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Liu L. The direct and indirect effects of the COVID-19 pandemic on the mental health of confined youth. HEALTH & JUSTICE 2024; 12:14. [PMID: 38589594 PMCID: PMC11003086 DOI: 10.1186/s40352-024-00267-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 03/13/2024] [Indexed: 04/10/2024]
Abstract
The COVID-19 pandemic posed an unprecedented threat to the mental health of youth due to its attendant, drastic changes in everyday life brought about by restrictions such as social distancing and the cancelation of in-person classes. Although numerous articles have discussed the impact of the pandemic on youths' mental health, most of them have been opinion pieces. This study used state-wide empirical data to quantify the direct and indirect effect of the pandemic on the mental health of confined youth, a vulnerable social group that is rarely represented in school survey data. Group comparisons of youth who entered juvenile justice facilities during pandemic and non-pandemic times were also conducted. Findings revealed that youth who entered residential facilities during the pandemic due to criminal offenses had higher rates of prior mental health problems and victimization. With major confounders controlled, multivariate regression results showed that the impact of the pandemic on confined youths' mental health is indirect: it conditioned the effect of underage drinking on the youths' mental health. Youth who were admitted into facilities during the pandemic were more likely to experience mental health problems than their peers who entered facilities during non-pandemic times. Implications for policymaking are discussed.
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Affiliation(s)
- Lin Liu
- Department of Sociology and Criminology & Law, University of Florida, Gainesville, FL, USA.
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2
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Baccon WC, Salci MA, Carreira L, Gallo AM, Marques FRDM, Paiano M, Baldissera VDA, Laranjeira C. Meanings and Experiences of Prisoners and Family Members Affected by the COVID-19 Pandemic in a Brazilian Prison Unit: A Grounded Theory Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6488. [PMID: 37569028 PMCID: PMC10419247 DOI: 10.3390/ijerph20156488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 07/20/2023] [Accepted: 07/23/2023] [Indexed: 08/13/2023]
Abstract
Worldwide, the COVID-19 pandemic represented a health emergency for prisons. This study sought to understand the meanings and experiences through the narratives of prisoners and family members affected by the COVID-19 pandemic in the context of a maximum-security state penitentiary complex in southern Brazil. For this purpose, a qualitative study was developed based on the methodological framework of constructivist grounded theory. Data were collected between February and August 2022 through individual in-depth interviews and field notes. The sample consisted of 41 participants: 28 male prisoners, and 13 family members. Guided by the Charmaz method of grounded theory analysis, the study afforded the core category "Feeling trapped in prison during the COVID-19 pandemic" with three interrelated phases: "Triggering", "Escalating", and "Readjustment". The "Triggering" phase refers to COVID-19-related elements or events that triggered certain reactions, processes, or changes in prison. During the "Escalating" phase, participants became overwhelmed by the suffering caused by incarceration and the pandemic crisis. The "Readjustment" phase involved adapting, reorienting, or reformulating previous approaches or strategies for dealing with a specific situation. Prisons faced complex challenges during the pandemic and were forced to prioritize protecting public health. However, the measures adopted must be carefully evaluated, ensuring their needs and that they are based on scientific evidence. The punitive approach can undermine inmate trust in prison authorities, making it difficult to report symptoms and adhere to preventive measures.
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Affiliation(s)
- Wanessa Cristina Baccon
- Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Maringá, Avenida Colombo, 5790—Campus Universitário, Maringá 87020-900, PR, Brazil; (W.C.B.); (M.A.S.); (L.C.); (A.M.G.); (F.R.D.M.M.); (M.P.); (V.D.A.B.)
| | - Maria Aparecida Salci
- Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Maringá, Avenida Colombo, 5790—Campus Universitário, Maringá 87020-900, PR, Brazil; (W.C.B.); (M.A.S.); (L.C.); (A.M.G.); (F.R.D.M.M.); (M.P.); (V.D.A.B.)
| | - Lígia Carreira
- Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Maringá, Avenida Colombo, 5790—Campus Universitário, Maringá 87020-900, PR, Brazil; (W.C.B.); (M.A.S.); (L.C.); (A.M.G.); (F.R.D.M.M.); (M.P.); (V.D.A.B.)
