Reasons and trends in youth’s suicide rates during the COVID-19 pandemic.
Open accessAbstract
Background: The COVID-19 pandemic posed many mental health challenges to youth through unprecedented infection control measures such as nationwide school closures. Despite this, few studies have investigated trends in suicide among youth during the pandemic, let alone their reasons. Methods: Population-level data on crude monthly suicide rates (2016-2021) and reasons of suicide (2018-2020) among youth aged 10-19 years were obtained from the Japanese Ministry of Health, Labour and Welfare and the National Police Agency, respectively. Using an event study design (with a Poisson regression model to calculate changes-in-changes (CiC) estimates) and interrupted time series analysis, we investigated changes in monthly suicide rates during the first 12 months of the pandemic (May 2020 to April 2021) compared to pre-pandemic levels (May 2016 to March 2020). Additionally, we investigated the changes in reasons of suicide (family-related, mental illness, social concerns, and academic concerns). Findings: In the event study analysis, suicide rates among youth increased during the pandemic relative to pre-pandemic levels, especially between August-November 2020 (e.g., ratio of the suicide rate in November 2020 relative to previous years, 1.86; 95% confidence interval (CI), 1.30 to 2.66). Though suicide levels returned closer to pre-pandemic levels by December 2020, they remained slightly elevated into 2021. In the interrupted time series analysis, suicide rates increased from May to August 2020 (0.099 cases per 100,000 youth per month; 95% CI, 0.022 to 0.176), followed by a decrease from September to December 2020 (-0.086 cases per 100,000 youth per month; 95% CI, -0.164 to -0.009). We observed elevated suicide rates for all major reasons from summer to autumn 2020, especially suicides attributed to family-related problems and social concerns. Furthermore, rates of suicides attributed to mental illness remained higher than pre-pandemic levels into December 2020. Interpretation: Suicide rates among youth remained slightly elevated compared to pre-pandemic levels into 2021. The reasons of the increase in suicide rates were multifactorial, including mental health issues and disruptions in social relationships. During a pandemic, interventions that provide mental support as well as opportunities for regular social interactions to youth may be beneficial. Funding: Norwegian Agency for International Cooperation and Quality Enhancement in Higher Education.
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A similar trend in suicides is commonly seen among persons affected by crises such as natural disasters and wars.
“A similar trend in suicides is commonly seen among persons affected by crises such as natural disasters and wars.”
From Suspected Suicide Attempts by Self-Poisoning Among Persons Aged 10–19 Years During the COVID-19 Pandemic — United States, 2020–2022 (2023) · cites this paper as [8]
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Adolescent Acetaminophen and Ibuprofen Self-Poisoning, 2017–2022
Weigel, B., Adams, A. J., Wahrenbrock, T. N., & Wahl, M. (2024) · Pediatric Emergency Care · doi:10.1097/pec.0000000000003246 · Cited by 2 · see citing works
Vardi, I., Hamdan, S., Zalsman, G., & Stukalin, Y. (2025) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.13156 · Cited by 3 · see citing works
Chen, Y.-C., Chen, P., Chiang, C., Sung, P.-C., Chen, P.-Y., Hsieh, J.-H., Tsai, W.-C., Ho, C., Chow, J. C., & Chang, T. (2025) · Asian Journal of Social Health and Behavior · doi:10.4103/shb.shb_368_24 · Cited by 2 · see citing works
Takeuchi, H., Satoh, Y., Raman, S., & Spencer, N. J. (2024) · Children · doi:10.3390/children11030330 · Cited by 2 · see citing works
“…of changes in suicide rates and possible explanations for changes they observed in children aged 10–19 years between 2020 and 2021, identified several factors associated with the increase in suicides including family-related concerns, mental illness, social concerns and academic concerns [23].”
BackgroundThe Effect of Voluntary Staying at Home on Japanese Female Suicide During the COVID‐19 Pandemic
Ibuka, Y., Kakehi, H., Kobayashi, R., & Nakajima, R. (2026) · Health Economics · doi:10.1002/hec.70078 · Cited by 1 · see citing works
“…the causes of Japanese youth suicides during the pandemic using time‐series data revealed periodic increases attributed to family related and social concerns, whereas suicides linked to mental illness particular increased as the pandemic progressed into the later months of 2020 (Goto et al. 2022).”
