Impact of the COVID-19 Pandemic on Suicide-Related Emergency Department Presentations: A Retrospective Cross-Sectional Study from a Turkish Tertiary Care Center
DOI:
https://doi.org/10.66288/actamedi.2026.97Keywords:
COVID-19, Suicide attempt, Emergency department, Mental healthAbstract
Background
The COVID-19 pandemic has profoundly affected mental health worldwide by increasing psychological distress, social isolation, unemployment, and barriers to healthcare access. These factors may have contributed to changes in suicidal behavior and emergency department (ED) utilization. This study aimed to evaluate the impact of the COVID-19 pandemic on suicide-related ED presentations in a tertiary care hospital in Türkiye.
Methods
This retrospective, cross-sectional study included adult patients (≥18 years) presenting to the emergency department with suicidal ideation or suicide attempts between March 11, 2019, and March 11, 2021. Eligible patients were identified using ICD-10 codes related to intentional self-harm. Demographic characteristics, employment status, marital status, suicide methods, psychiatric history, COVID-19 history, clinical outcomes, and healthcare costs were extracted from electronic medical records. Patients were divided into pre-pandemic (Group 1) and pandemic (Group 2) cohorts. Continuous and categorical variables were compared using appropriate statistical tests, with statistical significance defined as p < 0.05.
Results
A total of 750 patients were included, with a mean age of 32.27 ± 11.39 years. During the pandemic, suicide-related ED presentations increased from 0.125% to 0.264% of all ED visits despite a 39.4% reduction in overall emergency department admissions. The relative risk of suicide-related presentation during the pandemic was 2.11 (95% CI: 1.83–2.44; p < 0.001). The proportion of male patients increased significantly from 42.9% to 65.6% (p < 0.001), while unemployment and single marital status became more prevalent. Drug overdose remained the most common suicide method, although the use of more violent methods, including hanging and self-inflicted sharp object injuries, increased significantly (p = 0.017). Patients presenting during the pandemic were more frequently managed with short-term observation and less frequently required intensive care admission (p < 0.001). No significant differences were observed in seasonal presentation patterns.
Conclusions
The COVID-19 pandemic was associated with a marked increase in suicide-related emergency department presentations despite an overall decline in emergency department utilization. Significant changes in patient demographics, suicide methods, and clinical outcomes suggest that pandemic-related psychosocial stressors substantially influenced suicidal behavior. These findings emphasize the importance of maintaining accessible mental health services, implementing targeted suicide prevention strategies, and strengthening psychiatric support systems during future public health emergencies.
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Copyright (c) 2026 Ayşe Tekin, Cemil Kavalcı, Samiye Kocal, Beril Akkuş, Gülsüm Kavalcı, Fevzi Yılmaz, Cihan Bedel
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