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

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  • Thilini Rajapakse

    (Department of Psychiatry, Faculty of Medicine, University of Peradeniya, Peradeniya 20400, Sri Lanka
    South Asian Clinical Toxicology Research Collaboration, 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
    South Asian Clinical Toxicology Research Collaboration, 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
    National Institute of Health Research Biomedical Research Centre, Oakfield House, Oakfield Grove, Bristol BS8 2BN, 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
    Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2PS, UK)

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.

Suggested Citation

  • Thilini Rajapakse & Tharuka Silva & Nirosha Madhuwanthi Hettiarachchi & David Gunnell & Chris Metcalfe & Matthew J. Spittal & Duleeka Knipe, 2023. "The Impact of the COVID-19 Pandemic and Lockdowns on Self-Poisoning and Suicide in Sri Lanka: An Interrupted Time Series Analysis," IJERPH, MDPI, vol. 20(3), pages 1-14, January.
    • Handle: RePEc:gam:jijerp:v:20:y:2023:i:3:p:1833-:d:1040783
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    References listed on IDEAS

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    1. Allison Milner & Andrew Page & Anthony D LaMontagne, 2013. "Long-Term Unemployment and Suicide: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 8(1), pages 1-6, January.
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