A Decreasing Pandemic Suicide Rate Doesn't Tell the Full Story, Experts Say

With pandemic lockdowns, social isolation, and economic insecurity taking a mental health toll on the nation, many hypothesized a rise in suicide rates during the past year.

But new preliminary data from the Centers for Disease Control and Prevention (CDC) shows a 5.6% decrease in the overall suicide rate in the U.S. during 2020. Still, experts note that we may not understand the complex interplay between the pandemic and how all its ripple effects—on the economy, job security, personal safety, and mental health—impact suicide. The data was published in JAMA Network in late March.

However, there are a few factors we do know, Anna Mueller, PhD, professor of sociology at the University of Indiana who studies adolescent suicidality, tells Verywell. The first is that the CDC data is preliminary and should therefore be interpreted with caution. "It usually takes the CDC two years to produce this data in a clean and rigorous fashion," she says, so we should keep in mind that the numbers are provisional and subject to change.

Additionally, Mueller says two other factors should be taken into account when considering the data: the fact that they do not offer breakdowns by demographic, and that suicide rates are not the only indicator for mental health.

Lacking Demographic Breakdown

The 5.6% decrease in the overall suicide rate only offers broad strokes of the entire picture, Mueller says. There are various demographic categories that need to be broken down, including gender, race, education level, income, and region, to see where the suicide rate varies.

"Some of those breakdowns could be really important because we are seeing demographic differences in who is impacted negatively by the pandemic," Mueller says.

In the past year, studies have shown that some communities are more negatively impacted than others and healthcare disparities that existed prior to 2020—especially among Black Americans—were only exacerbated by the pandemic.

For instance, by mid-April in 2020, Black Americans were already contracting COVID-19 at higher rates and were more likely to die from it in comparison to White Americans. "In Chicago, more than 50% of COVID-19 cases and nearly 70% of COVID-19 deaths involve Black individuals, although [Black people] make up only 30% of the population," cardiologist Clyde W. Yancy, MD, MSc, wrote in a journal article. He noted various cities and states where Black Americans and individuals from other marginalized groups were getting sick and dying at disproportionate rates compared to White Americans, including New York City, Louisiana, and Michigan.

A December study also found that during the early stages of the pandemic, the suicide rates for Black and White Maryland residents swung in opposite directions. Where the suicide rate seemed to double compared to previous years for Black residents between March 5 and May 7, it "nearly halved" among White residents in the same period and in the months following.

Other populations that were hit hard by the pandemic include frontline workers, notably Filipino American nurses, who are "at increased risk due to their outsized proportion in the nation's nursing force," according to an October 2020 paper. Filipino American nurses account for 4% of all nurses and are more likely to work in acute care units.

Given the variety of ways the pandemic has impacted individuals, Mueller says, she worries that the statistic doesn't tell the full story. The decrease may account more for those who haven't been impacted as negatively by the pandemic. For instance, some have been able to work from home, have counted on financial stability, and haven't had to homeschool their children. "Some of those demographic differences could be really salient to how people have experienced the pandemic," she says. "It could be that once we have more refined data, we'll see that maybe it wasn't awful for everybody, but it was hard for some groups and that might be reflected in the suicide rate."

"When you have a really big statistic, but you can't see the demographics within it, or you can't break it down, that can lead to a lot of misinterpretation with any data," Mueller adds.

Suicide Rate Is Just One Indicator

Although we may look to the suicide rate to gauge the mental health of a nation, it's not the only statistic we should consider. "My suspicion is that people are going to use this number to say, 'Oh, the pandemic isn't as bad for people's mental health as we thought,'" Mueller adds. "And of course suicide is just one measure."

For example, the CDC reported in December that overdose deaths were "accelerating" during COVID-19, recording the highest number of drug overdose deaths in a 12-month period. Alcohol-related deaths have also been on the rise during the past two decades, and experts found that alcoholism rose during the pandemic.

Increased fatality rates related to substance use and overdose, Mueller says, offer signals that more people are now facing mental health challenges and may not be able to seek help when they need it.

Other life events, such as losing one's home, Mueller says, may be adding to the distress experienced during the pandemic. "Research has shown that economic insecurity and economic hardship can be extraordinarily distressing and can be tied to suicide rates," she says. "I'm very worried about people who lost their homes or experienced significant economic insecurity during this pandemic. I'm very worried about their ability to recover going forward, especially if there are any children in the household."

"Whether it's trauma from being stuck at home in a domestic violence situation or the loss of somebody that you loved to COVID-19," she adds, everything can be a potential risk factor for suicide. "I'm not saying that grief causes suicide. We can't say that," she says. However, challenging life experiences can be emotionally taxing. "And for some people, that means that they go on to develop suicidal thoughts."

How to Move Forward

While COVID-19 upended countless lives, suicide still remains the eleventh leading cause of death in the United States, regardless of the preliminary 5.6% decrease. The flip side to all this, Mueller says, lies in our response.

"The thing I'm most hopeful about in this pandemic is that I feel like people have started talking about mental health much more explicitly," she says. Ideally, this would carry over into more explicit conversations about mental health in schools, healthcare systems, and workplaces. She hopes it may even put pressure on policymakers to expand mental healthcare coverage.

Mueller adds that in schools specifically, she would love to see changes in educational values and practice. "If [educators and schools] could all become more trauma-informed and have a more whole-child sort of educational philosophy," she says, where it's not just about educating students but supporting them through life's challenges, "that's my hope."

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