COVID-19 suicidal behavior among couples and suicide pacts: Case study evidence from press reports.

Introduction

The novel coronavirus-19 (COVID-19) disease is not a typical physical illness. It has caused economic, social, and mental crises in a very short period of time (Usman et al., 2020). It has swept across countries and can affect anybody young or old, abled or disabled (Mamun & Griffiths, 2020a). It has spread internationally and has affected all aspects of human life. The World Health Organization declared the virus outbreak as a pandemic in March 2020, and at the time of writing (May 6, 2020) there were over 3,588,000 confirmed cases and over 247,500 deaths reported globally (World Health Organization, 2020). However, many personal aspects have been affected by the pandemic (e.g., physical health, societal wellbeing, financial wellbeing, etc.), all which have a direct link to mental suffering among some individuals (Montemurro, 2020; Jahanshahi et al., 2020; Sakib et al., 2020). The most extreme consequence of mental instability can result in suicidal thoughts, suicide attempts, and actual suicide (Jahan et al., 2020; Mamun & Griffiths, 2020b). Like previous pandemics (e.g., 2002 SARS [severe acute respiratory syndrome; Cheung et al., 2008]), the present COVID-19 pandemic appears to be leading to higher suicidality.

There are many reasons for COVID-19-related suicides including the fear of getting the disease, the fear of passing the disease onto others, mental instability (e.g., depression, anxiety and/or stress) as a consequence of quarantine, isolation, economic hardship, and the unavailability of food and alcohol based on published reports (Dsouza et al., 2020; Goyal et al., 2020; Mamun & Griffiths, 2020a; Mamun & Ullah, 2020; Thakur & Jain, 2020). However, another worrying type of suicide cases concerns couples dying together that are related to COVID-19, the majority of which concern suicide pacts by couples. Here, we present six cases in chronological order of couple suicides and attempted suicides relating to COVID-19 comprising 12 individuals from four countries (i.e., Bangladesh, India, Malaysia, and the US).

Case 1 (April 2, 2020;Source – BBC, 6 April 2020): An American couple from Lockport, Illinois – Patrick Jesernik (aged 54 years) and partner Cheryl Schriefer (aged 59) – were involved in a COVID-19-related murder-suicide by gunshot. Mr. Jesernik shot his partner (who had been suffering from severe breathing problems) before killing himself. He was scared that he had been infected with COVID-19 from his girlfriend. Both had been tested for COVID-19 but it appears neither had received their results before their deaths. The autopsies showed that neither was infected with COVID-19 (Source: https://www.bbc.com/news/world-us-canada-52192842).

Case 2 (April 2, 2020:Source – Hindustan Times, 6 April 2020): An Indian elderly couple from Amritsar, India – Balwinder Singh (aged 65) and his wife Gurinder Kaur (age not reported) – committed suicide by consuming a poisonous substance together. Their suicide note said there was tension because of COVID-19. Their suicide note simply said: “We are finishing our lives. No one is responsible for this. There has been a tension due to coronavirus. We both were also ill”. The police reported they were not actually infected with COVID-19 (Source: https://www.hindustantimes.com/cities/covid-fear-elderly-couple-ends-life-in-amritsar/story-6jdldsvs4NIlvpPRo71HbJ.html).

Case 3 (April 4, 2020:Source – New Indian Express, 5 April 2020): At Tiruchy International Airport, India, a Malaysian couple – Subramaniam (aged 65) and his wife Lalitha (aged 55) – both attempted suicide together by swallowing sleeping pills because they were not provided seats on a special COVID-19 rescue flight back to their home country of Malaysia. They were told by airport officials that their names were not listed on the flight and were dismayed by the responses from embassy officials and attempted to take their own lives. The suicide attempt was prevented by the police (Source: https://www.newindianexpress.com/states/tamil-nadu/2020/apr/05/no-seats-in-special-rescue-flight-malaysian-couple-attempts-suicide-2125937.html).

