Stress, anxiety, and depression increased during the peak of the Covid-19 pandemic in early 2020. However, deaths by suicide decreased 9% between March and August of last year, according to a new study in the Journal of the American Medical Association.

Key findings

For the study, Jeremy Faust, an emergency physician in the division of health policy and public health at Brigham and Women's Hospital and an instructor at Harvard Medical School, and colleagues examined data on excess mortality—the difference between the number of deaths projected to occur in an average year and the number of deaths that actually occurred. Specifically, they examined monthly excess mortality data from March 2020 through August 2020 and compared it with similar data from 2015 through 2020, USA Today reports.

The researchers found there were more than 2,400 fewer deaths by suicide between March and August 2020 than would be expected to occur during an average year. "They went down, and they went down dramatically at the peak of the shelter in place period," Faust said. "In April we had a 16% decrease of suicides, and that's the time when most of the country was shut down."

According to USA Today, the findings were surprising not only because many people reported increased rates of anxiety, stress, and depression during the pandemic, but also because the rate of death by suicide has been steadily increasing for several years, climbing 35% since 1999. In fact, experts had estimated last year that so-called "deaths of despair" from suicide, alcohol, and drugs could go as high as 150,000.

5 theories for the decline

Faust and other researchers offered several possible hypotheses for the decline, including:

1. The increased availability of mental telehealth services

Thomas Joiner, a professor of psychology at Florida State University, explained that although there was a "rise in risk factors like stress, anxiety, and depression," overall deaths by suicide may have decreased because access to mental health care services via telehealth increased—and performed better—"than many of us anticipated."

2. Greater awareness of mental health needs

Another reason for the decline, Joiner said, could simply be a greater awareness among major employers and organizations of employees' mental health needs.

3. The Covid-19 death rate

April Foreman, a clinician and board member of the American Association of Suicidology, said the rate of death by suicide may have decreased because people who would have otherwise died by suicide died instead of Covid-19.

Foreman pointed out that in 2019, the rate of death by suicide was greatest among those age 45 and older—the same demographic at greatest risk of Covid-19. Similarly, she pointed out that people with higher rates of health issues and poverty are at greater risk of both death by suicide and Covid-19.

4. Less isolation for some

Foreman also hypothesized that because suicide tends to happen when people are isolated, the lockdowns imposed amid the pandemic may have forced people who would otherwise be alone to temporarily live with family members or friends.

"Suicide is one of those things that very rarely happens in front of other people, it happens when you’re alone," she said. "While a lot of people were alone during Covid-19, a lot of people were locked down with their families."

5. Shared purpose

Separately, Faust hypothesized that the decline could stem from a national sense of coming together to fight the pandemic. "People had a sense of shared purpose," he said. "They were home in March and April because we were making a collective sacrifice so we could help each other. So people felt we were part of something" (Weise, USA Today, 5/25).