There is increasing cross-sectoral unease about the mental health impact of COVID-19 and the lockdown put in place to combat it. A recent commentary in the Lancet suggested that “suicide is likely to become a more pressing concern as the pandemic spreads and has longer-term effects on the general population, the economy, and vulnerable groups” (Gunnell et al. 2020).
While a relationship between COVID and suicide is not clearly established, key to forging understandings of their potentially complex connections is an attention to the many suicide-related discussions currently happening on social media.
At the University of Birmingham, Dr Rachel Winter and I are currently investigating the impact of the pandemic on self-harm and suicide-related online content across a range of social media platforms using online ethnography. Funded by Samaritans, this project is part of our broader portfolio of research into online harms and relationships between social media and mental health.
The past few years have seen widespread concern about the potentially detrimental impact of online content related to self-harm and suicide. Both have been argued to encourage harmful offline behaviours and even, completed suicide. Whilst there are dangers to each, our previous research has argued for the need to recognise that informal peer support is a core part of self-harm content (Lavis and Winter 2020) and this is also acknowledged in relation to suicide content. As such, both can be an, albeit ambivalent, lifeline against an offline background of stigma, social isolation and mental health service lacks.
This function of peer-support is also emerging from our current analyses of suicide content during the pandemic. Users describe seeking online suicide discussions to gain the perspectives of others and be listened to without judgement. Crucially, our analyses suggest that COVID and lockdown may be leading people who were not previously suicidal to contemplate dying by suicide and also to seek support online. In addition, there are myriad posts from people recounting how the current pandemic has taken them back to a previous, subsequently resolved, suicidal ideation. One user was not alone in describing this as a return to “a dark and scary place.” There is a sense running through the discussions of how, as lockdown curtails other possibilities such as travel and socialising, suicide may become ‘more possible;’ it inches closer or, as another social media user put it, “creeps back.”
Social media also offers key insights into the causes of distress, with isolation, family troubles and job losses all discussed. In relation to the latter in particular, users poignantly recount financial strain, daily worry and being unable to afford food. Weaving through these online discussions are also pervasive uncertainty and hopelessness; some social media users describe how the atmosphere is “so tense,” how they have “horrible visions of the future,” and that “stories of financial collapse and death” dominate the news. Whilst this hopelessness may incite individual anxiety or distress, it is described in terms more societal and collective than individual.
There is therefore a clear link emerging from social media between the pandemic and suicidality, but this necessitates cautious reflection. It is crucial that we do not tie causality so neatly to COVID or lockdown that we fail to look beyond these at the societal contexts that have shaped their impact. Just as the unequal effects of the virus across communities have shone a light on existing social determinants of physical health, social media users’ narratives poignantly elucidate the existing social contexts onto which COVID has mapped its mental health impact. The pandemic has both laid bare and exacerbated the structural violence, pervasive inequalities and unmet mental health needs that were already rooted in British society. It is therefore to these that suicide prevention needs to turn its attention, both through and beyond the pandemic. They demonstrate that easy solutions do not lie in the easing of lockdown or a quick return to a ‘previous normal’; for many that ‘normal’ was already too precarious. What COVID has shown us is that a whole systems approach to the intersections of social precarity and suicide in policy and practice is overdue. A prevention agenda needs to pay attention not only to the distress and inequality that COVID has precipitated but also to those that it has simply uncovered.