Suicide prevented or delayed? Suicide rates during North Carolina's stay-at-home order

To assess the impact of the COVID-19-related stay-at-home (SAH) order in North Carolina (NC) on suicide mortality.

We used controlled interrupted time series to examine weekly suicide death rates before, during and after the SAH order compared with 2015-2019 rates.

Between 1 January 2020 and 30 March 2020, the suicide death rate in NC was stable. On SAH order implementation, there was an immediate decline in the suicide rate of 2.0 deaths per 100 000 person-years (PYs) (95% CI -7.7, 3.7) during the first SAH week, relative to combined weekly data 2015-2019, followed by a sustained decline of 1.0 death per 100 000 PYs (95% CI -2.0, 0.1) per week over the eight weeks under SAH. On lifting the SAH order, we observed an immediate increase in suicide (3.7 per 100 000 PYs (95% CI -0.7, 8.2)) and from that point through the end of 2020, suicide mortality increased at a rate of 0.7 per 100 000 PYs (95% CI -0.2, 1.6) per week.

During the SAH period, suicide mortality declined for 8 weeks but returned to prior rates after the SAH order was lifted. Increased family supervision and decreased access to lethal means may explain the observed reduction in suicide during the SAH order.