| | - Adriana Martins Gallo
- Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Maringá, Avenida Colombo, 5790—Campus Universitário, Maringá 87020-900, PR, Brazil; (W.C.B.); (M.A.S.); (L.C.); (A.M.G.); (F.R.D.M.M.); (M.P.); (V.D.A.B.)
| | - Francielle Renata Danielli Martins Marques
- Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Maringá, Avenida Colombo, 5790—Campus Universitário, Maringá 87020-900, PR, Brazil; (W.C.B.); (M.A.S.); (L.C.); (A.M.G.); (F.R.D.M.M.); (M.P.); (V.D.A.B.)
| | - Marcelle Paiano
- Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Maringá, Avenida Colombo, 5790—Campus Universitário, Maringá 87020-900, PR, Brazil; (W.C.B.); (M.A.S.); (L.C.); (A.M.G.); (F.R.D.M.M.); (M.P.); (V.D.A.B.)
| | - Vanessa Denardi Antoniassi Baldissera
- Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Maringá, Avenida Colombo, 5790—Campus Universitário, Maringá 87020-900, PR, Brazil; (W.C.B.); (M.A.S.); (L.C.); (A.M.G.); (F.R.D.M.M.); (M.P.); (V.D.A.B.)
| | - Carlos Laranjeira
- School of Health Sciences, Polytechnic of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
- Centre for Innovative Care and Health Technology (ciTechCare), Rua de Santo André-66-68, Campus 5, Polytechnic of Leiria, 2410-541 Leiria, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, 7000-801 Évora, Portugal
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Mendes R, Baccon WC, Laranjeira C. Fear of COVID-19, Mental Health and Resilient Coping in Young Adult Male Inmates: A Portuguese Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085510. [PMID: 37107792 PMCID: PMC10138818 DOI: 10.3390/ijerph20085510] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 04/03/2023] [Accepted: 04/10/2023] [Indexed: 05/11/2023]
Abstract
Inmates are highly exposed to mental and physical disorders. Therefore, periodic screening of their mental health and other health risks is required. This study aims to investigate the perceived fear of COVID-19 and the psychological impact of the pandemic in a sample of young adult male inmates. An institutional-based quantitative cross-sectional study design was performed. Data collection took place from July to September 2022 at a juvenile prison in the central region of Portugal. Data were collected using questionnaires on demographic and health characteristics; fear of COVID-19; depression, anxiety and stress levels; and resilient coping. The sample included 60 male inmates imprisoned for over 2 years. Stress was the most common symptom among inmates (75%), followed by anxiety (38.3%) and depression (36.7%). The mean score on the Fear of COVID-19 Scale was 17.38 ± 4.80, indicating relatively low fear levels. Low resilient scores were found in 38 participants (63.3%). Participants reported moderately high ranges of 3.62 ± 0.87 regarding mental health perception, 3.73 ± 0.95 for physical health perception, and 3.27 ± 0.82 for global health concerning the previous month. The Pearson correlation matrix indicated significant and moderate to strong correlations between fear of COVID-19 and mental health-related variables (p < 0.001). The predicting factors of fear of COVID-19 were identified by deploying a multiple linear regression model. We found four predictors: age, perception of mental health, and overall levels of anxiety and stress (R2 = 0.497). Fear of a given scenario or factor may shift with time. Therefore, long-term research is needed to evaluate whether fear of COVID-19 is adaptive or long-reactive in victims. Our study can assist policymakers, mental health and public health experts, and others in recognizing and managing pandemic-related fears and mental health symptoms.
