Since the pandemic began, mental health experts have feared that grief, financial distress, and social isolation could put an unbearable strain on the American psyche. Some warned that the coronavirus created the "perfect storm" for a surge in suicides.
The concern was taken up by lawmakers eager to reopen the economy. In March 2020, Donald J. Trump predicted an increase in suicides as a result of statewide lockdowns. However, a tentative list of deaths over the past year has a surprising amount of good news.
While nearly 350,000 Americans died from Covid-19, the number of suicides fell 5 percent to 44,834 deaths in 2020 from 47,511 in 2019. It is the second year in a row that the number has fallen from the peak in 2018.
The decline even came as the number of accidental deaths from overdose rose dramatically during the pandemic. Some overdoses are classified as suicides. There is debate among researchers about how many should be included.
While the overall number of suicides may have decreased, preliminary studies by local communities in states like Illinois, Maryland, and Connecticut have found an increase in suicides among black Americans and other people of color compared to previous years.
It is not known whether this is the case nationally. Federal health officials have not yet released a detailed breakdown of the race and ethnicity of last year's suicide victims, and some experts have warned against making generalizations based on trends in some locations.
"We can't make bold statements until we have more national data," said Arielle Sheftall, a senior investigator at the Center for Suicide Prevention and Research at Nationwide Children's Hospital in Columbus, Ohio. "It may be that only certain areas or certain cities have seen this increase," she added.
Suicides are comparatively rare occurrences, and it is difficult to know how to interpret low-number changes and whether they represent statistical hiccups or general trends. During wartime or natural disasters, rates usually drop when people feel drawn together to fight for survival against a common enemy. But the effect can wear off over time, and fatigue and despair can ensue, experts say.
In the early days of the pandemic, families posted colorful drawings of rainbows in their windows, and children poked their heads out at 7 p.m. each day. Ring bells and cheer on healthcare workers.
"In the early stages of a natural disaster, there is a sense of community building, a feeling that we are all together," said Dr. Christine Moutier, Chief Medical Officer of the American Foundation for Suicide Prevention. "The survival instinct can really come to the fore."
That initial sense of crisis and purpose could have been a source of strength for people around the world. A new study of suicide trends among residents of 10 countries and 11 higher-income states or regions found the number remained largely unchanged or even decreased during the first few months of the pandemic, although suicide rates rose in some countries later in the year came areas. (Another study, which has not yet been peer-reviewed, reported a sharp rise in suicide in Japan from July to November, with female suicides rising more sharply during that period.)
In the United States, the pandemic has disproportionately affected color communities: Hispanic, Black and Native Americans and Alaska Natives are more likely than white Americans to be hospitalized with Covid-19 and die from it. Two in five Black and Hispanic Americans have lost a close friend or family member to the virus, compared to one in four white adults.
People of color have also been financially beaten, especially low-wage workers who have lost their jobs and have few resources to fall back on. Many who remain employed have jobs that are at risk of contracting the virus on a daily basis.
Anxiety and depression have grown across the board, and many Americans are concerned about their health and that of their families. A recent study found that 1 in 12 adults had thoughts of suicide. Hispanic Americans in particular said they were depressed and stressed, having a roof over their heads and having enough to eat.
Some Americans plunged into poverty for the first time, shattering their identity and self-awareness, said Dr. Brandi Jackson, psychiatrist, director of inclusive behavioral health at Howard Brown Health in Chicago.
News reports on the murders of blacks, from Breonna Taylor and Ahmaud Arbery to the shocking death of George Floyd in May, contributed to the trauma of black Americans, said Dr. Jackson.
"It's one stressor over another stressor over another stressor," said Dr. Sheftall. "You lost your job. You lost people in your family. Then there is George Floyd. At some point I had to turn off the television."
Researchers studying racial trends said the increase in suicide among people of color was consistent across the cities and regions studied – all the more noticeable since the suicide rate among black and Hispanic Americans had always been comparatively low, about a third of the rate among whites Americans.
April 15, 2021, 5:40 p.m. ET
Rodney Moore Sr. of Anaheim, California, lost his 14-year-old son Rodney Jr. to suicide in January. Mr Moore believes his son was distraught when his school did not reopen as expected earlier this year.
Mr Moore urged parents to look out for changes in behavior or mood in their children that could indicate hopelessness about the future. "Look for anything that is different in their sleep, their food, a change in attitudes, a change in personality," he said.
Chicago public health officials were among the first to notice that the number of suicides had increased among black residents, even though suicide numbers had generally remained stable for the first eight months of 2020.
Officials were particularly concerned about an increase in suicides among young black adults aged 20 and over, as well as an increase in older people of all races who issued health alerts in November and took steps to raise funding for crisis hotlines and mental health services improve .
The state's health department reported a similarly one-sided trend in January: suicides in the state fell by 6.8 percent overall, but blacks fell 27.7 percent and Hispanics fell 6 percent.
"It's important not just to monitor the topline numbers as we know Covid has affected different communities in different ways," said Matthew Richards, assistant commissioner for behavioral health for the Chicago Department of Public Health.
"When we talk about Covid and the levels of trauma, grief and stress at the community level, we shouldn't underestimate the importance of a public health problem that has the potential."
A similar trend was seen in Maryland, where researchers analyzed the suicide deaths from March 5, 2020, when a nationwide emergency was declared, to May 7, when public spaces reopened, and then compared them to the same time periods in previous years .
The study found that suicides among white Americans fell by almost half – but among black citizens doubled after the declaration of emergency in March. (There was no change in suicide trends from January 1 to March 4 last year.)
"It is clear that the pandemic has hit African Americans much harder than whites," said Dr. Paul Nestadt, Assistant Professor of Psychiatry and Behavioral Science at Johns Hopkins, who was the lead author of the study published in JAMA Psychiatry in December.
"The pandemic may have been a perfect storm, but we were all in very different boats in that storm," he added.
He and a colleague, Michael Bray, continued to investigate and say there is preliminary evidence that suicide rates have also increased among Hispanics in Maryland over the past year.
In Connecticut, Yale University researchers who studied the death rate during the strict home-home period between March 10 and May 20 last year were initially surprised to find that the total suicide rate in the state was compared to the same period last year down by 20 percent.
However, a closer look revealed that suicide among white residents had fallen to a six-year low, while the rate among non-white people had increased.
Of 74 Connecticut residents who died of suicide during the lockdown, 23 percent reported not being white, which is almost double the percentage of suicidal deaths compared to the last six years, the researchers found. Neither the mean age of suicidal death (50) nor the gender ratio (three quarters were men) had changed.
"It was deeply troubling," said Dr. Thomas O. Mitchell, psychiatrist and one of the authors of the paper published in Psychiatry Research in December. He said financial burdens – which are known to be strongly linked to suicide – could have played a crucial role in the deaths.
"People in minority groups are already facing unique economic challenges, so the financial crisis from losing a job during the pandemic may be even more perceptible to these communities," said Dr. Mitchell, adding that those who continue to work in publicly available professions "are putting their lives on the line every day – a stressful thing."
Jasmin Pierre, a black woman who is now a mental health advocate, barely survived a suicide attempt seven years ago after a string of setbacks including a job loss and the death of her sister.
Many friends and relatives replied in disbelief. "They said," Blacks don't do that "or" Girls, go and pray, "" recalls Ms. Pierre, who developed an educational app called "The Safe Place". “But actually we do it. We just don't talk about it. It is taboo. "
If you are thinking of suicide, call the National Suicide Prevention Lifeline at 1-800-273-8255 (TALK). For a list of additional resources, see SpeakingOfSuicide.com/resources.