Whether the coronavirus pandemic influences suicide rates in older adults is not yet known. However, the pandemic is likely to result in a confluence of the risk factors for suicidal behaviours.
In an effort to reduce rates of infection, governments have adopted various policies such as social distancing, social isolation, and quarantine. Older people have been specifically advised to stay home given their vulnerability to COVID-19 and to reduce the burden on health services by limiting the spread of the illness.
The adverse effects of isolation may be especially felt by older people and people with pre-existing mental illness. Living alone, loneliness, and social isolation are well-recognized risk factors for suicide in late life. Before the pandemic, even older adults living in senior housing communities designed to reduce social isolation described moderate levels of loneliness presumably now exacerbated by quarantine and social isolation.
A key risk factor for suicide in older people is psychiatric illness, especially affective disorders. The pandemic may result in new cases of affective disorders and create barriers to accessing treatment. During the SARS epidemic, high rates of psychological distress were associated with quarantine including symptoms of depression and post-traumatic stress disorder (PTSD).
People 65 years and older, especially men, have a high risk of suicide. As Canada’s largest population group, the baby boomers, approach the 65+ age range, there may be an increase in suicide in years to come. The suicide rate of men 65+ is 20 people per 100,000; of men age 90 and older, that rate jumps to 33.8 people per 100,000.
Older males die by suicide more often than any other group because they use more lethal means when attempting suicide. One out of every three attempts by men over 65 results in death. Youth see a rate of 1 death for every 200 attempts.
There are a few factors that put older adults at risk of suicide, factors that can put strain on one’s mental health and potentially lead to thoughts of suicide:
- Experiences of loss such as loss of health, loved ones, physical mobility and independence
- Major life changes such as retirement, change in financial status, a transition into care facilities
- Fewer relationships and connections as loved ones have passed away; also, older adults are more likely to live alone
- Feeling of being a burden to loved ones
- Chronic illness and pain
What can reduce risk?
- Good physical and mental health
- Strong, supportive relationships with friends and family
- Being willing and able to ask for help when it’s needed
- Having a meaning and purpose in life
- Not having access to lethal means such as guns or potentially deadly medications
Warning signs in older adults can be difficult to identify, as some changes in behaviour can be the result of changes as one gets older. For example, if someone is going out less frequently with friends, this could be seen as someone isolating themselves, when in reality they may be having mobility issues.
Any significant change in behaviour or mood is a warning sign that someone may be thinking about suicide, for example:
- Losing interest in a previously enjoyed hobby or activity
- Disconnecting from friends or family (not calling as much, not going out)
- Change in sleeping or eating patterns
Statements of hopelessness can also be a warning sign, or talk of being a burden:
- “I don’t want to have to rely on others for help… I’ve already become such a burden”
- “I can’t do many of the things I used to, including work. I feel like I have no purpose in life”
If you notice any of the following signs, get the person help immediately – call 9-1-1 your local crisis centre:
- Threatening to hurt or kill themselves
- Talking or writing about dying or suicide
- Seeking out ways to kill themselves
What can older adults do to stay mentally healthy?
- Maintain physical and mental health: This could be as simple as eating right and exercising a little bit every day.
- Have fun and do what you love to do: Make time for enjoyable activities or hobbies.
- Prioritize relationships: Call, text, or visit friends and family, be sure to stay in touch! Take part in a class or another kind of group activity, at a club or senior’s centre.
- Include activities with purpose and meaning into daily life: Volunteer to support friends or peers in your community. One in five volunteers at Haven Toronto are over the age of 60.
- Ask for help when it is needed: When struggling to cope with life, tell a loved one or call the local crisis line, which you can find at suicideprevention.ca/need-help/
If someone you know is exhibiting warning signs, have an open, non-judgmental conversation with them.
You can start the conversation by mentioning your concerns, “I haven’t seen you around the swimming pool lately, how are you doing?” or, “I notice you have been a bit stressed these past couple weeks. Are you okay?” Listen to them, be there for them.
You don’t have to offer solutions. If the person responds with statements of hopelessness or being a burden, ask them about those feelings. Then, ask them directly, “Are you thinking about killing yourself?”
It is not common for older adults to directly access mental health services. If an older person you know might be experiencing mental health concerns, encourage them and offer to go with them to find mental health supports.
Important Contact Numbers –
Suicide Prevention and Support: 833 456 4566 (Toll Free)
Toronto and GTA: (416) 408-4357
Survivor Support Program: (416) 595-1716
‘COVID-19: the implications for suicide in older adults’
By Anne Pamela Frances Wand, Bao-Liang Zhong,
Helen Fung Kum Chiu, Brian Draper, and Diego De Leo
National Center for Biotechnology Information
‘Older adults and suicide’
The Mental Health Commission of Canada