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Affiliation(s)
- Rute Mendes
- Estabelecimento Prisional de Leiria, Avenida da Comunidade Europeia, No 1-Apartado 460, 2410-755 Leiria, Portugal
- School of Health Sciences of Polytechnic, University of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
| | - Wanessa Cristina Baccon
- Postgraduate Nursing Program, State University of Maringá, Av. Colombo, 5790-Zona 7, Maringá 87020-900, PR, Brazil
| | - Carlos Laranjeira
- School of Health Sciences of Polytechnic, University of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
- Centre for Innovative Care and Health Technology (ciTechCare), Rua de Santo André—66–68, Campus 5, Polytechnic University of Leiria, 2410-541 Leiria, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, 7000-801 Évora, Portugal
- Correspondence:
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Wainwright L, Senker S, Canvin K, Sheard L. "It was really poor prior to the pandemic. It got really bad after": A qualitative study of the impact of COVID-19 on prison healthcare in England. HEALTH & JUSTICE 2023; 11:6. [PMID: 36749526 PMCID: PMC9903265 DOI: 10.1186/s40352-023-00212-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 01/31/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND The impact of COVID-19 has been exceptional, particularly on the National Health Service which has juggled COVID affected patients alongside related staff shortages and the existing (and growing) health needs of the population. In prisons too, healthcare teams have been balancing patient needs against staffing shortfalls, but with additional strains unique to the prison population. Such strains include drastic lockdown regimes and prolonged isolation, the need to consider health alongside security, known health inequalities within prisoner groups, and an ageing and ethnically diverse population (both groups disproportionately affected by COVID). The aim of this paper is to contribute to emerging research on the impact of COVID-19 on prison healthcare. METHODS We conducted 44 in depth interviews (over phone or video) across three groups: prison leavers, healthcare staff and decision makers, between July and December 2021. Framework analysis was undertaken. RESULTS Three themes were found. First, we found that Covid-19 had a significant impact on prison healthcare which involved reduced access and changes to how healthcare was delivered. This affected the health of prisoners by exacerbating existing conditions, new conditions being undiagnosed and mental health needs increasing. Second, the pandemic impacted on healthcare staff through creation of stress, frustration and exhaustion due to minimal staffing levels in an already under-resourced system. Third, an emerging conflict was witnessed. People in prison felt neglected regarding their healthcare needs but staff reported doing the best they could in an unprecedented situation. Healthcare staff and decision makers felt that prison healthcare was seen as a poor relation when compared with healthcare in the community, with no extra resource or staffing for Covid-19 testing or vaccinations. CONCLUSION The Covid-19 pandemic has significantly impacted almost all aspects of prison healthcare in the UK. This includes delivery of healthcare by staff, receipt of it by people in prison and the management, planning and commissioning of it by decision makers. These three groups of people were all affected detrimentally but in vastly different ways, with some participants describing a sense of trauma. Health needs that were exacerbated or went unmet during Covid urgently need to be addressed in order to reduce health inequalities. In order for welfare and wellbeing to be maintained, and in some cases repaired, both prisoners and staff need to feel heard and recognised.
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Affiliation(s)
- Lucy Wainwright
- Department of Health Sciences, University of York, Seebohm Rowntree Building, Heslington, York, YO10 5DD, UK
| | - Sarah Senker
- Department of Health Sciences, University of York, Seebohm Rowntree Building, Heslington, York, YO10 5DD, UK
| | - Krysia Canvin
- Leeds Institute of Health Sciences, School of Medicine, University of Leeds, Worsley Building, Leeds, LS2 9JT, UK
| | - Laura Sheard
- Department of Health Sciences, University of York, Seebohm Rowntree Building, Heslington, York, YO10 5DD, UK.
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Hewson T, Gutridge K, Bernard Z, Kay K, Robinson L. A systematic review and mixed-methods synthesis of the experiences, perceptions and attitudes of prison staff regarding adult prisoners who self-harm. BJPsych Open 2022; 8:e102. [PMID: 35659128 PMCID: PMC9230562 DOI: 10.1192/bjo.2022.70] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Self-harm, including suicide, is common among prisoners. Staff attitudes and perceptions regarding self-harm may affect quality of care and patient safety. AIMS To systematically review the experiences, perceptions and attitudes of staff in adult prisons regarding self-harm. METHOD Systematic searches of EMBASE, Medline, PsycINFO and CINAHL databases were conducted, and supplemented by hand-searching and grey literature review, to identify relevant English-language articles published since the year 2000. Articles were screened by two authors and evaluated with standardised quality appraisal tools. Qualitative data were analysed thematically, whereas quantitative data were narratively synthesised because of high study heterogeneity. RESULTS Two thousand articles were identified, of which 32 were included, involving 6389 participants from five countries. Most studies were moderate (n = 15) or poor (n = 10) quality, and seven were rated as good quality. Staff frequently witnessed self-harm and described multiple perceived risk factors and causes of this. Perceptions that self-harm is 'manipulative' or 'attention-seeking' were associated with hostility toward prisoners and lower quality of care. Perceived barriers to preventing and managing self-harm included low staffing levels, prison environments and culture, poor staff confidence and insufficient training. The importance of multidisciplinary teamwork and building staff-prisoner relationships were highlighted. Staff occasionally experienced intense psychological reactions to self-harm, which resulted in adaptive or maladaptive coping that influenced their capacity to care. CONCLUSIONS There are mixed attitudes and perceptions toward self-harm among prison staff. Further training, support and resources are required to protect staff's well-being and improve self-harm prevention and management in prisons.
