Attack on the soul

Studies in several countries provide indications of the effects of the lockdown on the mental health of the population.

By Andreas Heyer.

A new survey by the U.S. Center for Disease Control reveals a high proportion of concrete suicidal thoughts, especially among the younger generation during the corona lockdown. Similarly, surveys in several countries indicate that anxiety disorders and depression tendencies in the population have increased significantly compared to the previous year. However, those responsible still see themselves as the protectors of public health.

In the USA, the National Center for Health Statistics (NCHS), which is part of the Center for Disease Control (CDC), together with the US Department of Statistics, conducted 90-day surveys from April 23, 2020 to assess the psychological “consequences of the coronavirus pandemic” in the US population. In its representative surveys, the NCHS determined a threefold increase in the occurrence of anxiety and depressive symptoms compared to the previous year.

While the regular household surveys conducted by the agency for the 2nd quarter of 2019 revealed an occurrence of 11 percent anxiety and depression symptoms in the population, in the 2nd quarter of 2020 these symptoms occurred in about 35 percent of the participants in the comparable survey. With a share of about 50 percent, the accumulation of symptoms was particularly pronounced among the young population between 18 and 29 years of age.

In a further study conducted by the CDC as part of the “Morbidity and Mortality Weekly Reports,” a representative survey of 5,412 adult U.S. citizens was conducted from June 24 to 30, 2020, on mental health during Covid-19 control measures. While 31 percent of respondents reported experiencing anxiety or depression symptoms, 11 percent of respondents said they had seriously considered suicide in the past 30 days. At 26 percent, the proportion with serious thoughts of suicide was particularly high among 18 to 24-year-olds.

Another group particularly affected by psychological symptoms was the quarter of the sample who cared for people in need of help – for example relatives or friends – free of charge: 56 percent reported anxious or depressive symptoms and 31 percent had serious suicidal thoughts.

Of those surveyed, 13 percent said that they had begun or increased their abuse of alcohol or other drugs to cope with the “pandemic-related” stress. Among 18 to 24-year-olds, this was true of 25 percent of those surveyed, and 33 percent of the nursing staff. In addition, analysis of 500,000 urine samples from a drug testing laboratory showed an increase in positive test results from mid-March 2020 for the non-prescription painkiller fentanyl, cocaine and metamphetamines.

Information from other countries

Likewise, the Office for National Statistics (ONS) has been conducting regular surveys on the mental health of the population since 2011. While 30 percent of those surveyed stated that they experienced a strong degree of anxiety before the lockdown measures, the figure rose to 50 percent at the beginning of the lockdown in April.

For the first time since the start of the investigations, the authorities had found significantly negative values for data on life satisfaction, happiness and anxiety at the same time. In particular, a correlation between anxiety and loneliness was observed. In particular, a correlation between anxiety and loneliness was observed. At the same time, 10,000 additional deaths of dementia patients in England and Wales were registered by the Office for National Statistics (ONS) in April 2020. As these additional deaths could not be explained by Covid-19 diseases, this was attributed to the patients’ declining courage to face life in view of the significantly reduced social contacts.

Surveys conducted by the Australian statistical office during the corona lockdown from mid-March to mid-April 2020 also revealed an increase in psychological symptoms in the population in a household survey. Whereas in a survey in 2017/2018 only 24 percent of those questioned indicated symptoms of restlessness or agitation, the figure was 40 percent during the lockdown phase. During this period, 9 percent of those surveyed stated that they were so depressed that nothing could cheer them up.

In India, the Indian Psychiatric Association noted a 20 percent increase in mental illness during the lockdown. The Suicide Prevention India Foundation also found a significant increase in their study Covid-19-Blues. In a survey of 159 psychotherapists, an increased suicidal tendency was perceived among young patients.

In the study conducted in April/May 2020, 30 percent of the therapists stated that they noticed an increase in self-injury and suicidal tendencies among patients. This was attributed to job loss, financial insecurity, isolation and loneliness due to the lockdown.

Insufficient monitoring in Germany

In Germany, the Robert Koch Institute is responsible for national health monitoring. Current representative and regular surveys on the occurrence of psychological symptoms in the population are not apparent. A project to introduce a “National Mental Health Surveillance” is not scheduled to be completed until the end of 2021. For this reason, it is currently not possible in Germany to rely on data from government agencies for indications of the mental health of the population during the lockdown measures.

Current studies from universities in Germany seem to confirm the tendency of the CDC studies from the USA to include risk groups in the population. The Copsy study of the University Medical Center Hamburg-Eppendorf conducted an online survey of 1,000 children and adolescents and 1,500 parents in May/June 2020. The risk of psychological abnormalities had risen from 18 percent in previous surveys to 31 percent during the crisis. While one third of the children had previously indicated a low level of psychological well-being, this figure had risen to two thirds during the crisis.