Mohamad, N., Ismail, R., Ibrahim, M. F., Shukor, I. H. A., Mohamad, M. Z., Mahmud, M. F., & Yaacob, S. S. (2023) · Healthcare · doi:10.3390/healthcare11162339 · Cited by 1 · see citing works
“The overwhelmed healthcare system likely led to an underestimation of COVID-19 deaths, and the uncertainty of the future led to an increase in suicide rates, especially among youth [4].”
BackgroundChen, M., Wang, X., Wang, Y.-X., Ren, L.-Y., Jiang, H., Xia, L., Zhang, L., & Dong, C.-Q. (2024) · Journal of Forensic and Legal Medicine · doi:10.1016/j.jflm.2024.102658 · Cited by 2 · see citing works
Shaw, B. R., Patel, N. A., & Durham, M. P. (2024) · Child and Adolescent Psychiatric Clinics of North America · doi:10.1016/j.chc.2024.03.013 · Cited by 1 · see citing works
Способы совершения самоубийств: различия между поколениями (на примере населения Санкт-Петербурга)
Rozanov, V. A., Vuks, A. J., Anokhina, M. V., Isakov, V. D., Freize, V. V., & Semenova, N. V. (2024) · Суицидология · doi:10.32878/suiciderus.24-15-02(55)-3-28 · Cited by 1 · see citing works
“…за по-следние десятилетия среди молодёжи (дети, подростки, юноши, девушки) наблюдается в разных странах, об этом , в частности , упоминается в сообщениях из Финляндии [19], Швеции [20], Великобритании [21], Турции [22], Балкан-ских стран [23], а также Гонконга [24], Южной Кореи [25] и США [26].”
InfluentialLitenski, M. N., Shtanko, Y., O'Reardon, A. B., Castro, G., Castellanos, D., & Varella, M. H. (2024) · Cureus · doi:10.7759/cureus.68205 · Cited by 1 · see citing works
Suicide Attempts and Self-harm in Adolescent Patients
Lin, C.-H., & Sung, C. (2023) · Taiwanese Journal of Psychiatry · doi:10.4103/tpsy.tpsy_19_23
Adolescenti e suicidio: qualcosa è cambiato durante e dopo la pandemia?
Valletta, E. A., & Fornaro, M. (2023) · QUADERNI ACP · doi:10.53141/qacp.2023.107-109
Larraz, A. M., García‐Salido, A., Casanova, N. L., Zaghlul, M. D. C., Braza-Claver, M., & Nieto‐Moro, M. (2023) · Revista de Psiquiatría y Salud Mental · doi:10.1016/j.sjpmh.2023.05.003
WPŁYW PANDEMII COVID-19 NA EPIDEMIOLOGIĘ I UWARUNKOWANIA SAMOBÓJSTW
Konieczny, M. K. (2023) · International Journal of Legal Studies ( IJOLS ) · doi:10.5604/01.3001.0053.9028
Drawing Insights from the COVID-19 Pandemic
Milkovich, J. (2023) · Canadian Journal for the Academic Mind · doi:10.25071/2817-5344/54
Okubo, Y., Ishitsuka, K., & Goto, A. (2024) · Research Square · doi:10.21203/rs.3.rs-3960071/v1
Leite, R. R., Ferreira, S. B., Ventriglio, A., & Chagas, W. (2024) · International Review of Psychiatry · doi:10.1080/09540261.2024.2336622
“However, in Japan, there was an increase in the number of suicides due to the stress of returning to school after the initial closure, the overload of school activities after returning, less social interaction and greater exposure to dysfunctional family arrangements (Goto et al., 2022).”
