SPR30831 WLF SPA WhitePaper v12 - Flipbook - Page 9
What the evidence says
unprecedented high (18.6 per 100,000 people), from previous years (16.5 per 100,000 people in
2002 and 15.3 per 100,000 people in 2001)14,15.
A study into the impact of suicide rates during the SARS epidemic found a significant increase
among older people aged 65 and above over the month of April 2003 in comparison to previous
years14. The significant increase in suicide rates among older people was attributed to loneliness
and disconnectedness14. It was further determined through examination of cases notes from
Coroner Court’s death records that the SARS epidemic appeared to trigger suicidal thoughts
among older people14.
In March 2020, a man from Bangladesh died by suicide due to stigma and discrimination from
people within his community who suspected he had COVID-19, and in February 2020 a man in
India died by suicide to prevent transmission to other people within his community16. Stigma and
discrimination are perpetuated by fear and misinformation during pandemics and can prevent
people from engaging in help-seeking behaviours and accessing support services6.
Risk factors for suicide during pandemics
While evidence concerning the impact of COVID-19 on the community is still emerging, past
pandemic response measures can amplify risk factors for suicide such as unemployment,
financial stress, social isolation, mental illness (e.g. depression, post-traumatic stress disorder
(PTSD) symptoms), homelessness, domestic violence and drug and alcohol misuse5,9.
Evidence indicates that COVID-19 will have significant social, economic and financial impacts on
individuals, communities and broader economies4. This impact is already being felt in Australia,
with one in 13 Australians (7.5 per cent) reporting “their household lacked the money to pay one
or more bills on time, and one in 10 (10 per cent) had to draw on accumulated savings to support
basic living expenses2”. Grattan Institute estimates that between 1.9-3.4 million Australians will
be unemployed due to physical distancing, and while the JobKeeper wage subsidy will provide
support for many, the unemployment rate is estimated to rise between 10 and 15 per cent17.
During COVID-19, several countries (China, France, Brazil, Italy and the United States) have
reported increases in domestic violence28. Pandemic response measures pose significant safety
concerns for people who may be in isolation with their abuser, who are unable to seek help due
to the forced closure of shelters and support services28. These concerns will be further
compounded by limited financial income and unemployment because of COVID-19 28.
Stress is a key risk factor for alcohol misuse18. A study of hospital employees (n=549) exposed to
SARS to examine alcohol abuse/dependence symptoms in Beijing, identified that three years
post outbreak, current alcohol/dependence symptoms were associated with being quarantined
or working in ‘high risk’ units19.
The mental health of frontline workers
Frontline workers are increasingly at risk of developing poor mental health during pandemics
due to potential exposure to the virus, potential to transmit the virus to their loved ones, moral
injury (e.g. ‘not doing enough’ narratives), having to work in environments where necessary
equipment (whether medical or preventative e.g. masks) are under resourced or being assigned
to work in ‘high risk’ units 20,21,22.
A strong evidence base exists on the increase of emotional distress among healthcare workers
during and post pandemic outbreaks 6,7.
A study surveyed the psychological impact of SARS exposure on hospital workers in Beijing
(n=549) and found 10 per cent experienced high levels of PTSD symptoms following the
epidemic23,6. Employees who quarantined, worked in high-risk units (e.g. SARS units) or had
loved ones who were infected, were “two to three times more likely to have high PTSD symptom
levels, than those without these exposures21,6”. These results are consistent with a survey of
healthcare workers at three Toronto hospitals (n=1557), in which higher psychological stress
Reducing distress in the community following the COVID-19 pandemic
June 2020
9
