By some measures, Japan has managed the covid-19 pandemic relatively well. Compared with other major countries, Japan has seen fewer infections, hospitalizations and deaths. But the country is facing another serious public health crisis — an alarming rise in suicide deaths, whose number now far exceeds the direct toll of the pandemic. In October alone, more people died by suicide (2,158) than the nation’s total of coronavirus deaths registered by the end of the month (1,765). The numbers reversed a recent trend that had seen Japan’s suicide rate fall to a 40-year low in 2019.
During the initial phase of the pandemic, Japan experienced a decline in suicide deaths. In April and May, when a national state of emergency was in place, the number of suicides in Japan was approximately 20 percent lower than the same period over the past three years. However, the declining trend reversed direction in July, when the first wave of the pandemic had been brought under control and many in Japan had returned to a somewhat “normal” routine. By October, the total number of suicide deaths was 30 percent higher than the 2017 to 2019 average.
While this sharp increase in suicides is worth noting on its own, even more remarkable is that the profile of those taking their own lives has changed. The main source of the increase was suicides among women; the number of women killing themselves was approximately 70 percent higher this October compared with the three preceding Octobers. In particular, the largest increase in suicides was found among relatively young women, those less than 40 years old. In addition to these trends among women, students took their own lives at a notably higher rate in August and September than in past years.
The potential causes of this change in suicidal behavior are diverse, and we must be wary of oversimplification, but among the likely factors are the economic consequences of the pandemic and school closures. The economic impact of the pandemic in Japan was particularly felt in sectors where many women work, such as the service, retail and travel industries. In addition, employers were more likely to fire or reduce the hours of nonpermanent workers — precarious positions that women are more likely to hold.
Additional evidence comes from monthly online surveys of the Japanese population that my research team has been conducting since April. We found that young female workers were more likely than any other group to have experienced a job or income loss in recent months. We also found that more than 30 percent of young women could be classified as depressed in October.
Schools in Japan closed in early March, and elementary to high school students had to stay at home for almost three months. Most universities in Japan switched to online teaching when the new academic year started in April, and largely stayed online during the fall semester. About 30 percent of the adult students in our surveys were classified as depressed, equivalent to the prevalence of depression symptoms among those who had lost their jobs. Suicides by young women significantly increased after the end of school closures; it is possible that the increased burden at home during the school closure negatively affected some individuals.
The situation in Japan may shed light on suicide trends in other countries. Based on our observations, we might expect a temporary decline in the number of suicides during the peak of the pandemic to be followed by a surge during the “recovery” period, when infection risk becomes less important and individuals focus on other daily concerns, such as making a living or taking care of family.
Notably, the sudden increase in suicides at the end of Japan’s state of emergency came despite the fact that the Japanese government did not introduce strict lockdown measures or movement restrictions. Thus, the impact of the pandemic on suicide risk in countries with more rigid restrictions could be larger.
Containment of the coronavirus must be the first priority, but we should also keep in mind that the causalities of the pandemic might include individuals who take their lives in the face of increased economic and psychological stress. Policymakers should pursue policies that might reduce these concerns.
The Japanese government should offer targeted financial assistance to those in need, including struggling single parents, in a more aggressive manner. At the same time, they should make it easier for contingent workers who have lost their job to find a new position by assisting them to learn new skills. The government should also identify the impact of school closures on schoolchildren, university students and their caregivers, and provide proper care to prevent tragic deaths by suicide.
We will defeat the current pandemic at some point, but its economic and social ramifications will stay with us for much longer. Japan’s experience suggests that economic assistance for those severely affected, continuous monitoring of mental health and appropriate suicide prevention efforts are necessary during, and in the aftermath of, the covid-19 pandemic.
Michiko Ueda, a professor at Tokyo’s Waseda University, studies suicidology and suicide prevention.