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Suicide attempt and intentional self-harm during the earlier phase of the COVID-19 pandemic in Washtenaw County, Michigan
  1. Rachel S Bergmans,
  2. Peter S Larson
  1. Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
  1. Correspondence to Dr Rachel S Bergmans, Institute for Social Research, University of Michigan, Ann Arbor, MI 48106, USA; rbergs{at}med.umich.edu

Abstract

Objective Determine the early impact of the COVID-19 pandemic on emergency department (ED) encounters for suicide attempt and intentional self-harm at a regional tertiary academic medical centre in Washtenaw County, Michigan, which is one of the wealthier and more diverse counties in the state.

Methods Interrupted time series analysis of daily ED encounters from October 2015 through October 2020 for suicide attempt and intentional self-harm (subject n=3002; 62% female; 78% Caucasian) using an autoregressive integrated moving average modelling approach.

Results There were 39.9% (95% CI 22.9% to 53.1%) fewer ED encounters for suicide attempt and intentional self-harm during the first 7 months of the COVID-19 pandemic (ie, on or after 10 March 2020, when the first cases of COVID-19 were identified in Michigan).

Conclusions Fewer individuals sought emergency care for suicide-related behaviour during the earlier phase of the COVID-19 pandemic than expected when compared to prior years. This suggests initial outbreaks of COVID-19 and state of emergency executive orders did not increase suicide-related behaviour in the short term. More work is needed to determine long-term impacts of the COVID-19 pandemic on suicide-related behaviour and whether there are high-risk groups.

  • suicide
  • time-series
  • social epidemiology
  • clinical epidemiology

Data availability statement

Data came from electronic medical records that are not publicly available.

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

https://doi.org/10.1136/jech-2020-215333

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    Data availability statement

    Data came from electronic medical records that are not publicly available.

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    Footnotes

    • Correction notice This article has been corrected since it first published. A correction has been made to the Results section of the Abstract.

    • Contributors RSB conceived the study, extracted and analysed the data, interpreted the study findings and wrote the initial draft of the manuscript. PSL analysed the data, interpreted the study findings, generated figures and tables and assisted in writing the manuscript.

    • Funding RSB was supported by funding from the USA National Institute for Environmental Health Sciences Michigan Center on Lifestage Environmental Exposures and Disease (NIEHS P30ES017885). PSL was supported through a postdoctoral research fellowship from the University of Michigan Institute for Global Change Biology.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.