With millions of Americans restricted to their homes and many losing their jobs due to the coronavirus pandemic, a spike in suicides may follow, experts fear.

At a time when suicide in America has been increasing, many of the effects of social distancing are known suicide risk factors, Mark Reger, chief of psychology services at VA Puget Sound healthcare System in Seattle, said in a viewpoint published online April 10 in the journal JAMA Psychiatry.

"Social distancing may increase economic stress, social isolation and loneliness for some people," he said.

On top of that, community and religious support may be more difficult to find, and anxiety and fear may affect people who already faced mental health or substance use challenges before the crisis, Reger said. 

"All of these possibilities are concerning from a suicide prevention perspective, especially among those who were already at high risk before the crisis, like those with a recent suicide attempt," he said. 

By highlighting the potential suicide risk linked to the coronavirus, Reger hopes to alert communities and healthcare facilities around the country to the heightened need for suicide prevention. 

Suicide is preventable, he said. "A rise in suicide rates is not inevitable. There is an opportunity to apply what we already know about suicide prevention to mitigate any new risk our communities may face," Reger added.

Social distancing requires physical distance, not social distance, so people can feel less isolated by keeping in touch with friends and family, Reger said. 

"Telephone and video connections should be used to keep people connected to friends, loved ones and even mental health clinicians," he said. "Also, telephone outreach programs or simply mailing caring letters to individuals at risk have reduced suicide rates in prior research studies." 

The coronavirus pandemic has led to unprecedented public health challenges, Reger said. 

"Public health strategies designed to minimize the spread of COVID-19 should occur alongside public health efforts to minimize adverse effects of the pandemic on mental health, including suicide," he said.

Jonathan Singer, president of the American Association of Suicidology, agrees that social isolation and economic pressures brought on by the pandemic could result in more suicides. 

Suicides, along with increases in domestic violence, child abuse and substance abuse, are all part of the package that being shut in may cause, he said. 

"There can be trauma where people are being physically abusive or emotionally abusive," Singer said. "It could also just be what we think of as non-physical trauma, which is where there's more arguing and fighting, and harsh and critical parenting and more conflict between siblings, so just more of a tense situation, which could increase suicide risk among youth." 

But family can also be supportive and a positive force in preventing the fear and anxiety that might increase the risk for suicide, he said. 

"Folks should use the support that is available, like the suicide prevention hotline," Singer said. "These are services that haven't changed, and the folks on those lines are trained to provide services." 

The number for the National Suicide Prevention Lifeline is 1-800-273-TALK (8255).

Other things you can do for loved ones is reach out, he said. "Go through your [contact list] and pick some folks to reach out to — send a text or call to say, 'Hey, do you want to eat lunch over the phone.'" 

Singer said that helping others is a way to relieve the feeling of being isolated. 

"There are things that you can do at home for other people. And one of the things that we know is that doing things for others can be very beneficial in getting a sense of purpose, and feeling you have some control of your life," Singer said. "It can be rewarding to say, 'I made a difference for somebody.'"