Bortenschlager Ferdinand, Lutz Maximilian, Streb Judith, Astudillo-García Claudia I, Barzilay Shira, Chistopolskaya Ksenia, Çinka Elif, Enikolopov Sergey N, Husain Muhammad Ishrat, Kuśmirek Oskar, Menon Vikas, Peper-Nascimento Jefté, Rogers Megan L, Valvassori Samira S, Yilmaz Fatma Kantaş, You Sungeun, Dudeck Manuela, Galynker Igor
Department of Forensic Psychiatry and Psychotherapy, Ulm University, Ulm, Germany.
Department of Epidemiology and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico.
BJPsych Open. 2025 May 9;11(3):e99. doi: 10.1192/bjo.2025.58.
Limited access to health services and overwhelmed healthcare systems created a challenging environment for those in need of mental health support during the COVID-19 pandemic, and the pandemic impacted suicide risk in several ways.
The present study aimed to analyse how the quality of the health security systems in 12 countries affected suicide crisis syndrome (SCS) during the pandemic. We hypothesised that countries with robust health systems were better able to respond to the increased demand for (mental) health support, resulting in fewer cases of SCS.
From June 2020 to September 2021, 11 848 participants from 12 different countries took part in an online survey. Besides asking about sociodemographic information, the survey assessed the severity of SCS with the Suicide Crisis Inventory (SCI). The Global Health Security Index and the Legatum Prosperity Health Index were used to operationalise the quality of the national health systems. Multilevel analyses were performed to evaluate the impact of health system quality and COVID-19-associated factors on SCI scores.
SCS was more prevalent among participants with COVID-19 symptoms and in countries with high rates of COVID-19-associated deaths. Multilevel analyses revealed a significant interaction effect of COVID-19 symptoms and national health indices. SCS occurred significantly less frequently in participants with COVID-19 symptoms living in countries with good health security systems.
The challenges posed by the pandemic highlight the necessity to promote accessible and affordable health services to mitigate the negative impact of the pandemic on suicidal ideation and behaviour.
在新冠疫情期间，医疗服务获取受限以及医疗系统不堪重负，给那些需要心理健康支持的人营造了一个充满挑战的环境，并且疫情在多个方面影响了自杀风险。
本研究旨在分析12个国家的卫生安全系统质量在疫情期间如何影响自杀危机综合征（SCS）。我们假设拥有强大卫生系统的国家能更好地应对（心理）健康支持需求的增加，从而减少SCS病例。
2020年6月至2021年9月，来自12个不同国家的11848名参与者参加了一项在线调查。除了询问社会人口统计学信息外，该调查还使用自杀危机量表（SCI）评估SCS的严重程度。全球卫生安全指数和列格坦繁荣健康指数被用于衡量国家卫生系统的质量。进行多层次分析以评估卫生系统质量和与新冠疫情相关的因素对SCI分数的影响。
SCS在有新冠症状的参与者以及新冠相关死亡率高的国家中更为普遍。多层次分析显示新冠症状与国家卫生指数之间存在显著的交互作用。在卫生安全系统良好的国家中，有新冠症状的参与者出现SCS的频率显著更低。
疫情带来的挑战凸显了推广可及且负担得起的医疗服务以减轻疫情对自杀意念和行为的负面影响的必要性。