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Affiliation(s)
- Thomas Hewson
- Faculty of Biology, Medicine and Health, University of Manchester, UK; and North West School of Psychiatry, Health Education England, University of Manchester, UK
| | - Kerry Gutridge
- Centre for Women's Mental Health, University of Manchester, UK
| | - Zara Bernard
- Greater Manchester Mental Health NHS Foundation Trust, UK
| | - Kathryn Kay
- Greater Manchester Mental Health NHS Foundation Trust, UK
| | - Louise Robinson
- Division of Psychology and Mental Health, University of Manchester, UK; and Lancashire and South Cumbria NHS Foundation Trust, UK
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6
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Obidoa M, Bello R, Hardman S. Self‐harm in an older adult population during the
COVID
‐19 pandemic. PROGRESS IN NEUROLOGY AND PSYCHIATRY 2022. [DOI: 10.1002/pnp.747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Michael Obidoa
- Dr Obidoa is a Consultant Liaison Psychiatrist at Great Western Hospital, Swindon, Avon and Wiltshire Mental Health NHS Partnership Trust
| | - Rakiya Bello
- Dr Bello is a Core Psychiatry Trainee at Tatchbury Mount, Southern Health NHS Foundation Trust
| | - Stephen Hardman
- Dr Hardman is a Clinical Research Fellow at Kingshill Research Centre, Victoria Centre, Swindon
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7
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Plugge E, Burke D, Czachorowski M, Gutridge K, Maxwell F, McGrath N, O'Mara O, O'Moore E, Parkes J. Determining the prevalence and incidence of SARS-CoV-2 infection in prisons in England: a repeated panel survey & enhanced outbreak investigation. JMIR Res Protoc 2021; 11:e30749. [PMID: 34751157 PMCID: PMC8757584 DOI: 10.2196/30749] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 09/03/2021] [Accepted: 09/08/2021] [Indexed: 11/27/2022] Open
Abstract
Background There are over 80,000 people imprisoned in England and Wales in 117 prisons. The management of the COVID-19 pandemic presents particular challenges in this setting where confined, crowded, and poorly ventilated conditions facilitate the rapid spread of infectious diseases. Objective The COVID-19 in Prison Study aims to examine the epidemiology of SARS-CoV-2 in prisons in England in order to inform public health policy and practice during the pandemic and recovery. The primary objective is to estimate the proportion of positive tests of SARS-CoV-2 infection among residents and staff within selected prisons. The secondary objectives include estimating the incidence rate of SARS-CoV-2 infection and examining how the proportion of positive tests and the incidence rate vary among individual, institutional, and system level factors. Methods Phase 1 comprises a repeated panel survey of prison residents and staff in a representative sample of 28 prisons across England. All residents and staff in the study prisons are eligible for inclusion. Participants will be tested for SARS-CoV-2 using a nasopharyngeal swab twice (6 weeks apart). Staff will also be tested for antibodies to SARS-CoV-2. Phase 2 focuses on SARS-CoV-2 infection in prisons with recognized COVID-19 outbreaks. Any prison in England will be eligible to participate if an outbreak is declared. In 3 outbreak prisons, all participating staff and residents will be tested for SARS-CoV-2 antigens at the following 3 timepoints: as soon as possible after the outbreak is declared (day 0), 7 days later (day 7), and at day 28. They will be swabbed twice (a nasal swab for lateral flow device testing and a nasopharyngeal swab for polymerase chain reaction testing). Testing will be done by external contractors. Data will also be collected on individual, prison level, and community factors. Data will be stored and handled at the University of Southampton and Public Health England. Summary statistics will summarize the prison and participant characteristics. For the primary objective, simple proportions of individuals testing positive for SARS-CoV-2 and incidence rates will be calculated. Linear regression will examine the individual, institutional, system, and community factors associated with SARS-CoV-2 infection within prisons. Results The UK Government’s Department for Health and Social Care funds the study. Data collection started on July 20, 2020, and will end on May 31, 2021. As of May 2021, we had enrolled 4192 staff members and 6496 imprisoned people in the study. Data analysis has started, and we expect to publish the initial findings in summer/autumn 2021. The main ethical consideration is the inclusion of prisoners, who are vulnerable participants. Conclusions This study will provide unique data to inform the public health management of SARS-CoV-2 in prisons. Its findings will be of relevance to health policy makers and practitioners working in prisons. International Registered Report Identifier (IRRID) DERR1-10.2196/30749
