The pandemic continues to take a toll on mental health. Sarah Carabott looks at the data and speaks to the experts.

The number of suicide attempts and deaths by suicide recorded by the police has increased among women during the pandemic, with experts believing the actual figures are even higher than those reported.

Police data show that between January and October, there were 47 attempts by women. This is already 50 per cent above the average of 32 for each year between 2016 and 2019.

The number of women who died by suicide over the last four years ranged between two and five each year. By the end of October 2020, that figure was already six.

Death by suicide is usually higher among men, with eight in every 10 victims between 2016 and 2019 being male. During the first 10 months of this year, the proportion has gone down to six in 10.

Extrapolating the data, there could be a total of 127 attempts and 20 deaths by suicide, among both men and women, by the end of 2020.

Psychiatrist Anton Grech, who chairs the Health Ministry’s Psychiatry Department, believes the numbers of attempted and completed suicides are too small to derive significant conclusions.

However, from his everyday clinical experience, he feels there is substantial under reporting of attempts.

Calls made to Richmond Foundation’s 1770 helpline have also shown an increase in thoughts about suicide and suicidal ideation during the pandemic.

So far this year there have been 92 suicide-related calls, of which only six came in before the first coronavirus case was recorded in Malta. In the whole of 2019, the helpline received only 25 calls related to suicide. 

The foundation’s CEO, Stephania Dimech Sant, said that towards the end of June they were getting at least one to two new suicidal callers a day, whereas before there used to be an average of one to two per month and sometimes fewer. She said one reason why official data may not mirror reality is that when deaths are not clearly by suicide, the incident may be registered as accidental.

UK research has shown that the impact of the pandemic on the mental well-being of women has been more significant than that on men.

“Prior to the pandemic, women had more social contacts than men, and subsequently reported more loneliness with the introduction of social distancing and lockdown.

“Another aspect is that women are generally more involved in care and family responsibility. Childcare has been another determining factor in the decline of women’s mental health,” she said.

These findings are mirrored in local research by the foundation: women in Malta have reported feeling more socially isolated than men and having more childcare responsibility. 

Women have also reported having more suicidal thoughts, and more often, than men.

Rise in anxiety and depression

Psychiatrist Anton Grech is “very concerned” about the psychiatric consequences of this pandemic.

Scientific studies are still underway, “but from our day-to-day experience it is very evident that this pandemic has caused an increase in psychiatric morbidity in the Maltese population.

“We are seeing an increase especially in anxiety disorders and depression. We are seeing this in people who never suffered from any psychiatric illness and also in those experiencing relapses after being well for many years.

“We are also seeing an increase in unhelpful ways to deal with anxiety and insomnia. This is mainly by excessive use of alcohol.

All these factors can cause an increase in ideas of helplessness with resultant suicidal ideation.

Among the most important factors are uncertainty and the drastic decline in social interaction, he says.

However, although it is impossible to prevent all episodes of depression and anxiety, they can be significantly reduced.

“Within the present circumstances, as a society we need to ensure that nobody feels isolated. We need to reach out to others and maintain social cohesion as much as possible. We need to have a life ‘beyond COVID’, and it is mentally healthy to limit the time people spend following news about COVID,” Grech said.

Depression and anxiety are highly treatable conditions. The earlier treatment is started, the greater the chance of success. It is very important that people seek help whenever they start to feel much more anxious than usual or feel overwhelmed, Grech said.

Help for the festive season

The best way to help a loved one is by acknowledging that they are suffering from a condition and that their behaviour, which is different from the norm, is not capricious, Grech says.

“Relatives and friends can be very helpful by supporting them in getting treatment, because one of the main hurdles for a person suffering from depression is accepting that there is help.

“If, in this festive season – which is going to be very different from usual – we all reach out to people who are withdrawing from others and feeling overwhelmed, we can prevent a lot of mental suffering.”

Dimech Sant notes that people going through a depressive episode may, among others, appear more pessimistic than usual or hopeless about the future. They may talk about feeling guilty, empty or worthless, seem less interested in spending time with others, are unusually irritable, neglect basic hygiene, seem forgetful, have trouble concentrating or making decisions, and talk about death or suicide.

If you want to help them, listen actively with a non-judgemental attitude and ask how they would like to be supported. Encourage them to reach out for professional support.

You should also learn about depression and establish boundaries to ensure your own mental wellbeing, she says.

If you have any questions about mental well-being, you can go on www.richmond.org.mt to chat with a professional or call on 1770.