In a cooperation between the University of Giessen and the Medical School Hamburg, a non-representative survey was conducted in March/April 2020, in which a sample of 949 people were asked about their mental health during the lockdown. The sample consisted of 63 percent students, had an average age of 29 years and included 80 percent women. Symptoms of clinical depression were identified in 35 percent of the study participants, symptoms of obsessive-compulsive disorder in 21 percent, increased fear of illness in 17 percent and symptoms of generalized anxiety disorder in 12 percent.

The authors point to the greatly increased incidence of mental illness compared to the general prevalence of mental illness, but also to distortions due to the lack of representativeness. Nevertheless, the study can provide indications of the effects of the lack of presence learning in groups and the associated increase in social isolation among students.

A representative survey of 1,005 senior citizens conducted by the University of Leipzig in April 2020, however, showed that no increase in mental symptoms was measurable in this population group compared to previous years.

The Kaufmännische Krankenkasse KKH in Hanover published an analysis of sick leave, according to which there was an 80 percent increase in sick leave due to mental illness in the first half of 2020 compared to the same period of the previous year. While 14,600 cases of mental illness were reported in the first half of 2019, this figure had already risen to 26,700 cases in the first half of 2020.

Development of the suicide rate during the lockdown

To date, no conclusive data on suicide rates in the second quarter of 2020 at the national level are known. Indications from individual regions and short periods of time give mixed indications.

In the Indian state of Kerala, 66 children alone committed suicide within 100 days of the lockdown. The reasons cited were not being able to afford the technical equipment needed to participate in online school lessons, general stress and loneliness. There were also several suicides of adults during the Corona quarantine.

An increase in suicides in a Californian clinic was reported from the USA, with more suicides in one month than usual in a year. In Berlin, a significant increase in suicides by a funeral home was reported.

On the other hand, an evaluation of all deployment codes of the Berlin rescue services on self-injuring behavior by Correctiv revealed a decrease in the number of deployments until the end of April 2020 compared to the previous year. In contrast, a significant increase in some types of suicide was noted. A survey on suicides conducted by the Augsburger Allgemeine in several German states showed that no increase in the suicide rate had been detected by the end of April.

The assumption of rising suicide rates with rising unemployment can be regarded as certain. A Canadian study determined a correlation between the unemployment rate and the suicide rate between the years 2000 and 2018, and based on this, scenarios of expected additional suicides due to the increased unemployment rate in Canada were calculated. In the case of an average increase in unemployment, the suicide rate is expected to rise by 6 percent, while a strong increase in unemployment is expected to be 27 percent.

A similar study for the USA predicts an increase in the suicide rate of 3 to 8 percent. Several U.S. studies discuss the role of isolation and feelings of loneliness for suicidal motives. It is reported that during and after the SARS epidemic in Hong Kong in 2003 and the nuclear disaster in Fukushima, the suicide rate also increased significantly in the respective populations.

A final assessment of the effects of the lockdown measures on suicides and suicide attempts will only be possible after the national data of individual countries have been published. Official evaluations are often only available after a long period of time.

Risk groups of mental illness

The studies indicate that the population was under great psychological stress during the lockdown. The CDC study shows a significant increase in psychological symptoms and suicidal thoughts. According to the study, the young generation is particularly affected, as are people who care for others free of charge. Both groups are likely to be particularly affected by the socially isolating side effects of the lockdown measures.

From a virological perspective, social distancing may be a good contribution against the spread of infectious diseases. From a psychological perspective, however, social isolation is one of the strongest risk factors for mental illness. In the future, a better balance must be struck between these perspectives in order to protect the health of the population. At this point, it is worth noting the definition of health in the constitution of the World Health Organization (WHO):

“Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”

Since mental stress and high levels of stress can often lead either inwardly to mental illness or outwardly to aggressive and impulsive outbursts, it is urgently necessary to reduce the mental stress of the young generation and strengthen their social resources. With the same vigor with which the protection of risk groups from infectious diseases has been promoted in recent months, the protection of risk groups of mental illness and suicidal tendencies should be focused on as well.

In order to be able to assess the impact of political decisions and social crises on the mental health of the population, continuous, representative health monitoring must be established in Germany in a timely manner. The methodologically well-designed surveys of the U.S. CDC can serve as a model here.

Note on the article: The present text first appeared in “Rubikon – Magazin für die kritische Masse”, on whose advisory board Daniele Ganser and Rainer Mausfeld are active, among others. Since the publication was done under a free license (Creative Commons), KenFM takes over this text for secondary use and explicitly points out that the Rubicon also depends on donations and needs support. We need many alternative media!

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