COVID-19 pandemic and suicidality: Durkheim revisited

To the Editor

There has been considerable focus on the wide-ranging emotional impact of COVID-19 and related suicidal behaviour. In this letter, we examine the links between COVID-19 and suicidality from the sociological perspective of Durkheim (1897).

First, among high-risk groups, such as healthcare workers, the fear of contracting COVID-19 and subsequently spreading it to kith and kin may trigger altruistic suicidal behaviour; such instances have already been reported. On a related note, extreme demands of work coupled with perceived limitations of medical science in finding a cure for the virus may trigger feelings of overwhelm, burnout and hopelessness among healthcare workers; these, in turn, may provoke altruistic suicide (Menon and Padhy, 2020).

Next, a lack of sufficient social integration due to the restrictions imposed on daily life such as lockdown and social distancing, while necessary to contain the spread of the virus, may foster feelings of entrapment and loneliness, and trigger anomic suicidal behaviour due to lack of social direction (Durkheim, 1897). A case in point are the suicides among migrant labourers, during the pandemic, where the concurrent loss of job opportunities, stress of being away from their families and support networks, and uncertainty about future may drive anomic suicidal behaviour. On a related but distinct note, for others who were insufficiently bound to social groups before the pandemic, being trapped in a prolonged lockdown may leave them without a sense of anchor and engender feelings of apathy, melancholy and depression, and trigger egoistic suicide (Durkheim, 1897).

Finally, excessive societal regulations such as curfew and lockdown may breed a sense of pessimism about the future and precipitate fatalistic suicide (Durkheim, 1897). Recent reports on surge in prison suicides have attributed the phenomenon to an overly restrictive regime, aimed at controlling the spread of the novel coronavirus infection, that threw inmates into despair (Grierson, 2020).

The case of quarantine suicides is probably a combination of the above factors. Quarantined individuals facing economic adversity, social stigma, discrimination, an uncertain future and stringent regulations that may trigger fatalistic ideas may altruistically consider suicide as an option in order to save their loved ones from infection.

To sum up, COVID-19 and suicidal behaviour are probably linked by various complex, interacting pathways. We advocate a biopsychosocial approach, incorporating sociological perspectives, to understand suicidal behaviour in the context of the pandemic.