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ORIENTATION AND PHILOSOPHY OF SOCIAL ENQUIRY

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RISE IN SUICIDAL ISSUES AMONG PSYCHIATRIC PATIENTS DURING COVID-19

PANDEMIC-NEW YORK CASE STUDY

Introduction

The focus of this study is on the impacts of the covid-19 pandemic on suicide risks among

individual diagnosed with mental disorders. The first official COVID-19 case was discovered on

February 21, 2020 and after one month, the World Health Organization proceeded to declared

COVID-19 a global pandemic (Walther et al., 2022). Various geographical jurisdictions took

various steps aimed at checking the spread of the pandemic among them imposition of national

lockdowns. This resulted in the limitation of the normal lifestyle habits of the human

demographics. The lifestyles were reduced to trips for health emergencies, necessities and work.

The anticipated psychological impacts of the nationwide lockdowns were among them fear of

infection besides falling ill, social isolation and frustration. Stress, anxiety and depression linked

with the COVID-19 were noted to be on the rise as a result of psychological stressors during the

pandemic (Hernández-Calle et al., 2020). Still, increased frequencies of depressive disorders and

anxiety, post-traumatic symptoms, sleep disorders alongside other psychiatric conditions were

noted among healthy individuals as well as individuals with pre-existing mental health disorders.

Pre-exiting mental health symptoms were further compounded by the COVID-19 pandemic and

the accompanying lockdown and reduced access to mental health services.

Psychiatric symptoms among them insomnia and depression were equally noted among

healthcare professionals as well as general practitioners. This is linked with the psychological as

well as physical pressures as a result of the COVID-19 pandemic.


Research Statement

The period of the COVID-19 pandemic has had effects on peopled with mental disorder in

various ways. Mental health disorders refer to a state of the mind that changes the emotions and

cognitive behavior of an individual. This study is aimed at explaining the factors identified by

the mental health professionals resulting in people with any identified mental health diagnoses to

suicide ideation and attempts during the COVID-19 pandemic with specific reference to New

York. Among the mental health disorders are depression, mood disorder, anxiety as well as

PTSD. People with suicidal ideation plan, think or even contemplate committing suicide.

It is projected that the problem has been on the rise all through the period of the COVID-19

pandemic. This has resulted in disproportionate effects on people with mental health disorders.

Research has not delved into the changes in the suicidal ideation rates among individuals with

mental diagnoses in particular. Studies have however been conducted on the changes in the

suicidal rates at a general scale (Hernández-Calle et al., 2020). Based on a survey carried out in

June 2020, there is a rise in the suicidal ideal especially among the young adults to 26% in 2020

from 11% in 2019. It is thus anticipated that there would be a rise in the suicidal ideal rates

among individuals with mental health issues.

The factors determining alongside the rate of people with suicidal ideal needs to be determined

in aiding the affected populations. Individuals might be in a positon to acquire the required

resources in overcoming the challenging through an understanding of the factors responsible for

the issue.

A comprehensive understanding of the way such factors affected people previously diagnosed

with mental health issues would be pivotal in the collection of data from different experts. This is
an issue of utmost significance since suicide has effects both on the individual as well as the

family members alongside friends. Knowledge on the way COVID-19 pandemic might have

borne impacts on this clientele might aid the agency in developing better strategies aimed at

addressing the possible rises in the suicide risk as a result of similar conditions for instance

natural disasters or even any other pandemics.

Research hypothesis

The COVID-19 pandemic resulted in an increase in the known risk factors for numerous mental

health conditions. Most of such factors are as well risk factors for suicide attempts and suicide

ideal. This study will be aimed at establishing if the frequency of suicide ideation and attempts

are different before and during the COVID-19 pandemic among psychiatric patients.

Selected Paradigm

The chosen paradigm adopted in this research will be post-positivism. This paradigm has three

assumptions regarding the nature of reality, nature of data alongside the relationship between the

observed and observer. The initial assumption will be that reality is objective and not

measurable. The second assumption will be that the collection of data will be qualitative as

opposed to being quantitative and gathered in a naturalistic setting. The last assumption will

define the researcher not being able to distance themselves from the fact they need to try to

minimize their impacts.

Post positivist paradigm is treated as the best approach for this research as it will allow the

researcher identify the different might which would arise from the collected data as oppose to

creation of a hypothesis beforehand. This will as well emphasize on the emerging relationships

which might be distinguishable should the researcher use quantitative data.