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Affiliation(s)
- Emma Plugge
- University of Southampton, Southampton General Hospital, Southampton, GB.,Public Health England, London, GB
| | | | | | | | - Fiona Maxwell
- University of Southampton, Southampton General Hospital, Southampton, GB
| | - Nuala McGrath
- University of Southampton, Southampton General Hospital, Southampton, GB
| | | | | | - Julie Parkes
- University of Southampton, Southampton General Hospital, Southampton, GB
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8
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Mitchell SM, La Rosa NL, Cary J, Sparks S. Considering the impact of COVID-19 on suicide risk among individuals in prison and during reentry. JOURNAL OF CRIMINAL PSYCHOLOGY 2021; 11:240-253. [PMID: 34659669 PMCID: PMC8514196 DOI: 10.1108/jcp-10-2020-0044] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
PURPOSE - This paper mains to bring attention to the potential impact COVID-19 could have on suicide risk among individuals who are incarcerated and those reentering the community after incarceration (i.e. reentry), with particular emphasis on the USA, as well as provide possible solutions to mitigate suicide risk. DESIGN/METHODOLOGY/APPROACH - This paper provides an overview of the association between the COVID-19 pandemic policies and suicide, the vulnerabilities specific to prisoners during the COVID-19 pandemic, relevant suicide risk factors among prisoners, the possible impact of COVID-19 on suicide risk during reentry and proposed solutions for moving forward to mitigate both risks for COVID-19 and suicide. FINDINGS - This paper highlights that prisoners and individuals reentering the community are particularly vulnerable to COVID-19 and suicide risk and COVID-19-related stressors may further exacerbate known suicide risk factors (e.g. psychiatric symptoms, lack of positive social ties, low feelings of belonging, feelings of burden, economic problems) and suicidal thoughts and behaviors. This paper also discusses barriers (e.g. lack of funds, access to health and mental health care, COVID-19 testing and personal protective equipment) to managing COVID-19 and suicide risk within prisons and during reentry. ORIGINALITY/VALUE - This paper provides a review of scalable solutions that could mitigate the impact of COVID-19 and suicide risk during this pandemic among prisoners and those reentering the community, such as psychoeducation, self-help stress management, telehealth services, increased access and reduced cost of phone calls, reduced or eliminated cost of soap and sanitization supplies in prisons and early release programs.
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Affiliation(s)
- Sean M Mitchell
- Department of Psychological Sciences, Texas Tech University, Lubbock, Texas, USA
| | - Nikki L La Rosa
- Department of Psychological Sciences, Texas Tech University, Lubbock, Texas, USA
| | - Julianne Cary
- Department of Psychological Sciences, Texas Tech University, Lubbock, Texas, USA
| | - Sarah Sparks
- Department of Psychological Sciences, Texas Tech University, Lubbock, Texas, USA
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Suhomlinova O, Ayres TC, Tonkin MJ, O’Reilly M, Wertans E, O’Shea SC. Locked up While Locked Down: Prisoners’ Experiences of the COVID-19 Pandemic. THE BRITISH JOURNAL OF CRIMINOLOGY 2021:azab060. [PMCID: PMC8344828 DOI: 10.1093/bjc/azab060] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Worldwide, the COVID-19 pandemic has had a devastating impact on prisoners. The prison environment and prisoner health put prison populations at a higher risk of contracting COVID-19. As a result, prison systems have adopted mitigation strategies to reduce the transmission of the virus into and within prisons. These strategies, however, have had an unintended impact on prisoners and their living conditions. In this article, we explore prisoners’ lived experiences of the pandemic in English and Welsh prisons, captured through correspondence with prisoners throughout 12 months of regime restrictions, from April 2020 to April 2021. Drawing on prisoner narratives, the analysis reveals how the restricted regime has exacerbated the pains of imprisonment and had a detrimental impact on prisoners.
