U.S. sees surprising suicide dip in 2020

Hands holding yellow ribbon
Hands holding yellow ribbon
Sew Cream via Shutterstock

Last year, a middle-aged man came to stay at Honey Lake Clinic, a Florida mental health treatment center, after having suicidal thoughts. Psychologist Karl Benzio remembers the man said he had attempted suicide in the past and worried he would have another serious attempt.

“I look at suicidal thoughts as a person saying, ‘I don’t want to live life this way anymore,’” Benzio explained. “I’m like, ‘That’s awesome! There are a whole lot of better ways that you can live life.’” The client agreed—he didn’t want to end his life; he wanted a new life. With medication and therapy, Benzio was able to help him control his depression.

After the pandemic began, Benzio saw a growing need for services targeting suicidal patients. His center opened an adolescent unit for 13- to 18-year-old females: “We had patients who came in more anxious, more depressed because they had been isolated.”

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Fear of getting infected with COVID-19 kept people in their homes and even hesitant to seek medical care. These patients tended to be in worse shape when they finally did arrive for care.

Many other mental health workers also feared the pandemic would fuel a rise in suicide, yet in late March the Centers for Disease Control and Prevention (CDC) released preliminary mortality data from 2020 that showed suicide dropped nearly 6 percent. Some experts believe this number is misleading, but others are optimistic.

The last decade has seen U.S. suicides consistently rise and—until 2020—make the list of the top 10 leading causes of death. As the coronavirus spread in the United States and states began locking down, concern rose about the restrictions’ impact on mental health. Calls to suicide hotlines and mental health crisis lines spiked in the spring. A June 2020 CDC survey revealed increased suicide ideation, especially among young adults and essential workers. Medical examiners began reporting increased deaths from drug overdoses.

Fieldstone Counseling, a center in northeast Ohio, had at least 200 more sessions per month on average, said director Jonathan Holmes. Through virtual sessions, Holmes said, the counselors saw many children and teens who said they had considered suicide as they felt disconnected from friends and wrestled with increased anxiety and depression.

He remembers one girl, a senior in high school, who had to be institutionalized after a suicide attempt. She struggled with anxiety in part as a side effect of the seizure medication she took. During the pandemic, not only was she unable to see her psychologist, she also missed going to school and playing soccer.

The girl received counseling through Fieldstone as one part of her care: “We were talking to her about anxiety, some coping strategies,” Holmes said. Besides helping clients like her learn about resources such as trusted adults, the national suicide hotline, and local health providers, the counselors try to communicate love and care.

“We also try to normalize their struggles,” said Holmes. “We suffer. That’s the nature of the broken world we live in. It’s OK to feel the way you’re feeling.”

In the first three months of 2021, Fieldstone has seen a 53 percent increase in clients from the year before—many people struggling with grief at losing loved ones during the pandemic.

The CDC typically takes a year to release mortality data, but the CDC said it wanted to provide preliminary data that could be useful in evaluating the pandemic. As the year goes on, states will provide more information through autopsy reports and cause of death investigations.

Both Benzio and Holmes were surprised to see the drop in suicide numbers, a phenomenon that didn’t match up with what they saw in their centers. Benzio believes suicides likely did increase last year but were undercounted.

Overdoses and accidental injuries were up—both categories that can overlap with suicides. Someone might not leave a note, or a family might not report a death as suicide because of the stigma. Some people also stop caring for their health and end up dying as a result, although those aren’t counted as suicides.

But Dan Reidenberg, executive director of Suicide Awareness Voices of Education, said the dip made sense. He noted more people had access to healthcare thanks to telemedicine, and although it seems counterintuitive, he saw people staying in touch with each other more.

“People were more intentional about staying more connected,” Reidenberg said. People reached out to family and friends through social media and phone calls. They found practical ways to serve each other, such as by delivering food or medicine. Media messaging highlighted ways people were struggling, and people thought about others in their circles who might need help. (Stimulus checks also likely reduced economic stress for some.)

While he recognizes the CDC numbers are still provisional and could change, Reidenberg was encouraged to see people talking seriously and openly about how they were struggling, another thing that promotes connection.

“Ideally, it would be wonderful if we could all continue that,” he said. “It really made a difference in people’s lives.”

—If you or someone you love is struggling with suicidal thoughts, call the National Suicide ­Prevention Lifeline at 1-800-273-8255, or text RemedyLIVE at 494949.

This story originally appeared in WORLD. © 2021, reprinted with permission. All rights reserved.

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