Wu, X., Palaniyappan, L. K., van Velzen, L. S., Yu, G., Fan, H., Liu, Y., Becker, B., Cheng, W., Zhao, X., Feng, J., et al. (2024) · medRxiv · doi:10.1101/2024.04.13.24305772
Temporal Fluctuations of Suicide Mortality in Japan from 2009 to 2023 Using Government Databases
Matsumoto, R., Motomura, E., & Okada, M. (2024) · European Journal of Investigation in Health Psychology and Education · doi:10.3390/ejihpe14040071
Suicidal thoughts and behaviors among adolescents during the COVID-19 pandemic
Robillard, C. L., Shen, A., & Turner, B. J. (2024) · Elsevier eBooks · doi:10.1016/b978-0-323-95648-2.00043-5
Museka, G., & Hlatywayo, A. M. (2024) · Pharos Journal of Theology · doi:10.46222/pharosjot.105.413
Understanding Suicide Symptoms and Peer Support in High School Students
Biber, D., & Brandenburg, G. (2024) · Trends in Psychology · doi:10.1007/s43076-024-00404-0
“Furthermore, suicide rates in adolescents increased globally during the COVID-19 pandemic and are related to social isolation, mental illness, academic difficulties, and family health issues (Goto et al., 2022).”
Singh, K., Kaur, R., Behera, C., Balhara, Y. P. S., & Kaushik, R. (2024) · Industrial Psychiatry Journal · doi:10.4103/ipj.ipj_304_24
Comprehensive Understanding of Young People Suicide Risk Assessment and Intervention
Martínez, V., & Vargas, B. (2025) · Depression and personality · doi:10.1007/978-3-031-96037-6_7
Analysis of suicide-related deaths among children aged 0–14 years in Türkiye
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“10 However, because that study lacked clinical assessments of psychiatric symptoms, its findings provided a limited understanding.”
Working with Adolescent Autodestructive Behavior in Kazakhstan
Kuandykova, B., Давлетова, А. А., Perlenbetov, M., & Sаngilbayev, О. S. (2026) · Journal of Forensic Psychology Research and Practice · doi:10.1080/24732850.2025.2612577
Ferro, V., Averna, R., Bellelli, E., Spinelli, E., Labonia, M., Apicella, M., Raucci, U., Cristaldi, S., Parisi, P., Vicari, S., et al. (2026) · Psychology Health & Medicine · doi:10.1080/13548506.2026.2651910
Novoa, E., Bustamante, F., Concha, C., Landeta, R., & Vidal, V. (2026) · School Mental Health · doi:10.1007/s12310-026-09884-0
“Existing studies have demonstrated that educational programs targeting parents significantly improve the outcomes of preven - tive interventions (Goto et al., 2022; Pistone et al., 2019; Radez et al., 2021).”
InfluentialJung, K. Y. (2026) · BMC Emergency Medicine · doi:10.1186/s12873-026-01663-z
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“Another study in Japan showed a slight increase in suicide among teenagers during the pandemic (19).”
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Ceballos-Espinoza, F., Acosta-Rodas, P., Chávez‐Hernández, A., & López-Ambi, V. (2026) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-026-03228-8
- Authors
- Goto, R., Okubo, Y., & Skokauskas, N.
- Affiliations
- University of Tokyo Hospital (JP)
- National Center For Child Health and Development (JP)
- Norwegian University of Science and Technology (NO)
- Corresponding author
- Skokauskas, Norbert
- Venue
- The Lancet Regional Health - Western Pacific
- Publisher
- Elsevier BV
- Published
- 2022-10
- Volume
- 27
- Pages
- 100567
- ISSN
- 2666-6065 (ISSN-L)
- PMC
- PMC9366131
- OpenAlex
- W4293153428
- Cited by
- 72
- References
- 36
- Citations by year
- 2026: 9 · 2025: 11 · 2024: 26 · 2023: 23 · 2022: 3
- FWCI
- 14.39
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- The Lancet Regional Health - Western Pacific (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- NORA - Norwegian Open Research Archives (submittedVersion, cc-by-nc-nd)
- Funders
- Direktoratet for internasjonalisering og kvalitetsutvikling i høgare utdanning (10012)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
- Keywords
- youth suicide, COVID-19 pandemic, suicide rates, suicide motives, mental illness, social problems, academic concerns, school closures, adolescent mental health, Japan, interrupted time series, mental health support services
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