key: cord-0834792-7fuq6pht
authors: Sher, Leo
title: Individuals with untreated psychiatric disorders and suicide in the COVID-19 era
date: 2020-07-17
journal: Braz J Psychiatry
DOI: 10.1590/1516-4446-2020-1210
sha: 278d5badc68aa0f8f577c87f46210c85d2469194
doc_id: 834792
cord_uid: 7fuq6pht

nan

attempt are mood disorders. 7 Stressful situations related to the COVID-19 crisis may significantly exacerbate mood and substance use disorders and other psychiatric conditions among individuals with untreated mental illnesses. Moreover, many individuals may start using alcohol and/ or drugs. People with comorbid major psychiatric disorders and substance abuse are at an especially high risk for suicide. 8 For example, research shows that men with comorbid depression and alcohol use disorder have a very high long-term suicide risk (16.2%). 9 Persons with untreated psychiatric disorders frequently have substantial morbidity and functional impairment and are at elevated suicide risk. COVID-19-related anxiety, uncertainty, social isolation, and economic issues may significantly increase suicide risk among people with psychiatric disorders, especially individuals with untreated mental illness. Economic problems such as job loss may increase suicides both during and after the COVID-19 pandemic. 1,10 A recent model indicates that job losses due to COVID-19 will lead to between 2135 and 9570 suicides per year worldwide. 10 It is important to note that economic problems reduce access to mental health treatment. Also, finding a job is more difficult for a person with a psychiatric illness than for a healthy person.

It is difficult to reduce suicidal behavior among individuals with psychiatric conditions who are not in treatment. However, some measures may reduce suicides in this population. These measures include: -Recognition of psychiatric disorders. Improving detection of psychiatric disorders in primary care may be a significant step towards addressing unmet mental health needs and decreasing suicides. Also, community or organizational gatekeepers such as clergy, first responders, school workers, and caregivers of older adults need to be educated about mental illness because they may have an opportunity to identify individuals at risk for suicide and direct them to proper evaluation and treatment. -Improved access to mental health care may reduce suicides. Governments and non-governmental organizations should try to improve access to psychiatric care during and after the COVID-19 crisis.

-Reduced mental illness stigma. Stigma is a contributing factor to non-help-seeking among people struggling with psychiatric illness. -The general population needs to be educated about mental illness and when to seek professional help if a person has symptoms of a psychiatric disorder.

In summary, suicide risk will probably increase among individuals with untreated mental illness during and after the COVID-19 pandemic. Public health systems should try to identify these individuals and engage them in mental health treatment.

The author reports no conflicts of interest.

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