As the coronavirus disease 2019 (COVID-19) pandemic spread across the world, it caused global health and economic disasters. More quietly, mental health issues also began to increase in quantity and severity, and there were strong concerns about the potential increase in suicide rates. Most of the population was protected from the disease by restrictions, lockdowns and social distancing orders.
However, healthcare workers not only had to stay on the job and risk contracting the disease from their patients, but also had to endure overtime and increased stress. A group of researchers from the University of Bristol and University College London recently collaborated to plan a survey of suicidal behavior and self-harm among healthcare workers.
A pre-printed version of the group’s study is available on the medRxiv* server, while the article is subject to peer review.
Although the Interim Office for National Statistics provides data indicating an increase in the number of suicides, as well as the proportion of healthcare worker deaths due to suicide in the first six months of 2020 compared to 2019, there is been few studies that show in-depth analysis of these figures.
The researchers designed their experiment to study: the prevalence of suicide and risky behaviors such as self-harm and suicidal ideation (the regular intrusion of suicidal thoughts) before and during the pandemic, and the survey between demographic characteristics on these factors.
In order to explore this, they looked at responses to NHS Check, an online survey distributed across 18 NHS Trusts during the COVID-19 pandemic. Although one result set was suppressed due to a low response rate (less than 5%), this should still provide plenty of data for statistical analysis.
The survey contained many questions such as, “Have you ever thought about killing yourself, even though you wouldn’t actually do it?” and “Have you ever attempted suicide by taking an overdose of pills or in any other way?” There were three possible answers: “Yes, in the last 2 months”, “Yes, but not in the last two months” and “No”.
Demographics explored include age, gender, ethnicity, and role, including non-clinical staff. Other factors will include concerns about issues such as access to personal protective activity and trust around handling safety issues, as well as satisfaction with the standard of care provided.
The researchers will use chi-square tests for each variable, which will allow them to identify any statistically significant differences between the groups. Beforehand, all initial survey responses will be weighted using a ranking algorithm based on the aforementioned factors to maximize the representativeness of the data, and any missing demographic data will be filled in using imputations. multiple. This will only affect the weighting and will not be used in further analysis. They will then look at the same data six months into the pandemic.
Using random-effects logistic regression models – traditionally used to model events with two incompatible outcomes – they will build a model that will allow them to study the relationships between the studied characteristics and suicidal behavior before and after the pandemic.
medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be considered conclusive, guide clinical practice/health-related behaviors, or treated as established information
- Padmanathan, R et al., (2021). Protocol: A two-wave cross-sectional study in England investigating suicidal behaviors and self-harm among healthcare workers during the Covid-19 pandemic. medRxiv preprint server. doi: https://doi.org/10.1101/2021.09.16.21263255.