Real-time suicide mortality data from police reports in Queensland, Australia, during the COVID-19 pandemic: an interrupted time-series analysis.
Open accessAbstract
BACKGROUND: Deaths by suicide can increase during infectious disease outbreaks. This study analysed suspected suicide rates in 2020 relative to 2015-19 to assess any early effects of the COVID-19 pandemic in Queensland, Australia. METHODS: We analysed data from the interim Queensland Suicide Register (iQSR), a state-wide real-time suicide surveillance system, using an interrupted time-series design. The data source for the iQSR is the Form 1 police report of a death to a coroner. Two QSR staff independently classed the probability of a death by suicide as possible, probable, or beyond reasonable doubt. The analysis included the probable or beyond reasonable doubt categories as suspected suicides. The primary outcome was the monthly suspected suicide rate. We applied Poisson and negative binomial regressions to assess whether Queensland's Public Health Emergency Declaration on Jan 29, 2020, affected suspected suicides from Feb 1 to Aug 31, 2020. Secondary outcomes included absolute or relative changes in police-reported motives of recent unemployment, financial problems, domestic violence, and relationship breakdown. FINDINGS: 3793 suspected suicides were recorded with an unadjusted monthly rate of 14·85 deaths per 100 000 people (from Jan 1, 2015, to Jan 31, 2020) before the declaration, and 443 suspected suicides were recorded with an unadjusted monthly rate of 14·07 deaths per 100 000 people (Feb 1, 2020, onwards) after the declaration. An interrupted time-series Poisson regression model unadjusted (rate ratio [RR] 0·94, 95% CI 0·82-1·06) and adjusted for overdispersion, seasonality, and pre-exposure trends (RR 1·02, 95% CI 0·83-1·25) indicated no evidence of a change in suspected suicide rates. We found no absolute or relative increases in the motives for suspected suicides, including recent unemployment, financial problems, relationship breakdown, or domestic violence from February to August, 2020, compared with the pre-exposure period. INTERPRETATION: There does not yet appear to be an overall change in the suspected suicide rate in the 7 months since Queensland declared a public health emergency. Despite this, COVID-19 has contributed to some suspected suicides in Queensland. Ongoing community spread and increasing death rates of COVID-19, and its impact on national economies and mental health, reinforces the need for governments to maintain the monitoring and reporting of suicide mortality in real time. FUNDING: None.
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Four of the 13 studies published since the search use appropriate time-series modelling approaches to control for underlying trends and report either no change or a fall in suicide deaths in the early months of the pandemic.
“Four of these use appropriate time-series modelling approaches to control for underlying trends ( Leske et al., 2021, Australia; Faust et al., 2020, USA; Vandoros et al., 2020, Greece; Ando et al., 2020, Japan) – these report either no change or a fall in suicide deaths in the early months of the pandemic, although in keeping with Tanaka & Okamoto (2020); Tanaka & Okamoto (2021) and Ueda et al.’s”
From The impact of the COVID-19 pandemic on self-harm and suicidal behaviour: update of living systematic review (2021) · cites this paper as Leske et al., 2021
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- Authors
- Leske, S., Kõlves, K., Crompton, D., Arensman, E., & de Leo, D.
- Affiliations
- Griffith University (AU)
- Corresponding author
- Leske, Stuart
- Venue
- The Lancet Psychiatry
- Publisher
- Elsevier BV
- Published
- 2021-01
- Volume
- 8
- Issue
- 1
- Pages
- 58-63
- ISSN
- 2215-0366 (ISSN-L)
- PMC
- PMC7836943
- OpenAlex
- W3100594904
- Cited by
- 163
- References
- 21
- Citations by year
- 2026: 4 · 2025: 8 · 2024: 28 · 2023: 24 · 2022: 52 · 2021: 41 · 2020: 6
- FWCI
- 12.29
- Type
- journal article
- Language
- en
- Update notices
- erratum (2021-01-01)
- Open access
- hybrid
- doi.org
- Locations
- The Lancet Psychiatry (publishedVersion, cc-by)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Griffith Research Online (submittedVersion, cc-by-nc-nd)
- Funders
- U.S. Department of Justice
- Queensland Health
- Mental Health Commission
- National Coronial Information System
- 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
- suicide, COVID-19 pandemic, public health emergency declaration, suicide surveillance, suicide motives, unemployment, financial problems, domestic violence, breakup, Queensland
- MeSH terms
- COVID-19, Adult, Cause of Death, Female, Humans, Male, Middle Aged, Queensland, Registries, Suicide, Police, Interrupted Time Series Analysis
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