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Affiliation(s)
| | | | | | - Michelle O’Reilly
- School of Media, Communication and Sociology and School of Psychology, University of Leicester, Leicester, UK
- Leicestershire Partnership NHS Trust, Thurmaston, Leicester, UK
| | - Emily Wertans
- School of Criminology, University of Leicester, Leicester, UK
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10
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John A, Eyles E, Webb RT, Okolie C, Schmidt L, Arensman E, Hawton K, O'Connor RC, Kapur N, Moran P, O'Neill S, McGuiness LA, Olorisade BK, Dekel D, Macleod-Hall C, Cheng HY, Higgins JP, Gunnell D. The impact of the COVID-19 pandemic on self-harm and suicidal behaviour: a living systematic review. F1000Res 2020; 9:1097. [PMID: 33604025 PMCID: PMC7871358 DOI: 10.12688/f1000research.25522.1] [Citation(s) in RCA: 88] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/17/2020] [Indexed: 12/22/2022] Open
Abstract
Background: The COVID-19 pandemic has caused morbidity and mortality, as well as, widespread disruption to people's lives and livelihoods around the world. Given the health and economic threats posed by the pandemic to the global community, there are concerns that rates of suicide and suicidal behaviour may rise during and in its aftermath. Our living systematic review (LSR) focuses on suicide prevention in relation to COVID-19, with this iteration synthesising relevant evidence up to June 7 th 2020. Method: Automated daily searches feed into a web-based database with screening and data extraction functionalities. Eligibility criteria include incidence/prevalence of suicidal behaviour, exposure-outcome relationships and effects of interventions in relation to the COVID-19 pandemic. Outcomes of interest are suicide, self-harm or attempted suicide and suicidal thoughts. No restrictions are placed on language or study type, except for single-person case reports. Results: Searches identified 2070 articles, 29 (28 studies) met our inclusion criteria, of which 14 articles were research letters or pre-prints awaiting peer review. All articles reported observational data: 12 cross-sectional; eight case series; five modelling; and three service utilisation studies. No studies reported on changes in rates of suicidal behaviour. Case series were largely drawn from news reporting in low/middle income countries and factors associated with suicide included fear of infection, social isolation and economic concerns. Conclusions: A marked improvement in the quality of design, methods, and reporting in future studies is needed. There is thus far no clear evidence of an increase in suicide, self-harm, suicidal behaviour, or suicidal thoughts associated with the pandemic. However, suicide data are challenging to collect in real time and economic effects are evolving. Our LSR will provide a regular synthesis of the most up-to-date research evidence to guide public health and clinical policy to mitigate the impact of COVID-19 on suicide. PROSPERO registration: CRD42020183326 01/05/2020.
