Background: The coronavirus disease (COVID-19) pandemic is an unprecedented public health crisis, but its effect on suicide deaths is little understood. Method: We analysed data from monthly suicide statistics between January 2017 and September 2020 and from online surveys on mental health filled out by the general population during the COVID-19 pandemic in Japan. Outcomes: Compared to the last three years (2017-2019), the number of suicide deaths was lower than average during the initial phase of the pandemic but, starting in July 2020, exceeded the past trend. The source of the increase was mainly female suicides, whose numbers increased by more than 20% in August and September 2020. Suicides by young women (less than 40 years of age) experienced a 63.1% increase in August 2020 compared to the same month in the past three years. The number of suicides among students was also notably higher in August and September 2020 than the corresponding numbers of past years. Our survey data indicated the status of mental health among young women was worse than that of women above 40 years and also that young female workers were more likely than any other group to have experienced a job or income loss in recent months, suggesting adverse economic conditions surrounding some of these individuals. Interpretation: Our results strongly indicate that continuous monitoring of mental health, particularly that of the most vulnerable populations identified in this study, and appropriate suicide prevention efforts are necessary during, and in the aftermath of, the COVID-19 pandemic.
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