Suicide and self-harm: Bereaved families count the costs of lockdowns

Sunny, driven and with a new engineering master’s degree in hand, Joshua Morgan was hopeful he could find a job despite the pandemic, move out of his mother’s house and begin his life.

But as lockdowns in Britain dragged on and no job emerged, the young man grew cynical and self-conscious, his sister Yasmin said. Morgan felt he could not get a public-facing job, like working at a grocery store, because his mother, Joanna, had open-heart surgery last year, and Morgan was “exceptionally careful” about her health.

He and his mother contracted the coronavirus in January, forcing them to quarantine in their small London apartment for over two weeks. Concerned by things he was saying, friends raised the alarm and referred him to mental health services.

But days before the end of his quarantine last month, Morgan, 25, took his own life.

“He just sounded so deflated,” his sister said of their last conversation, adding that he said he felt imprisoned and longed to go outside.

Suicides are challenging to link to specific reasons, but Morgan’s sudden death has left his sister with a feeling that is hard to shake.

“The cost of the pandemic was my brother’s life,” she said. “It’s not just people dying in a hospital — it’s people dying inside.”

More than 2.7 million people have died from the coronavirus — and at least 126,000 in Britain alone. Those numbers are a tangible count of the pandemic’s cost. But as more people are vaccinated, and communities open up, there is a tally that experts say is harder to track: the psychological toll of months of isolation and global suffering, which for some has proved fatal.

There are some signs indicating a widespread mental health crisis. Japan saw a spike in suicide among women last year, and in Europe mental health experts have reported a rise in the number of young people expressing suicidal thoughts. In the United States, many emergency rooms have faced surges in admissions of young children and teenagers with mental health issues.

Mental health experts say prolonged symptoms of depression and anxiety may prompt risky behaviours that lead to self-harm, accidents or even death, especially among young people.

Some intellectuals, like Israeli historian Yuval Noah Harari, have asked authorities to weigh the risks of depression if they impose new virus restrictions. And public health officials in some areas that have seen a surge of adolescent suicides have pushed for schools to reopen, although researchers say it is too early to conclusively link restrictions to suicide rates.

In Europe, with the crippled economy and the aftermath of the restrictions, the psychological fallout of the pandemic could unfold for months, or even years, public health officials say, with young people among the most affected.

But bereaved families of young people who have died during the pandemic are haunted by questions over whether lockdowns — which not only shut stores and restaurants but also required people to stay home for months — played a role. They are calling for more resources for mental health and suicide prevention.

“Mental health has become a buzzword during the pandemic, and we need to keep it that way,” said Annie Arkwright, whose 19-year-old daughter, Lily, died by suicide in western England in October. “So many of us have never been taught the skills to help ourselves or help others.”

While people may have felt a sense of togetherness during the first lockdowns, that feeling began to wear thin for some as it became clear that restrictions were hitting disadvantaged groups, including many young people, harder.

“If you are a young person, you are looking for hope,” said Dr Rory O’Connor, a professor of psychiatry at the University of Glasgow who specialises in the study of suicide. “But the job market is going to be constrained, and opportunities to build your life are going to be slimmer.”

As winter approached, mental health experts began to see more teenagers in emergency rooms and psychiatry wards and warned of a rise in drug use, gambling or self-harm. A June CDC survey found that younger adults, along with ethnic minorities and essential workers, experienced increased substance use and suicidal ideation.

“Imagine a young person in a small room, who takes their course online and has limited social life due to restrictions,” said Fabrice Jollant, a professor of psychiatry at the University of Paris. “They may be tempted to consume more drugs or drink more alcohol, and may have less physical activity, all of which can contribute to symptoms of depression, anxiety and poor sleep.”

For Pepijn Remmers, such temptations had tragic consequences.

Pepijn, 14, greeted lockdown restrictions last spring with positive energy. An adventurous and sociable teenager, he picked up piano playing and would slip under the fence of the local soccer pitch on the outskirts of Amsterdam in the afternoons to play with his best friend, Thijs.

But as the pandemic dragged on, Pepijn struggled to focus and online classes became too “booooring,” he told his parents. New restrictions in the fall stopped the soccer.

He began to take drugs in October, according to his father, Gaston Remmers, and his exercising routine waned in December. As his sleep patterns began to change, his parents took him to a therapist.

“We would ask him if he was depressed, and he would say, ‘Depressed? I don’t know what depressed is, I don’t think I am. I feel bored, but I don’t feel depressed,’” Remmers said.

Then one cold January night, Pepijn left the house. He was found the following day in a tent, where he had taken drugs and lit a barbecue to keep himself warm. Remmers said his son’s death was caused by a combination of carbon monoxide poisoning and drugs.

“With the pandemic, the things that spiced his life, that made it worth going to school, were gone,” he added.

As Pepijn’s death made headlines in the Netherlands, a lawmaker asked if lockdown had killed him. It’s not as simple as that, Remmers said.

But the pandemic, he added, “provided a context in which things become possible, and which may have otherwise not happened.”

After a series of lockdowns in Britain last year, one suicide hotline for young people, Papyrus, saw its calls increase by 25%, in line with an increase of about 20% each year.

It is unclear, the organisation says, whether this is a sign of more people experiencing more suicidal thoughts or symptoms of mental health issues, or if people now feel more comfortable reaching out for help.

Lily Arkwright confided in her friend and housemate Matty Bengtsson. A 19-year-old history student at Cardiff University, Lily was self-confident, outgoing and charismatic in public, her friends and family said, but as she went back to school in September, she began to struggle with the effects of lockdown.

She also became more withdrawn, Bengtsson said.

One evening in October, as Bengtsson and Arkwright were getting ready to see some friends, she grew upset and called her mother to say that she was coming home, Bengtsson said.

Arkwright took her own life there, a day after the birthday of her brother, one of her closest confidants.

“Lockdown put Lily in physical and emotional situations she would never have in normal times,” said Lily’s mother, Annie.

Annie Arkwright said she hoped that growing concerns about young people’s mental health during the pandemic would prompt more of them to share their struggles and seek help.

“It’s OK for a young child to fall over and let their parents know that their knee hurts,” Arkwright said. “This same attitude needs to be extended to mental health.”

But though stigma around discussing mental health has lessened, society, too, needs to normalise talking about suicide, said Ged Flynn, chief executive of Papyrus, adding that the more comfortable people were with the subject, “the less we need help lines like us.”

People should be praised for adapting and finding resilience during these difficult times, Flynn said.

“Even the need to reach out to a help-line shows resilience,” he said, adding that considering the circumstances, many people were doing “really well.”

For Morgan’s friends, the loss of a man they called confident and kind has given them a resolve.

“Josh always said: One day he’s going to make it,” said his friend Sandy Caulee, 25. “At least we will — for him.”

© 2021 The New York Times Company