Case 4 (April 16, 2020:Source – Telegraph India, 17 April 2020): A young newlywed couple from Uttarakhand, India – Ashok Kumar (aged 24) and his wife Rajju Devi (age nor reported) – both committed suicide together by hanging themselves from a tree. Mr. Kumar was quarantined (after returning from Punjab) at a school that had been turned into an isolation center near his village. Although he had no COVID-19 symptoms, he was prevented from going home and his wife was being pressured and harassed by neighbors to leave the village because they all thought Mr. Kumar had COVID-19. The wife visited her husband at the quarantine center and both felt the situation was hopeless so committed suicide together in a forest nearby the center (Source: https://www.telegraphindia.com/india/hounded-over-coronavirus-couple-kill-themselves/cid/1765526)

Case 5 (April 24, 2020:Source – Manab Zamin, 24 April 2020): A poverty-stricken young couple from Bangladesh –Shamim (aged 30) and wife Renoka Begum (aged 24) – committed suicide together by hanging themselves in their house. They had a three-year old child and they were fighting poverty exacerbated by the economic crisis caused by the COVID-19 lockdown (Source: https://mzamin.com/article.php?mzamin=223588).

Case 6 (March 4, 2020:Source – Deccan Herald, 4 May 2020): A man from Bihar, India – Ramesh Shah (aged 35) – committed suicide by hanging himself after his wife (Suman, age not reported) committed suicide by setting herself on fire. The couple were unable to pay back a loan on a truck they had bought because they were unable to work during the COVID-19 lockdown. After an argument concerning their finances, Suman deliberately set herself on fire. The husband tried to save his wife but she died at hospital. The husband was so distraught that he then killed himself. The couple left behind two young children (aged 7 and 10) (Source: https://www.deccanherald.com/national/east-and-northeast/coronavirus-lockdown-30-unable-to-repay-loan-couple-commits-suicide-in-bihar-833285.html).

Discussion

COVID-19 pandemic-related issues such as economic recession and movement restriction (i.e., isolation, quarantine, etc.) have led to psychological suffering including anger, annoyance, fear, frustration, guilt, helplessness, loneliness, nervousness, sadness, and worry (Ahorsu et al., 2020; Pakpour & Griffiths, 2020; Sakib et al., 2020). For a small minority, this becomes so unbearable that suicide becomes the only option. The reasons for COVID-19-related suicides are multi-faceted and include the fear of infection, money problems as a result of the financial and economic recession associated with national lockdowns, being harassed or victimized by others because individuals have (or are thought to have) COVID-19, and the stress of being in isolation or quarantine (Bhuiyan et al., 2020; Dsouza et al., 2020; Goyal et al., 2020; Mamun & Griffiths, 2020a; Mamun & Ullah, 2020; Thakur & Jain, 2020). All of these factors were also apparent in these cases of the couple suicides documented here, although in one case the attempted suicide pact was because the couple were unable to get back to their home country on a COVID-19-related rescue flight.

Couples who commit suicide together are generally referred to as suicide pacts if they commit suicide at the same given time and place (Pridmore & Reddy, 2010). However, there are other types of suicide pacts including two or more people who commit suicide together on the internet because they do not want to die alone (Ozawa-de Silva, 2008). Previous findings indicate that the majority of suicide pact victims are married, socially isolated, with a serious physical illness in one or both partners (Part et al., 2013). Research has also indicated the most common reasons for couples committing suicide together (particularly in Western countries) include health problems, external pre-marriage relationship complexities, social isolation, being unable to have children, psychological disorders, and financial difficulty. In Eastern countries, one of the most common reasons for suicide pacts among couples is among young couples whose parents refuse to let the couple get married (Milin & Turgay, 1990; Part et al., 2013; Pridmore & Reddy, 2010).

Conclusions

Globally, the psychological impact of the COVID-19 pandemic is of concern. While existing health facilities are prioritizing the medical treatment of individuals with COVID-19, the resources to treat the subsequent and related psychological effects are arguably insufficient. While the consequences of the physical infection can be seen, the psychological effects are often not seen until it is too late. Given the fact there is no vaccine for treating COVID-19, no-one can be sure when the pandemic will end. This in itself can be a psychological stressor that may lead to more COVID-19-related suicides and suicide pacts. Relevant public mental health strategies are therefore needed (see Mamun & Griffiths, 2020a) and should be adopted as soon as possible to minimize further suicides.

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Declaration of Competing Interest

The authors of the paper do not have any conflict of interest. The authors involved in this research communication do not have any financial and personal relationships with other people or organizations that could inappropriately influence (bias) their work.