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Affiliation(s)
- Ann John
- Population Psychiatry, Suicide and Informatics, Swansea University, Swansea, UK
- Public Health Wales NHS Trust, Swansea, UK
| | - Emily Eyles
- National Institute for Health Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol NHS Foundation Trust, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Roger T. Webb
- Division of Psychology and Mental Health, University of Manchester, Manchester, UK
- NIHR Greater Manchester Patient Safety Translational Research Centre, Manchester, UK
| | - Chukwudi Okolie
- Population Psychiatry, Suicide and Informatics, Swansea University, Swansea, UK
- Public Health Wales NHS Trust, Swansea, UK
| | - Lena Schmidt
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Ella Arensman
- School of Public Health and National Suicide Research Foundation, University College Cork, Cork, Ireland
| | - Keith Hawton
- University Department of Psychiatry, Centre for Suicide Research, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Rory C. O'Connor
- Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Nav Kapur
- Division of Psychology and Mental Health, University of Manchester, Manchester, UK
- NIHR Greater Manchester Patient Safety Translational Research Centre, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Paul Moran
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health Research Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK
| | | | - Luke A. McGuiness
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Dana Dekel
- Population Psychiatry, Suicide and Informatics, Swansea University, Swansea, UK
| | | | - Hung-Yuan Cheng
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Julian P.T. Higgins
- National Institute for Health Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol NHS Foundation Trust, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health Research Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK
| | - David Gunnell
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health Research Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK
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John A, Eyles E, Webb RT, Okolie C, Schmidt L, Arensman E, Hawton K, O'Connor RC, Kapur N, Moran P, O'Neill S, McGuiness LA, Olorisade BK, Dekel D, Macleod-Hall C, Cheng HY, Higgins JP, Gunnell D. The impact of the COVID-19 pandemic on self-harm and suicidal behaviour: update of living systematic review. F1000Res 2020; 9:1097. [PMID: 33604025 PMCID: PMC7871358 DOI: 10.12688/f1000research.25522.2] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/12/2021] [Indexed: 12/19/2022] Open
Abstract
Background: The COVID-19 pandemic has caused considerable morbidity, mortality and disruption to people's lives around the world. There are concerns that rates of suicide and suicidal behaviour may rise during and in its aftermath. Our living systematic review synthesises findings from emerging literature on incidence and prevalence of suicidal behaviour as well as suicide prevention efforts in relation to COVID-19, with this iteration synthesising relevant evidence up to 19 th October 2020. Method: Automated daily searches feed into a web-based database with screening and data extraction functionalities. Eligibility criteria include incidence/prevalence of suicidal behaviour, exposure-outcome relationships and effects of interventions in relation to the COVID-19 pandemic. Outcomes of interest are suicide, self-harm or attempted suicide and suicidal thoughts. No restrictions are placed on language or study type, except for single-person case reports. We exclude one-off cross-sectional studies without either pre-pandemic measures or comparisons of COVID-19 positive vs. unaffected individuals. Results: Searches identified 6,226 articles. Seventy-eight articles met our inclusion criteria. We identified a further 64 relevant cross-sectional studies that did not meet our revised inclusion criteria. Thirty-four articles were not peer-reviewed (e.g. research letters, pre-prints). All articles were based on observational studies. There was no consistent evidence of a rise in suicide but many studies noted adverse economic effects were evolving. There was evidence of a rise in community distress, fall in hospital presentation for suicidal behaviour and early evidence of an increased frequency of suicidal thoughts in those who had become infected with COVID-19. Conclusions: Research evidence of the impact of COVID-19 on suicidal behaviour is accumulating rapidly. This living review provides a regular synthesis of the most up-to-date research evidence to guide public health and clinical policy to mitigate the impact of COVID-19 on suicide risk as the longer term impacts of the pandemic on suicide risk are researched.
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Affiliation(s)
- Ann John
- Population Psychiatry, Suicide and Informatics, Swansea University, Swansea, UK
- Public Health Wales NHS Trust, Swansea, UK
| | - Emily Eyles
- National Institute for Health Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol NHS Foundation Trust, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Roger T. Webb
- Division of Psychology and Mental Health, University of Manchester, Manchester, UK
- NIHR Greater Manchester Patient Safety Translational Research Centre, Manchester, UK
| | - Chukwudi Okolie
- Population Psychiatry, Suicide and Informatics, Swansea University, Swansea, UK
- Public Health Wales NHS Trust, Swansea, UK
| | - Lena Schmidt
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Ella Arensman
- School of Public Health and National Suicide Research Foundation, University College Cork, Cork, Ireland
| | - Keith Hawton
- University Department of Psychiatry, Centre for Suicide Research, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Rory C. O'Connor
- Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Nav Kapur
- Division of Psychology and Mental Health, University of Manchester, Manchester, UK
- NIHR Greater Manchester Patient Safety Translational Research Centre, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Paul Moran
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health Research Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK
| | | | - Luke A. McGuiness
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Dana Dekel
- Population Psychiatry, Suicide and Informatics, Swansea University, Swansea, UK
| | | | - Hung-Yuan Cheng
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Julian P.T. Higgins
- National Institute for Health Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol NHS Foundation Trust, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health Research Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK
| | - David Gunnell
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health Research Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK
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