Suicidal Ideation Is Increasing During COVID-19: How Best to Cope

  • Experts say mental health issues and suicidal ideation are rising as the COVID-19 pandemic continues.
  • They say the mental strain of the pandemic is particularly difficult for people in marginalized groups.
  • They note men and people who live in rural areas are particularly vulnerable to suicidal ideation.
  • Experts recommend people avoid becoming isolated, stick to a regular schedule, and look for uplifting moments in their week.

COVID-19 is taking a toll on the nation’s mental health.

Struggles with mental health issues or substance use were reported by nearly 41 percent of adults who responded to a recent Centers for Disease Control and Prevention (CDC) survey.

Almost 11 percent of respondents reported suicidal ideation within the previous 30 days, according to the Morbidity and Mortality Weekly Report (MMWR) published Aug. 14.

This compares to 2018, when 4 percent of adults reported suicidal ideation within the previous 12 months.

Of those who said they had seriously considered suicide, there was disproportionate representation among:

  • unpaid caregivers for adults
  • people ages 18 to 24
  • essential workers
  • Hispanic people
  • Black people

More than 5,400 invited adults at least 18 years old completed the web-based survey between June 24 and June 30. Mental health issues and substance use were self-reported.

A perfect storm

Nikki Young is a licensed marriage and family therapist and the CEO of Catalyst Counseling Inc. in Modesto, California.

Young told Healthline that the threat of COVID-19 itself isn’t the only consideration in this mental health crisis.

Isolation, economic stressors, and political strife are contributing factors.

In addition, when someone is in trouble, it may not be obvious to others.

“As a clinician, I have had individuals share with me significant suicidal ideation resulting from debilitating levels of anxiety, without some of the corresponding depressive symptoms that we are accustomed to seeing,” Young explained.

David Rozek, PhD, is a suicide prevention expert for UCF RESTORES in Orlando, Florida.

Rozek told Healthline that this situation is different from any other traumatic event we’ve experienced. That includes natural disasters, instances of mass violence, and other major events, such as 9/11.

“This is an ongoing pervasive stressor that does not have a known endpoint,” he said.

“We do not know how long the pandemic will last, and we do not know what ‘normal’ will look like going forward. Major stressors like this, especially those that come with such an element of uncertainty, tend to increase mental health issues,” Rozek added.

Why some groups are more affected

Rozek notes that people in marginalized groups are at higher risk for mental and physical health issues.

“The pandemic is only continuing to exacerbate these concerns. Also, there are often more barriers to treatment and resources for these groups — crucial points that need to be addressed far beyond once the pandemic has dissipated,” Rozek said.

Thinking that you, or someone close to you, might contract the virus is stressful.

So is having a loved one in intensive care or on a ventilator, or who loses their life to COVID-19.

But there’s more.

“Others are providing care for loved ones at high risk. Individuals are often isolated from friends and family outside the home,” Young said.

“Essential workers may be facing heightened stress resulting from increased likelihood of exposure. Those working from home are likely to experience increased stress in managing work-life and home-life balance. Many parents are now taking on the role of teacher. The list goes on and on,” Young continued.

Of those in the 18 to 24 age group, Young lists multiple factors increasing the risk of mental health problems.

“It’s during this time of their lives that young adults develop increasingly secure and intimate connections with peers. It’s also a time during which young adults begin to identify and pursue life goals, including transitioning out of the family’s home and into independent living settings, and entering the workforce or the world of higher education,” Young said.

“In many cases, the arrival of COVID has hindered the ability of young adults to proceed with many of their life plans,” Young added.

Dr. Patricia Gentile is psychiatric medical director at The Buckeye Ranch, with locations throughout central and southwestern Ohio.

She’s concerned about the strain current events are putting on Black youth.

“The effects of this year have only added to this population’s burden of stress, which will make this unfortunate trend likely to continue escalating,” Gentile hold Healthline.

“The bottom line is that our Black youth do not feel safe. The generational trauma that their families have endured has also resulted in them having fewer and less effective coping mechanisms to manage the stress they are experiencing,” she said.

Rural areas, men at risk for suicide

Before the pandemic, overall suicide rates were already on the rise, according to CDC data.

The pace of increase has been greater in rural areas, rising 48 percent from 2000 through 2018. During the same period, the urban suicide rate increased 34 percent.

Gentile suspects that the rural suicide rate may be tied to the economic downturn and the opioid crisis.

“Small-town America has taken huge hits economically over the last 2 decades for various reasons. Poverty creates immense stress and anxiety, leading to hopelessness and depression, which are precursors for suicide,” she explained.

“The opiate crisis and other substance abuse have hit rural America deeply and profoundly. At The Buckeye Ranch, we take care of kids across Ohio, including rural communities. We’ve seen a trend in the last several years of kids coming in from rural areas who have families with significant substance abuse issues,” Gentile said.

“While it may not be accurate, I have had kids tell me that no one in their town is clean,” she added.

Rural or urban, male suicide rates are more than three times higher than for females.

Gentile believes that’s because for many men, self-esteem and self-worth are tied to jobs and being providers.

She works with struggling families and says they’re exhausted after months of little external support and deteriorating structure in the home.

“With the economic downturn, many of these families have taken the hardest hits, losing jobs or having to leave work to care for children in the home. The unknown of future months is weighing heavily on them. They don’t know how they will provide structure for schooling virtually from home. Stress levels are rising steadily, which can lead to suicide ideation,” Gentile said.

Coping with mental health issues

Social distancing is often mentioned as a key to stopping the spread of COVID-19.

But Young says the name itself directly contradicts all sound mental health advice.

“When someone is experiencing depression or anxiety, one of the last things that a mental health provider would do is encourage social isolation,” Young said.

That’s why many in the mental health field prefer the term “physical distancing,” according to Young.

“In times of crisis, it becomes even more important to make our mental health a priority,” said Young, who provides these self-care tips:

  • Please don’t socially isolate. While the necessity to physically distance will change the way socialization looks during this time, we can still take steps to connect with others. That could be via video call platforms or from a safe physical distance with appropriate safety precautions.
  • Set a schedule for yourself and follow a daily routine.
  • Schedule time each day to engage in a healthy, stress-relieving activity.
  • Challenge yourself to find examples of positive, uplifting moments in your week.
  • If constant exposure to information via social media or television becomes overwhelming, limit it to a set amount each day.

Reaching out for help

Rozek says some barriers to help are being broken down by the growing adoption of telehealth technology.

He wants people to know that help is available.

“Many organizations and treatment clinics, including UCF RESTORES, are providing treatment via telehealth, including brief treatments (e.g., single-session consultations) that are proven to be successful for those in need. Treatments that are flexible in delivery, minimal in cost, and work to increase access to services will be key for those seeking ways to cope with these excruciating circumstances,” he advised.

“For those that feel overwhelmed and like they do not have anywhere to turn, the National Suicide Prevention Lifeline (1-800-273-8255) is an incredible resource, available 24/7, to support anyone in need during times of crisis,” Rozek said.

If you’re dealing with suicidal ideation, Gentile reminds that depression is treatable.

“It’s important to remember that the level of pain and distress being felt at this moment is temporary for many. Breathe, go for a walk, and listen to music. Consider reaching out to a friend and asking for help. To talk to a trained counselor who can help, text HOME to 741741 or call 911,” Gentile said.


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