According to an article published by Berliner Morgenpost on January 6, a study of the Essen University Hospital claims that up to 500 children required treatment in intensive care units in Germany after suicide attempts. Since it is not possible to verify this statement, this claim must be classified as uncheckable.
The article explains that the lockdown due to coronavirus could be a possible cause. There was a strict lockdown in Germany between november 2020 and may 2021. Many children and teenagers weren’t able to meet their friends and could not pursue their hobbies since sport clubs, swimming pools and gyms were closed. Also, stores except supermarkets were closed and schools were open or closed again and again.
Unfortunately, it wasn’t possible to get access to the primary source. According to Dr. Christian Dohna-Schwake, who participated in the study, it isn’t published yet.
Nevertheless, according to the German Federal office of statistics there was a small increase in suicide rates from 2019 to 2020. But as you can see in figure 1, overall, the trend has been declining since 2015. Unfortunately, the numbers for 2021 are not out yet.
Statistical recording of suicide attempts
Ute Lewitzka, a specialist in psychiatry and psychotherapy from the German Society for Suicide Prevention, pointed out that suicide attempts are not recorded in a statistically valid way at all. Dr. Lewitzka explained that it is possible that there are regional clusters, but this is difficult to generalize and not possible to verify. She also stated that there are estimated 10–20 suicide attempts for one suicide case.
The psychological effects of the lockdown
However, there are several studies that explain that the lockdown has had a negative effect on the psyche of children and teenagers. According to a study by the german federal institute for population research, the number of teenagers between the ages 16 to 19 who show clinically relevant symptoms of depression has more than doubled after the first lockdown in 2020. The depressiveness score of female teenagers has even tripled, from 13 to 35 percent (see figure 2). Helena Ludwig- Walz, who works at the institute, explains that isolation and loneliness in particular are very stressful especially for children and can lead to psychological problems.
The COPSY study by the university hospital Hamburg also shows that the pandemic reduced the mental well-being of children and adolescents and increased the risk for mental disorders. In the study, children and teenagers from the age 11 to 17 were interviewed and also parents were interviewed about their 7- to 10-year-old children. According to the study, psychosomatic complaints as stomachache, feeling low, headache, sleeping problems and irritability increased with each wave of infection and the associated lockdown (see figure 3). It is also stated in the study that 71 percent of the interviewed children and teenagers felt burdened by the contact restrictions, in the second wave it was already 83 percent.
Therapy requests increased
According to a survey from the German Psychotherapists Association, the number of therapy requests increased from 2020 to 2021. 60 percent more children and adolescents than in the previous year requested a therapy place. “Corona will leave its mark on the next generation. […] We need a support program for mental health and social interaction” explains German Psychotherapists Association Federal chairman Gebhard Hentschel.
Youth suicide deaths in Spain
In Spain, suicide is the second external cause of youth death just after traffic accidents, according to the study CrecerSaludable(mente). This report was made by the NGO Save the Children to analyse the impact of the pandemic in terms of mental health.
According to the data available in the Spanish National Statistics Institute (INE), there were 314 deaths by suicide in 2020 in young people under the age of 30. The number is more or less the same as the year 2019 when 316 young people took their own life. There is still no data for the year 2021, which is expected to be released in October 2022.
In the following graphic, we see the evolution of youth suicide during the past decade in Spain and how it has been relatively stable. It must be taken into account that the data provided by the Spanish authorities rely on death-certificates information on the cause of death. According to Pere Taberner, one of the authors of the study previously mentioned, that could give a low estimate of the real number, especially in children under 15, where official deaths are relatively low.
However, it is true that 2020 has been the year with more suicides in the past decade if we consider all age groups. In the year when the pandemic started, 3941 Spanish people took their own life. The average between 2011 and 2020 was 3650 deaths. This increase does not apply to young people. In the following graphic, we see the percentage of suicide of youth under the age of 30 in relation to the total number of all age groups.
We have focused so far on deaths, but suicide attempts are also relevant when talking about mental health and the pandemic. INE stopped publishing data about attempts in 2007. The reason given was to „follow international standards on the subject”. Before that year the institute developed a specific study on suicide with information about attempts and methods. After 2007, suicide was included in the death cause report and the only information given is now the deaths by gender and age group.
However, the report CrecerSaludable(mente) includes data from the Teléfono de la Esperanza the Spanish suicide prevention hotline. During 2020, they attended 160.646 calls, 38 percent more than the previous year. Around 8.000 of them were cases of people under the age of 25.
There is no denying that the lockdown has led to increased psychological distress in children and teens. However, because there was no insight into the primary source and none of the experts could confirm the statement, it is classified as uncheckable. In addition, it must be said that psychological stress does not necessarily lead to suicide.
If you are not in your best moment and have recently experienced suicidal thoughts, remember that you are not alone. There is help available for you. In case of an emergency, in Spain, you can call 112 or Teléfono de la Esperanza (717 00 37 17). In Germany, you can call the Telefonseelsorge (0800/111 0 111). If you live elsewhere in the world, you can find your national hotline here.
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RESEARCH | ARTICLE © Jan Weffers and Rieke Poppinga, Jade University of Applied Sciences Wilhelmshaven, Germany and Pau Torres-Pagès, University Pompeu Fabra Barcelona, Spain