Collection of qualitative data will be done from the perspective of the clinician depending on

their experiences with their various clients. Such will aid the researching in collecting as much

comprehensive information as possible through zoom from various clinicians. This will aid the

study in exploring the risks factors and the way it will impact people with mental health

conditions during the period of the COVID-19 pandemic.

Literature Review

Suicide risk is affected by numerous various social, psychiatric, relational, psychological factors.

The effects of the COVID-19 pandemic on vulnerable people might have resulted in an increase

in the suicide risk. Research on previous epidemics for instance the severe respiratory syndrome

have shown a short-term decline in the suicidal risks, may be due to the honeymoon period or

even the pulling together phenomenon. A study conducted by Yip et al. (2010) during the

outbreak of the severe respiratory syndrome in Hong Kong, china noted higher suicide

incidences related with mental stress and social disengagement alongside anxiety.

There were no reports of increased suicide rates during the severe respiratory syndrome in the

early months in numerous countries. While studies on this issue is on the rise, there is still

limited data on suicide ideal alongside suicide attempts during the COVID-19 pandemic among

numerous European countries including Italy (Zhu, Li & Xu, 2022). As such research on suicide

attempts and suicide ideal among mental health disorder individuals during the COVID-19

pandemic might aid in offering crucial information on the impacts on the pandemic on mental

health.

The COVID-19 pandemic affected numerus family worldwide and with specific reference to

people diagnosed with pre-exiting mental health disorders. Such led to a rise in the suicidal
attempts and ideation. Numerous factors resulted in the rise in the suicide risks among these

people. The COVID-19 pandemic might have resulted in regression among some people and

halted any progress among others (Sher, 2020). This survey review entails the causes, prevalence

and impacts of this issues besides the existing interventions adopted aimed at curbing social

ideation among people living with mental health disorders.

A big fraction of adults has been diagnosed with mental disorders. Estimates place the figures at

20% of the total population living in the US having been diagnosed with mental health disorder.

Numerous adults as well experience social ideation with CDC placing the figures at about 12

million people having suicidal ideal and 1.4 million suicide attempts.

The period of the COVID-19 pandemic has seen a rise in the rates of suicidal ideation and

mental health disorders. 40% of the individuals have, during the COVID-19 pandemic, reported

depressive disorder and anxiety I comparison with 10% that was reported in 2019. There has

been an increase in suicidal ideal all through the COVID-19 pandemic, having effects on people

with mental health disorders (Rømer et al., 2021). A research conducted among 2050

respondents between June 24, 2020 and June 30, 2020 found that 11% of the respondents

considered suicide in the last 30 days. A comprehension of this rate offers crucial insights into

the challenges faced by individuals during the COVID-19 pandemic.

Among the factors that might have resulted in individuals with mental health disorders

experiencing suicidal ideals include social isolation, unemployment, quarantine, financial

challenges, stress and copping with death. Still, some people experienced lack of psychiatric and

mental health services (Berardelli et al., 2021). This resulted in a rise in suicide attempts. The

factors bore substantial impacts in the way of living of such individuals besides affecting those

around them.
Uncertainty of being exposed to COVID-19 pandemic and fear coupled with other factors might

have been among the contributors to people developing various disorders. The constant

exposure, based on a study conducted by Sher (2020), might result in individuals developing

depression, anxiety alongside sleep disorders. Such frequent exposure might compound these

disorders among people with mental health issues. Living in endless uncertainty and fear has

resulted in detrimental impacts on the individuals.

The strategies and approaches that were adopted aimed at curbing the spread of the COVID-19

pandemic caused fear and anxiety besides leading to feelings of isolation. Loneliness might lead

to a reduction in the physical and mental health (Rocha et al., 2022). A research conducted in

March 2020 established that after stay-at-home orders were adopted, numerous people who were

isolated were found to exhibit increased negative mental health impacts in comparison with those

who were not isolated. While these safety measures were adopted to keep people safe, they bore

secondary implications on the mental health.

There was an increase in the relapse in psychiatric disorders among people with mental health

disorders during the COVID-19 pandemic. This was linked with reduced access to treatment. A

research conducted noted that nearly 60% of the people discontinued their medication during the

initial months of the COVID-19 pandemic (Hoekstra, 2020). Such termination in the

consumption of mediations might be linked with self-isolation mandates that were imposed

aimed at curbing the spread of the COVID-19 pandemic.

As the COVID-19 pandemic is a relatively new pandemic, further studies is needed in the

determination of the long-term impacts on individuals. It is nonetheless known that suicide

ideation might result in suicide attempts that might bear economic impacts on the individual.

