Suicide in England in the COVID-19 pandemic: Early observational data from real time surveillance

Background: There have been concerns that the COVID-19 pandemic may lead to an increase in suicide. The coronial system in England is not suitable for timely monitoring of suicide because of the delay of several months before inquests are held. Methods: We used data from established systems of "real time surveillance" (RTS) of suspected suicides, in areas covering a total population of around 13 million, to test the hypothesis that the suicide rate rose after the first national lockdown began in England. Findings: The number of suicides in April-October 2020, after the first lockdown began, was 121.3 per month, compared to 125.7 per month in January-March 2020 (-4%; 95% CI-19% to 13%, p = 0.59). Incidence rate ratios did not show a significant rise in individual months after lockdown began and were not raised during the 2-month lockdown period April-May 2020 (IRR: 1.01 [0.81-1.25]) or the 5-month period after the easing of lockdown, June-October 2020 (0.94 [0.81-1.09]). Comparison of the suicide rates after lockdown began in 2020 for the same months in selected areas in 2019 showed no difference. Interpretation: We did not find a rise in suicide rates in England in the months after the first national lockdown began in 2020, despite evidence of greater distress. However, a number of caveats apply. These are early figures and may change. Any effect of the pandemic may vary by population group or geographical area. The use of RTS in this way is new and further development is needed before it can provide full national data. (C) 2021 The Authors. Published by Elsevier Ltd.