COVID-19-Related Suicides-Public Health Role of Forensic Pathologists

Concerns about potential increases in suicidal behavior during the coronavirus disease 2019 (COVID-19) pandemic arose in response to reported widespread mental health deterioration. Although early data did not corroborate such concerns, suicide remains a significant cause of preventable deaths worldwide and is of significant interest to public health in the setting of a pandemic. In this study, we present 17 cases of COVID-19-related suicides seen in our West Michigan Medical Examiner's office from 2020 to 2022, which exhibit the complex relationship between mental health and pandemic-related psychological, social, and economic stressors. The relationships were generally categorized as increased anxiety and/or stress due to COVID-19 (5/17 [29.4%]), the loss of social support and/or social isolation occurring as a result of COVID-19 restrictions (5/17 [29.4%]), financial concerns or loss of income as a result of COVID-19 policies (3/17 [17.6%]), grief related specifically to COVID-19 (2/17 [11.8%]), and purported neuropsychiatric sequelae of a prior COVID-19 infection (2/17 [11.8%]). By examining these cases, we highlight ways in which public health systems might prepare for and respond to mental health crises during current or future pandemics and the need for increased collaboration between forensic pathologists and epidemiologists in collating high-quality data during death investigations.