Post Publication Independent Review of

"Suicide risk and prevention during the COVID-19 pandemic"

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Part XXVI. Post Publication Independent Review of "Suicide risk and prevention during the COVID-19 pandemic"

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Post Publication Independent Review of

Suicide risk and prevention during the COVID-19 pandemic

David Gunnell, Louis Appleby, Ella Arensman, Keith Hawton, Ann John, Nav Kapur et al.

Published: April 21, 2020 DOI:

Review Comments:

1. Quote "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. Preventing suicide therefore needs urgent consideration. The response must capitalise on, but extend beyond, general mental health policies and practices." End of Quote.

The author is calling to attention a significant undesirable probable outcome of the COVID-19 outbreak, viz., suicide. Since the COVID-19 outbreak is massive and spread across geographies and demographies, it can be expected that the undesirable probable outcome of suicide may have to be curtailed so that it doesnt cause footfall widely.

2. Quote "A wide-ranging interdisciplinary response that recognises how the pandemic might heighten risk and applies knowledge about effective suicide prevention approaches is key. Selective, indicated, and universal interventions are required (figure)." End of Quote.

The authors have proposed Selective & Indicated Interventions as well as Universal Interventions (subtitled "Figure: Public health responses to mitigating suicide risk associated with the COVID-19 pandemic"), which may be worthy to be considered at the highest levels of Government. The figure is available via the article url at . Direct url of the figure is

3. Quote "The likely adverse effects of the pandemic on people with mental illness, and on population mental health in general, might be exacerbated by fear, self-isolation, and physical distancing.4 Suicide risk might be increased because of stigma towards individuals with COVID-19 and their families. Those with psychiatric disorders might experience worsening symptoms and others might develop new mental health problems, especially depression, anxiety, and post-traumatic stress (all associated with increased suicide risk)." End of Quote.

These observations by the authors need to be given attention

4. Quote "These mental health problems will be experienced by the general population and those with high levels of exposure to illness caused by COVID-19, such as frontline health-care workers and those who develop the illness. " End of Quote.

The severity of the concern is brought out here. The population can be treated if they develop mental health problems, and so can the patients. But if frontline health-care workers start developing mental health problems, then it has the potential to throw the entire COVID-19 containment and treatment processes haywire.

5. Quote "The suicide-related consequences of the pandemic might vary depending on countries' public health control measures, sociocultural and demographic structures, availability of digital alternatives to face-to-face consultation, and existing supports. The effects might be worse in resource-poor settings where economic adversity is compounded by inadequate welfare supports." End of Quote.

The Nation may need to develop its own customized suicide prevention mechanisms to address the variations present in the societal structure.

6. Quote "These are unprecedented times. The pandemic will cause distress and leave many people vulnerable to mental health problems and suicidal behaviour. Mental health consequences are likely to be present for longer and peak later than the actual pandemic. However, research evidence and the experience of national strategies provide a strong basis for suicide prevention. We should be prepared to take the actions highlighted here, backed by vigilance and international collaboration." End of Quote.

These observations and suggestions of the authors seem to indicate that an adaptive continuous long term mental health support system needs to be put in place. Such a mental health support system may find use even after the COVID-19 pandemic, as general mental health of the population is also a criteria to achieve better growth in all identified areas of growth of the Nation and this COVID-19 mental health support system may also help to streamline the population, whenever required on a case-by-case basis.

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