The Impact of the COVID-19 Pandemic and Lockdowns on Self-Poisoning and Suicide in Sri Lanka: An Interrupted Time Series Analysis

Thilini Rajapakse (), Tharuka Silva, Nirosha Madhuwanthi Hettiarachchi, David Gunnell, Chris Metcalfe, Matthew J. Spittal and Duleeka Knipe ()
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Thilini Rajapakse: Department of Psychiatry, Faculty of Medicine, University of Peradeniya, Peradeniya 20400, Sri Lanka
Tharuka Silva: Department of Psychiatry, Faculty of Medicine, University of Peradeniya, Peradeniya 20400, Sri Lanka
Nirosha Madhuwanthi Hettiarachchi: Toxicology Unit, Teaching Hospital, Peradeniya 20400, Sri Lanka
David Gunnell: Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2PS, UK
Chris Metcalfe: Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2PS, UK
Matthew J. Spittal: Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC 3010, Australia
Duleeka Knipe: South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya 20400, Sri Lanka

IJERPH, 2023, vol. 20, issue 3, 1-14

Abstract: Evidence from high-income countries suggests that the impact of COVID-19 on suicide and self-harm has been limited, but evidence from low- and middle-income countries is lacking. Using data from a hospital-based self-poisoning register (January 2019–December 2021) and data from national records (2016–2021) of suicide in Sri Lanka, we aimed to assess the impact of the pandemic on both self-poisoning and suicide. We examined changes in admissions for self-poisoning and suicide using interrupted time series (ITS) analysis. For the self-poisoning hospital admission ITS models, we defined the lockdown periods as follows: (i) pre-lockdown: 01/01/2019–19/03/2020; (ii) first lockdown: 20/03/2020–27/06/2020; (iii) post-first lockdown: 28/06/2020–11/05/2021; (iv) second lockdown: 12/05/2021–21/06/2021; and (v) post-second lockdown: 22/06/2021–31/12/2021. For suicide, we defined the intervention according to the pandemic period. We found that during lockdown periods, there was a reduction in hospital admissions for self-poisoning, with evidence that admission following self-poisoning remained lower during the pandemic than would be expected based on pre-pandemic trends. In contrast, there was no evidence that the rate of suicide in the pandemic period differed from that which would be expected. As the long-term socioeconomic impacts of the pandemic are realised, it will be important to track rates of self-harm and suicide in LMICs to inform prevention.

Keywords: suicide; self-harm; Sri Lanka; COVID-19; pandemic; low- and middle-income country; global mental health (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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