key: cord-1012577-795wzuwn
authors: Samson, Kaitlin; Sherry, Simon B
title: Projected increases in suicide in Canada as a consequence of COVID-19 revisited
date: 2020-09-30
journal: Psychiatry Res
DOI: 10.1016/j.psychres.2020.113492
sha: a9e09ea7f6a91f51628a535e3f4c4db81849757a
doc_id: 1012577
cord_uid: 795wzuwn

nan

Our concern is McIntyre and Lee's research greatly underestimates suicides due to unemployment. Our argument is four-pronged. First, their research uses a flawed measure of unemployment to calculate suicide rates. This measure comes from Statistics Canada, where unemployed individuals are defined as "those who, during reference week, were without work, were available for work and were either on temporary layoff, had looked for work in the past four weeks or had a job to start withing the next four weeks." 3 This measure of unemployment fails to account for those who were employed working zero hours or those unemployed and not seeking work. As such, this measure does not represent Canadians who are currently unemployed due to the COVID-19 pandemic but do not fall within the labour force definition. Economists suggest taking these individuals into account would raise the unemployment rate by an additional 18.9%. 4 Thus, a measure of effective unemployment would better predict expected suicide rates by accounting for individuals excluded from the narrowly defined official unemployment rate. Effective unemployment, or U6 unemployment, accounts for those who are conventionally unemployed as well as those unemployed who cannot look for work due to the pandemic.

Second, McIntyre and Lee point out a 1% increase in suicide linked with a 1% increase in unemployment. However, research specific to Canada suggests there may actually be a 2.1% increase in suicide for every 1% increase in unemployment. 5 Third, McIntyre and Lee's research is questionable in comparing the COVID-19 pandemic to the recession of 2008-2009. A recession, or a downtrend in the economy affecting employment and production, fails to account for the speed and the magnitude with which the COVID-19 pandemic halted the economy. Defining the current pandemic along the same lines as the recession of 2008-2009 does not seem to capture the weight of sudden economic standstill we are experiencing. In fact, the International Monetary Fund suggested the global economy is expected to decline by 3% in 2020, compared to the 0.1% decline experienced during the recession of 2008-2009. 6 The current spike in job losses is unlike anything we have experienced since the Great Depression of the 1930s, where economic contraction reached nearly 10%.

Fourth, McIntyre and Lee's study would benefit from emphasizing the unequal effects of unemployment and how these impacts are unevenly distributed by sex, education, and income levels. Evidence suggests differences in capacity to work from home mean less educated and lower income earning individuals are more likely to experience a reduction in working hours compared to those who are more educated and higher income earning. 4 Women are also more likely to hold jobs with flexibility to work from home, with 50% of women being able to work from home compared to 33% of men. 5 The importance of these statistics cannot be understated. For many men, their sense of worth and identity is greatly tied to employment status. Preceding the pandemic, men were already three to four times more likely to die by suicide than women. In a period of economic recession, research suggests men who are involved in the labour force and aged 24-64 years are at the highest risk for increase in suicide. 7 When the ability to work is taken away, as it was so rapidly for those unable to continue working from home during the pandemic, the risk of suicide may be even greater for men.

Sadly, our critique only magnifies the importance of McIntyre and Lee's original estimates and underlines the importance of suicide prevention efforts during the COVID-19 pandemic.

World Economic Outlook

Suicide in Italy during a time of economic recession: some recent data related to age and gender based on a nationwide register study. Health and Social Care in the Community