Reduced suicidal presentations to emergency departments during the COVID-19 outbreak in Queensland, Australia

A Rapid Systematic Review of the Prevalence of Suicide and Self-Harm Behaviors in Adolescents During the COVID-19 Pandemic

Background: COVID-19 has caused psychological, social, and physical isolation in adolescents resulting in varying rates of suicidal behavior and self-harm. Aims: We investigated the pandemic's impact on adolescent suicidal behavior and self-harm by reviewing the existing literature. Methods: We searched PubMed using keywords: adolescent, suicide, suicidal behavior, self-harm, prevalence, and COVID-19 and included studies reporting primary data only. Results: Of the 551 studies identified, we included 39 studies in the final analysis. Two of the six high-quality population-based suicide registry studies reported increased suicide rates during the pandemic. Seven of fifteen emergency department-based studies out of which four were of high quality and three high-quality population-based health registry studies reported increased self-harm. A few school and community-based surveys and national helpline data also reported an increase in suicidal behavior or self-harm. Limitations: Methodological heterogeneity of the included studies. Conclusions: There is wide variation in study methodology, population, settings, and age groups in the included studies. Suicidal behavior and self-harm were increased in specific study settings and adolescent populations during the pandemic. More methodologically rigorous research is needed to evaluate the impact of COVID-19 on adolescent suicidal behavior and self-harm.

Help-seeking behaviors for mental health problems during the COVID-19 pandemic: A systematic review

BACKGROUND

During the COVID-19 pandemic, the nature of communication has changed dramatically owing to lockdowns and the need for social distancing with ongoing outbreaks. As a result, patient's help-seeking behavior for mental health may have changed. We summarized the research on help-seeking behavior for mental health during the COVID-19 pandemic and investigated changes that have occurred.

METHODS

This study was a systematic review. We searched four literature databases: MEDLINE, EMBASE, CHINAHL, and PsycINFO. We included the following in the review: 1) studies conducted during the COVID-19 pandemic, and 2) studies that dealt with help-seeking behavior for mental health. Eligible studies were summarized according to characteristics such as research participants and study type.

RESULTS

In total, 41 studies (38 observational studies 2 qualitative studies and 1 randomized trial) were eligible for the review. Most studies reported delays, decreases, or deficits in help-seeking behavior. The study participants included medical professionals, local residents, hospitals, children and adolescents, online participants, pregnant women, people who experienced intimate partner violence, those with eating disorders, and other individuals.

LIMITATIONS

Findings from observational studies may have bias as confounder. Meta-analysis could not be performed, because the studies had variations of design.

CONCLUSION

During the COVID-19 pandemic, delay in seeking help from mental health services may have resulted in lost opportunities to link patients with appropriate treatment and care. The COVID-19 pandemic is ongoing as of 2022. Therefore, it is important to examine the impact of the pandemic on mental health in future research.