Newer Determinants of an Old Problem: Factors for Suicidal Behaviour in the Current Era

BACKGROUND: The national record crime bureau of India reported more than 1.53 lakh suicide in 2020, which is the highest in the last decade. Suicide can be considered a public health problem. Suicide risk assessment is complex, having contributions from biopsychosocial and environmental influences. We aim to discuss the role of COVID Pandemic, behavioural addictions and climate change in suicidality. FINDINGS: COVID has brought grief, physical disability, loss of employment and financial constraints, loneliness, and scarcity of healthcare resources. Isolation and pandemic related anxiety can lead to self-harm ideation in certain vulnerable populations like elderly, homeless, dependent and those having chronic physical and mental illnesses. Additionally, there is a high probability of neuropsychiatric symptoms in individuals with post-COVID syndrome with an increase in suicidal behaviour. Behavioural addictions like gambling disorder, gaming disorder and sexual addictions have a high association with suicidality. Premorbid impulsivity, male gender, unemployment, comorbidities and poor support have been demonstrated to have a higher association in people with a behavioural addiction and suicidality. Increased suicide risk along with other neuropsychiatric complications has been reported due to poor air quality, increased temperature & rainfall changes. Natural disasters like hurricanes or earthquakes are known to have both acute and long term impacts on mental health & suicidality with higher impact on environmentally motivated migrants and displaced populations. CONCLUSION: There is a convincing association of these three conditions in increasing suicide risk, making these an issue of global concern. Robust scientific evidence should be generated for the same which can then guide clinicians & policymakers to act decisively on the issue.