The Covid-19 pandemic led to increased rates of stress, anxiety, and depression in 2020, but a recent report from CDC's National Center for Health Statistics found that the overall suicide rate dropped last year—however, some minority groups saw suicides rise.
According to the report, which is based on provisional data from 99% of all death records from 2020, the overall suicide rate in 2020 dropped 3% compared with 2019 levels. In total, just under 46,000 people died from suicide in 2020, roughly 1,600 fewer than in 2019.
Among women, the overall suicide rate dropped 8% from 2019 to 2020, while men saw a 2% drop.
The decline in suicides was largely driven by white people, the report found. While the United States is 62% white, almost three-quarters of people who died of suicide in 2020 were white.
Among other ethnic groups, however, suicide rates rose. For example, Black girls and women ages 10 to 24 saw suicide rates increase more than 30%, while Black boys and men in the same age group saw a 23% increase.
Hispanic women in that age group saw suicides increase 40%, and Hispanic men of the same age saw a 20% increase, according to the report. Meanwhile, Asian women ages 15 to 25 saw a nearly 30% increase in suicides.
Among all ethnic groups, suicide rates were highest among American Indians and Alaska Natives—a group that saw suicides increase 5% in 2020
While suicide rates declining during a pandemic may seem counterintuitive, it's actually fairly common, according to Craig Bryan, director of the Suicide Prevention Program at Ohio State University.
"Historically, we know that during times of crisis we tend to see reductions in suicide," he said. "Did the pandemic make things worse? That's what most people assumed would happen, and I expect the pandemic made things worse for some people and made things better for others."
Bryan added that it's possible "there were more family connections" during the pandemic, "but there are other possibilities too."
Last year, many people stayed home more as a result of the pandemic and stay-at-home orders. "When you are home with other people, you don't have as much time by yourself, and there is more likely going to be someone around who can rescue or intervene in a suicide attempt," Bryan said.
"Suicide is less predictable than other causes of death," said Sally Curtin, a statistician at CDC and lead author on the report. "You can have an increase in risk factors for suicidal behavior, such as mental health issues, depression, anxiety, substance abuse and financial stress ... but it does not necessarily translate into an increase in deaths."
While the drop in suicides is an improvement, Curtin said it's important to "remain vigilant."
"[T]his doesn't mean, 'Oh, wow,' you know, 'We've arrived,' or, 'This has been figured out,' because historically, the number is still quite high. It was just under 46,000 suicide deaths in 2020. It's lower than 2017, 2018, 2019, but then it's higher than any number before that," Curtin said. "So even though it's been down the last couple of years, it is … still high historically."
Maria Oquendo, chair of psychiatry at the University of Pennsylvania Perelman School of Medicine, said the drop in the overall suicide rate starting in 2019 "may be the beginning of a trend, and that's a very welcome thing." However, the data also shows "that some of the increase we are seeing among minority groups also seem to be trending upward," she said.
Since the report didn't analyze the reasons for suicide, it's unknown why suicide rates are increasing in some minority groups.
"The increase we're seeing in minority populations is a concern, and it may not be related to the pandemic at all because we did see an increase already in 2019," Oquendo said. "Whatever is happening in these communities is very worrisome because historically they had been relatively protected from suicidal behavior."
"There has been a very big push to raise awareness on suicide and how to prevent suicide and spotting the signs," said Melissa Shepard, a psychiatrist, psychotherapist, and assistant professor at Johns Hopkins School of Medicine. "We're doing a good job with some populations and not with others … whatever sort of advocacy that we're doing, it's not reaching [people of color]." (Carbajal, Becker's Hospital Review, 11/3; Sullivan, NPR, 11/3; Sullivan, NBC News, 11/3; Coleman, The Hill, 11/3; Rodriguez, USA Today, 11/4; Langmaid, CNN, 11/3)
The Covid-19 pandemic is rapidly increasing the need for behavioral health services. But there are significant gaps and barriers that stand in the way of people getting the help they need. Download our take to learn how health systems can prioritize addressing the immediate needs of both staff and patients, especially those with preexisting behavioral health needs or comorbid conditions.
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