A rapid review of the effects of epidemics or pandemics on suicide, suicidal behaviours and suicidal thoughts

Suicide remains one of the most important public health challenges worldwide, with more than 800,000 people dying every year. The effect of the pandemic, including physical distancing measures, on suicides and suicidal behaviors remains unclear. This proposal aims to gather and present all available evidence for the effect of infectious pandemics on suicide, suicidal behavior and suicidal thoughts. This rapid review will answer the question "in a population exposed to an infectious epidemic or pandemic, what is the effect on suicides, suicidal behavior and suicidal thinking both during and after the pandemic". The review will consider this question across all age groups; between men and women; within indigenous populations; those in lower socioeconomic classes; those with pre-existing health conditions (including mental illnesses); and those who have been infected with Covid-19. The review will include all articles found in several electronic databases using predetermined search terms and will be continuously updated. These will be studies published in peer-reviewed journals which address mental health outcomes in an epidemic or pandemic. Papers will not include research related to the epidemic of suicide. Using this review, we hope to provide policymakers with high quality evidence for suicide prevention planning during pandemics. We will also use the review to modify existing guidelines on suicide prevention to be appropriate during times of pandemics and physical distancing. Also, we propose to use this review as a first step in creating a suicide prevention rapid synthesis team with our knowledge users to create "evidence on tap". We will create a governance group with our knowledge users to oversee the generation and answering of questions related to Covid-19 and suicide. The review will inform planning for a strategic plan for suicide and Covid-19 research.