides among white people were nearly halved during this period. Nestadt pointed out that suicide rates tend to be higher among white people historically.
The new study does have its share of limitations. For starters, the findings may not reflect suicides in other states due to differences in race relations, COVID-19 experiences and government responses to the outbreak between the states, he said.
It's also possible that the increase in suicide among Black people could be due to something other than the pandemic, Nestadt said. "It may not be COVID-19, but other things going on in the world as this timeframe also corresponds with the racial justice movement," he noted. To get answers, researchers plan to speak with family members to find out what was going on in the days leading up to the suicides that may have played a role in the death.
Calling the new findings a "warning sign," Dr. Robert Dicker, associate director of the division of child and adolescent psychiatry at Northwell Health in New Hyde Park, N.Y., said they offer "one more piece of evidence that COVID-19 has the potential to become a behavioral health pandemic."
More research is needed to understand how the pandemic is affecting mental health and who is at greatest risk, he said. "We need to do more outreach across the board in terms of behavioral issues related to the pandemic, especially in the African-American community, and take a close look at access to evaluation and care, and whether there is a difference in stigma for receiving behavioral health assessment and treatments among different racial and ethnic groups," Dicker explained.
As researchers seek these answers, the onus is on communities and state and federal governments to improve access to mental health care and build a better safety net for at-risk individuals, Nestadt added.
"We have to make sure we are taking care of people while they are doing their best to avoid spreading COVID-19 by offering economic stimulus packages and cushions that are distributed equitably so the most vulnerable aren't left out to dry," he said, noting that rent and loan-forgiveness programs may help ease some of the financial pressure on these at-risk individuals.
Everyone can do their part to help prevent suicide, Nestadt said. "If you are experiencing stress and sadness that becomes severe, or if you start having suicidal thoughts, call 911 or a suicide crisis line," he urged.
If someone in your household is at risk for suicide, make sure that any guns or dangerous medicines are stored safely. "Access to lethal means is arguably the most important suicide risk factor that we can do something about," Nestadt said.
The National Suicide Prevention Lifeline provides free 24/7 support for people in distress.
SOURCES: Paul Sasha Nestadt, MD, assistant professor, psychiatry, Johns Hopkins School of Medicine, Baltimore; Robert Dicker, MD, associate director, division of child and adolescent psychiatry, Northwell Health, New Hyde Park, N.Y.; JAMA Psychiatry, Dec. 16 , 2020, online
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