Alcohol, suicide and COVID-19 in Victoria

What's the issue?

The COVID-19 pandemic impacted individuals and communities in Australia in numerous ways including health and wellbeing. Data shows that patterns of alcohol consumption changed significantly during the pandemic.1

Research has shown a link between lockdown periods and restrictions during the COVID -19 pandemic and an increase in alcohol consumption, and mental health concerns.4,5

In addition, research has shown that there is a relationship between harmful alcohol use and mental health conditions, and other risk behaviours including suicide attempts and self-harm.6

Ambulance call-outs for alcohol-related incidences increased during the pandemic. However, we don’t know if ambulance call-outs were higher for people experiencing an alcohol-related concern linked to mental health concerns, self-harm or suicide.7

What was done?

Researchers examined data capturing ambulance attendances for alcohol intoxication following the pandemic to:

  1. Determine the impact of COVID-19 restrictions on alcohol-related ambulance attendances involving mental health, suicide or self-harm by metropolitan or regional location in Victoria, Australia.
  2. To understand the burden, repeat ambulance attenders put on emergency services and to assess whether there is a pattern of difference in characteristics or outcomes between repeat attenders and those who only use an ambulance once.

Researchers examined data collected between March 2018 and February 2022 for ambulance patients aged 15 years and older. Patients with missing age or sex records were excluded from the analysis.

Data was taken from the National Ambulance Surveillance System (NASS). NASS is an ongoing Australian surveillance system that receives a filtered dataset of clinical records where alcohol, another drug, mental health or self-harm/suicide behaviours are recorded.

What was found?

Data analysis showed there were 32,053 attendances for alcohol-related intoxication in Victoria between March 2018 and February 2022. The researchers found that ambulance attendances related to alcohol intoxication decreased during the COVID-19 lockdowns (from March 2020 to February 2022).

Despite fewer overall ambulance attendances for alcohol intoxication, there was a 37% increase in the number of attendances, which involved both alcohol intoxication and mental health concerns.

The analysis showed that during the pandemic:

  • Ambulance attendances related to alcohol intoxication involving mental health and/or suicide or self-harm concerns increased in both metropolitan and regional areas.
  • There was an increase in suicidal thoughts for alcohol-related ambulance attendances.
  • There was an increase in suicidal behaviours for alcohol-related ambulance attendances, especially in regional Victoria.
  • Higher numbers of alcohol-related attendances were recorded in metropolitan areas, and almost two-thirds of these attendances were for men.
  • In the majority of cases in both metropolitan and regional areas, patients were transported to hospital (79.2%–82.2%), and police co-attended between 31% and 39% of attendances.
  • Repeat ambulance attendances for alcohol intoxication were more common during lockdown periods. Repeat attendances were most common in the 45–54-year age category and had higher rates of transport to hospital.

NOTE: This data only captures alcohol-related harm requiring an ambulance. It is likely that rates of alcohol-related harm were higher across a population level in Victoria during the pandemic however data was not captured for incidences not requiring an ambulance.

Why are the findings important?

Although ambulance attendances for alcohol intoxication decreased, ambulance attendances for alcohol intoxication coupled with mental health concerns, self-harm, and suicidal thoughts and behaviours increased. People experiencing alcohol-related harm and or mental health concerns, self-harm, and suicidal thoughts and behaviours may have accessed ambulance services more frequently due to pandemic-related closures of other support services.

The findings suggest an opportunity for population-based health messages that promote online help services during adverse events to help counteract harmful alcohol use and distress. These messages could target both the negative health impacts of alcohol and mental health concerns. Promotion of accessible health and support services targeted to vulnerable groups may further minimise harm.

Notes

1

Callinan S, Mojica-Perez Y, Wright C, Livingston M, Kuntsche S, Laslett A, Room R, Kuntsche E. Purchasing, consumption, demographic and socioeconomic variables associated with shifts in alcohol consumption during the COVID-19 pandemic. Drug Alcohol Rev 2021;40, 183–191.

2

Acuff S, Strickland J, Tucker J, Murphy J, Changes in alcohol use during COVID-19 and associations with contextual and individual difference variables: a systematic review and meta-analysis. Psychol Addict Behav 2022;36, 1–19.

3

De Goeij M, Suhrcke M, Toffolutti V, Van De Mheen D, Schoenmakers T, Kunst A. How economic crises affect alcohol consumption and alcohol- related health problems: a realist systematic review. Soc Sci Med 2015; 131, 131–146.

4

Avery A, Tsang S, Seto E, Duncan G. Stress, anxiety, and change in alcohol use during the COVID-19 pandemic: findings among adult twin pairs. Front Psychiatry 2022; 11, 571084.

5

McBride O, Bunting E, Harkin O, Butter S, Shevlin M, Murphy J, Mason L, Hartman T, McKay R, Hyland P, Levita L, Bennett K, Stocks T, Gibson-Miller J, Martinez A, Valli`eres F, Bentall R. Testing both affordability-availability and psychological-coping mechanisms underlying changes in alcohol use during the COVID-19 pandemic. PLoS ONE 2022;17, e0265145.

6

Amiri S, Behnezhad S, Alcohol use and risk of suicide: a systematic review and meta-analysis. J Addict Dis. 2020;38, 200–213.

7

Scott J, Pakpahan E, Marlow B, Daxner N. Defining a threshold above which an adult can be considered to frequently use ambulance services: a retrospective cross-sectional study of emergency calls to an ambulance service in England. Br. Paramedic J 2023; 7, 35–45.

Study information

Authors

  • Rowan P Ogeil
  • Michael McGrath
  • Jasmin Grigg
  • Annette Peart
  • Jonathan I Meddings
  • Christopher J Greenwood
  • Ziad Nehme
  • Dan I Lubman

Study originally published

3 November 2024

Read the full paper

Translated on Life in Mind

11 December 2024

Citation

Ogeil RP, McGrath M, Grigg J, Peart A, Meddings JI, Greenwood CJ, Nehme Z, Lubman DI. Diverging trends in alcohol-related harms: The role of comorbid mental health, suicide and self-harm behaviors in ambulance attendances for alcohol intoxication during the COVID-19 pandemic in Victoria, Australia. J Affect Disord. 2024 Nov 5; 371:170-176. doi: 10.1016/j.jad.2024.11.012.