Trends in Suicide Attempts in Israel during COVID-19: A National Representative Cohort Retrospective Study

Background: The pandemic outbreak that included quarantines and lockdown periods affected people's mental health negatively. The pandemic's impact on suicidal behavior is, however, unclear. The present study aimed to investigate whether the pattern of suicide attempts (SAs) in Israel changed during the pandemic, especially during the two lockdowns and immediately after them. The period three years prior to the pandemic was used as a control period for comparisons. Method: A retrospective cohort study was conducted. The cohort consisted of all Meuhedet members between January 1, 2017, and December 31, 2020. Data were retrieved from Meuhedet Health Maintenance Organization (Meuhedet) members daily suicide attempts (SA) register. Results: The SAs trend exponentially increasing over the years. Still, in 2020 the rate of SAs did not increase. No significant differences were found in SA rates from month to month during the pandemic. Neither were any significant differences found between any of the pandemic months and equivalent periods prior to, or following the Covid-19.However, two peaks were found in the rate of SAs in 2020: in July, the SA rate was 2.134 per 100,000 and in November it was 2.202, while the annual mean rate was 1.535 per 100,000. Both these peaks occurred during post-lockdown periods. Conclusion: During a prolonged crisis, the rate of SAs may vary over time. It may decline in the early stages but later increase due to cumulative stress. People living through continuous restrictions and stress may experience cumulative burnout.