Research notes that obtaining the required care for suicidal attempts tends to be costly both to the
insured and uninsured individuals, leading to inability of receiving the same care (Montalbani et

al., 2021). The state of mind of the individuals can further be worsened by lack of proper care

resulting in long term effects. The knowledge on the way suicide affects individuals offers

insights into the effects of COVID-19 pandemic in the future.

Research Methodology

A review of clinical records will be done of 1200 adult psychiatric inpatients admitted to a select

psychiatric unit. The inclusion criteria will include inpatient that are aged at least 18 years. A

checklist will be preparing for collection of the main features of the sample. Among the variables

that will be collected from the clinical records include diagnosis, sociodemographic data,

previous suicide attempts or even suicide ideation and previous hospitalizations. The presence of

suicide attempt will be evaluated at the arrival time of the patient at the emergency department as

well as at the admission within the psychiatric ward (Mortier et al., 2021). In complying with the

existing ethical issues and consideration in research, all the participants in the study will be asked

to sign a written informed consent form. Since psychiatric patient’s assessment with specific

focus on suicide attempts forms part of the numerous investigations recommended by the local

ethics review board, this current research will be carried out as part of the ongoing study

activities in this field.

The Statistical Package for Social Sciences will be used on the analysis of all the statistical data.

The sample will be divided into two categories depending on their admission dates to the

psychiatric ward. One category of 700 patents was admitted prior to the COVID-19 pandemic

lockdown even as the second one containing 500 patients was admitted during the period of the

COVID-19 pandemic. Fisher exact tests alongside chi-squared tests will be conducted for the

2x2 and NxN contingency tables in that order. Independent sample tests will be deployed in
evaluating the variations between the groups. Mann-Whitney test will be adopted for the case of

non-parametrical data.
References

Berardelli, I., Sarubbi, S., Rogante, E., Cifrodelli, M., Erbuto, D., Innamorati, M., ... & Pompili,

M. (2021). The impact of the COVID-19 pandemic on suicide ideation and suicide

attempts in a sample of psychiatric inpatients. Psychiatry research, 303, 114072

Hernández-Calle, D., Martínez-Alés, G., Mediavilla, R., Aguirre, P., Rodríguez-Vega, B., &

Bravo-Ortiz, M. F. (2020). Trends in psychiatric emergency department visits due to

suicidal ideation and suicide attempts during the COVID-19 pandemic in Madrid,

Spain. The Journal of clinical psychiatry, 81(5), 21721

Hoekstra, P. J. (2020). Suicidality in children and adolescents: lessons to be learned from the

COVID-19 crisis. European Child & Adolescent Psychiatry, 29(6), 737-738

Montalbani, B., Bargagna, P., Mastrangelo, M., Sarubbi, S., Imbastaro, B., De Luca, G. P., ... &

Comparelli, A. (2021). The COVID-19 outbreak and subjects with mental disorders who

presented to an Italian psychiatric emergency department. The Journal of Nervous and

Mental Disease, 209(4), 246-250

Mortier, P., Vilagut, G., Ferrer, M., Alayo, I., Bruffaerts, R., Cristóbal-Narváez, P., ... &

MINDCOVID Working group. (2021). Thirty-day suicidal thoughts and behaviours in

the Spanish adult general population during the first wave of the Spain COVID-19

pandemic. Epidemiology and psychiatric sciences, 30

Rocha, D. D. M., Oliveira, A. C. D., Reis, R. K., Santos, A. M. R. D., Andrade, E. M. L. R., &

Nogueira, L. T. (2022). Suicidal behavior during the COVID-19 pandemic: clinical

aspects and associated factors. Acta Paulista de Enfermagem, 35


Rømer, T. B., Christensen, R. H. B., Blomberg, S. N., Folke, F., Christensen, H. C., & Benros,

M. E. (2021). Psychiatric Admissions, Referrals, and Suicidal Behavior Before and

During the COVID‐19 Pandemic in Denmark: A Time‐Trend Study. Acta Psychiatrica

Scandinavica, 144(6), 553-562

Sher, L. (2020). The impact of the COVID-19 pandemic on suicide rates. QJM: An International

Journal of Medicine, 113(10), 707-712

Walther, A., Grub, J., Tsar, S., Ehlert, U., Heald, A., Perrin, R., ... & Eggenberger, L. (2022).

Status loss due to COVID-19, traditional masculinity, and their association with recent

suicide attempts and suicidal ideation. Psychology of Men & Masculinities

Zhu, Y., Li, Y., & Xu, X. (2022). Suicidal ideation and suicide attempts in psychiatric patients

during the COVID-19: A systematic review and meta-analysis. Psychiatry Research, 317,

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