Hawaii sees fewer suicides in pandemic
Despite financial and emotional stressors, early data shows decline
Suicide rates were lower than in previous years across all Hawaii counties during the COVID-19 pandemic, and while this trend is encouraging, state officials continue to work year-round to spread awareness and push suicide prevention, especially among young adults.
Given the amount of financial and emotional stress caused by the pandemic, early 2020 data provided by the state Department of Health does not indicate a significant connection of suicide to COVID-19; the average number of deaths by suicide were higher in February just before the pandemic hit and lowest in April, June, September and December.
“Conclusion was no apparent increase in deaths by suicide in 2020 compared to previous years, in any county,” said Dr. Dan Galanis, a state epidemiologist in DOH’s Injury Prevention Branch. “I think there have been reports on Mainland suicide that indicate an increase, however.”
It’s possible that economic hardship was somewhat mitigated by temporary state and federal “safety nets,” such as disaster relief, unemployment benefit extensions, business loans, and banning evictions, for example.
However, financial or employment issues are not commonly documented as suicide triggers, Galanis said.
He also emphasized that deaths from suicide are just one indicator among many of overall mental wellness in communities.
The first positive coronavirus case in Hawaii was reported on March 6, and Gov. David Ige’s stay-at-home order took effect on March 25, so the nine-month period of April through December represents the pandemic period.
Preliminary data shows that there were fewer deaths from suicide during that period (124) than in the same nine-month periods from 2010 to 2014 (138) or 2015 to 2019 (150), according to DOH.
The proportion of female victims was slightly higher in 2020 (29 percent) compared to the 2010-2019 period (21 percent).
Maui County followed the same overall trend of fewer deaths from suicides in the pandemic period compared to similar nine-month periods in previous years. In contrast, Galanis noted, there were higher totals during the pre-pandemic period of January through March in 2020 compared to previous years.
Although Neighbor Islands tend to be at higher risk, Galanis said that “Maui County has relatively low rates of deaths by suicide or nonfatal attempts that require treatment in hospitals.”
The American Foundation for Suicide Prevention ranks Hawaii as among the lowest in the country (41st) for suicide rates in 2020. On average, 190 Hawaii residents per year kill themselves, according to state data.
Suicide was the the second leading cause of death for ages 10 to 34 last year, fourth leading cause for ages 35 to 44, fifth for ages 45 to 54, eighth for ages 55 to 64, and 17th for those 65 and older.
According to DOH, 15- to 29-year-olds had the highest suicide rate of any age group from 2015-2019.
For Hawaii residents 15 years old and older, Oahu had the highest annual average number of deaths by suicide between 2015 and 2019 (107), followed by Hawaii island (38) and Maui County (29).
Identifying triggers can be challenging, but the most common life stressors among older victims were health-related. Problems with intimate partners are high among younger victims, according to Hawaii’s National Violent Death Reporting System.
Financial hardship, job stressors or family relationships were also noted.
“Financial issues were less frequently cited, and that’s been consistent across the many years we’ve been collecting this data,” Galanis said. “Mental illness, often with no documented treatment, is far more prevalent.”
He said it’s important to analyze trends in nonfatal suicide attempts and other possible indicators, such as reported mental health crises or the use of psychiatric care.
The Hawaii EMS and Injury Prevention System Branch leads suicide prevention activities within the Department of Health with support from the Child and Adolescent Mental Health, Adult Mental Health and Alcohol and Drug Abuse Divisions.
As of 2019, state law requires two hours of youth suicide awareness and prevention training each year for all public school and charter school staff who work directly with kindergarten through 12th grade students.
According to DOH’s Child & Adolescent Mental Health Division, which provides free mental health services for eligible children and youth, Hawaii’s young residents were already at risk for a number of mental health and substance use challenges prior to the pandemic.
But the division reported having 66 percent fewer applications in April 2020 in comparison to the same month in 2019.
“Decreases to service use are concerning, because it suggests that youth and families who need supportive services might not be accessing or receiving the services they need,” according to a program memo.
In a recent study of 445 Hawaii adults from Dec. 30 to Jan. 11, 82 percent of residents statewide said they experienced mental health issues over the last six months. Of the 43 Maui County residents surveyed, 82 percent cited mental health issues.
Statewide, 71 percent of those polled suffered mental stress at some point. Sixty-eight percent felt anxiety, 61 percent felt loneliness, 57 percent experienced depression and 33 percent reported panic attacks.
If family or friends see warning signs in their loved ones, such as extreme mood changes, negative self-talk, increasing use of drugs or alcohol, feelings of isolation, hopelessness or anxiety and having thoughts of suicide, experts say to seek help from a local medical or mental health professional.
When speaking with a person who is contemplating taking their own life, experts recommend letting the person know they are not alone; showing concern; listening and letting them share their feelings; being sympathetic and nonjudgmental; offering hope, such as reassuring them that help is available; and taking the person seriously.
• U.S. National Suicide Prevention Lifeline, (800) 273-TALK (8255).
• Neighbor Island Crisis Line, (800) 753-6879.
• Mental Health America of Hawaii, (808) 521-1846.
• Child & Adolescent Mental Health, (808) 733-9333. For the Crisis Hotline, text ALOHA to 741741 or call Crisis Mobile Outreach at (800) 753-6879. The division also has family guidance centers and branches that can be reached in Wailuku at 243-1252, Lahaina at 662-4045, Lanai at 264-5423 and Molokai at 553-7878.
• Prevent Suicide Maui County Task Force at preventsuicidemauicounty.weebly.com/.
* Dakota Grossman can be reached at firstname.lastname@example.org.