ArticleThe Psychiatric quarterly2026
Associations Between COVID-19 Business and Social Gathering Restrictions and Deaths by Suicide in the United States: A Cross-Sectional County-Level Analysis.
Article in The Psychiatric quarterly, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objectives Previous studies have reported inconsistent findings regarding the relationship between COVID-19 restrictions and suicide rates, particularly concerning business and social restriction policies. This study aimed to address this gap by analyzing detailed US county-level restriction and suicide death data. Study Design Data from the US Centers for Disease Control and Prevention (CDC) were obtained for county-level suicide rates by race, sex, and age from 2016 to 2023. Yale School of Management-Tobin Center State and Local COVID Restriction Database provided data on COVID-19 social and business restrictions. These datasets were combined with other relevant data on county-level demographics, gross domestic product (GDP), unemployment, and population density. Methods Poisson interrupted time-series regression was employed to assess whether these restrictions were associated with changes in suicide rates during pandemic (2020 and 2021) and post-pandemic (2022 and 2023) periods. Results During the pandemic restriction era of 2020–2021, stricter business capacity limits were linked to lower suicide rates overall (Poisson coefficient: -0.90 [95% CI -1.54, -0.25, p = 0.006]), and in particular among males (Poisson coefficient: -1.13 [-1.94, -0.32, p = 0.006]). The estimated coefficient was not statistically significant for females. Among age groups, individuals aged 25–34 and 35–44 experienced lower suicide rates in counties with tighter restrictions, while other age and sex groups did not show similar trends. Additionally, no statistically significant correlations were found across racial groups. In contrast, social gathering restrictions had a less consistent relationship with suicide rates; while those aged 15–24 experienced an increase in rates under tighter restrictions, those aged 25–34 had a decrease. No other demographic groups yielded statistically significant coefficient estimates. Conclusions Results underscore the importance of considering differential effects of business and social restrictions on suicide rates, and to tailor interventions to address the unique needs of specific populations during public health crises.
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