Suicide and quarantine during the COVID-19 pandemic: Do we know everything?

Background: There is widespread concern over the impact of COVID-19 and lockdown measures on suicidal behaviour. We assessed their effects on suicide and hospitalization for attempted suicide during the initial phase of the pandemic in Chile. Methods: We used panel data at the county and month level from January 1, 2016 to December 31, 2020 on suicides and related hospitalizations and a pandemic quarantine dataset. Poisson regression models and a difference-in-difference (DiD) methodology was used to estimate the impact of quarantine on both measures. Findings: Suicide and hospitalizations for attempted suicide decreased (18% and 5.8%, respectively) during the COVID-19 outbreak in Chile (March-December 2020) compared to the same period in 2016-2019. The DiD analysis showed that there was at least a 13.2% reduction in suicides in quarantined counties relative to counties without such restrictions. This reduction was in male suicides and unaffected by age. There was no significant difference between quarantined and non-quarantined counties in terms of hospitalization for suicide attempts. Conclusions: This study shows a significant quarantine effect on reducing suicide during the initial phase of the COVID-19 pandemic in Chile. Changes in the number of hospitalizations for suicide attempts do not explain the differences between quarantined and non-quarantined counties.