If history is any indication, we would expect the Covid pandemic to increase suicide rates. Dr Dennis Wesselbaum explains how that could be the case.
New Zealand is the ninth happiest country in the world as reported in the 2021 World Happiness Report.
Yet at the same time, New Zealand has the highest suicide rate in the world among 15 to 19-year olds, with 15.6 suicides per 100,000 people.
So, many New Zealanders are clearly not the happiest people in the world, and the Government is understandably acting by developing preventative policies. But are the Government’s actions going to be effective? This question can be answered by applying insights and research techniques from economics.
Let us first take stock. According to the annual report of the Chief Coroner, 654 people took their lives in 2019/2020. Alarmingly, the number of suicides is increasing since 2007 and the suicide rate has been increasing since 2015/2016 with a decline in 2019/2020 (based on provisional numbers).
These average statistics hide sizeable and important inequalities across various dimensions such as gender, age, ethnicity, and socioeconomic background.
For every suicide by a female, there are 2.6 male suicides. Most suicides for men occur in the 25-29 years age group, while for females most suicides are in the 15-19 years age group.
Suicide also varies sizeably across ethnicities. While Europeans have the largest number of suicides (414), Māori have the highest rate (20.24 per 100,000 people), which is almost double the rate of Europeans and triple the rate of Asians and Pacific peoples.
Moreover, socioeconomic factors appear to play a role in suicides with patterns, for example, across employment statuses. Finally, there also exists a regional pattern in suicides with most suicides committed in Canterbury, Waikato, and Auckland.
If history is any indication, we would expect the Covid pandemic to increase suicide rates. This pattern has been observed with the Spanish Flu and SARS.
Covid could potentially affect suicide via various channels. These range from the fear of catching the virus, increases in anxiety, the negative effects of social distancing on relationships, limited access to healthcare, unemployment and income risk, as well as other behavioural changes (e.g. domestic violence, alcohol consumption, less physical exercise, or overeating).
Recent studies have shown that suicides decreased in the first lockdown in numerous countries such as Japan, Germany, the UK and did not change in China or Greece.
There are two issues with these findings. First, evidence of previous disasters, like the September 11 terrorist attacks, have documented the so-called “honeymoon effect”, where suicide rates initially fall but later increase. Second, as argued above, average statistics hide important inequalities. Evidence from Maryland, for example, shows that the total suicide rate has not changed, but that the allocation has: the suicide rate in White people has fallen, while the suicide rate in Black people has increased.
Evidence from Japan has documented a similar result. The first lockdown reduced the suicide rate, while the second lockdown increased it. The evidence also shows that suicides of females have increased more than that of males.
The Government has recently developed the 'Every Life Matters' policy and committed to its Suicide Prevention Strategy 2019-2029 and the Suicide Prevention Action Plan 2019-2024. At its core, the strategy aligns with the goals of the transformation of the mental health and addiction system, such that New Zealanders have access to these services and receive effective support.
In order to develop effective policies and services, it is necessary to understand the underlying driving forces. This is where the Government’s strategy fails to deliver. While it briefly mentions research into suicide prevention, it lacks the emphasis on using the existing New Zealand data to understand the effectiveness of previous prevention strategies, what drives suicide, and what explains differences across demographic groups.
Obtaining these insights and developing effective suicide prevention policies is paramount not least due to the potential long-run effects of the Covid-19 pandemic and its different effects on communities.
