Two months after the World Health Organization (WHO) declared COVID-19 a pandemic, Colombia has reported over 10,000 confirmed cases of the disease and 400 deaths. On March 25, 2020, a stay-at-home (SAH) order was issued country-wide to prevent the spread of the virus. After that, media channels reported the suicide of a middle-aged man in Santa Marta, a city located on the Caribbean coast. At least three times, authorities had scold him for violating the SAH order, and he claimed at court that, for working as a street vendor, he would not be able to feed his family if forced to stay at home. According to the media, his arrest might play a role in his suicide ¹1. Urieles R. Hallan cuerpo sin vida de vendedor tras sanción por violar cuarentena. El Tiempo 2020; 17 apr. https://www.eltiempo.com/colombia/otras-ciudades/vendedor-en-santa-marta-sancionado-por-violar-cuarentena-fue-hallado-muerto-485896.
https://www.eltiempo.com/colombia/otras-... .

However, this is not an isolated case. Similar events have been reported worldwide: Bangladesh ²2. Mamun MA, Griffiths MD. First COVID-19 suicide case in Bangladesh due to fear of COVID-19 and xenophobia: possible suicide prevention strategies. Asian J Psychiatr 2020; 51:102073. and India ³3. Goyal K, Chauhan P, Chhikara K, Gupta P, Singh MP. Fear of COVID 2019: first suicidal case in India! Asian J Psychiatr 2020; 49:101989. have likewise reported cases of suicide related to COVID-19 in which xenophobia, stigma, and fear of contagion may have contributed.

Nunes recently stated that individuals’ vulnerabilities imposed by their social context determine how they experience this global pandemic ⁴4. Nunes J. The COVID-19 pandemic: securitization, neoliberal crisis, and global vulnerabilization. Cad Saúde Pública 2020; 36:e00063120.. This is particularly important considering that socio-economic determinants pose risk factors for suicide, reaching beyond person-centered preventive efforts. In fact, economic difficulties and unemployment are major “suicidal drivers” among the Colombian population ⁵5. Arenas A, Gómez-Restrepo C, Rondón M. Factores asociados a la conducta suicida en Colombia. Resultados de la Encuesta Nacional de Salud Mental 2015. Rev Colomb Psiquiatr 2016; 45 Suppl 1:68-75.^,66. García-Valencia J, Palacio-Acosta C, Diago J, Zapata C, López G, Ortiz J, et al. Eventos vitales adversos y suicidio: un estudio de autopsia psicológica en Medellín, Colombia. Rev Colomb Psiquiatr 2008; 37:11-28., and economic inequality is intrinsically associated with the country’s suicide rates ⁷7. Campo-Arias A, Herazo E. Asociación entre desigualdad y tasa de suicidio en Colombia (1994-2013). Rev Colomb Psiquiatr 2015; 44:28-32.. Considering the impact of this pandemic in the global economy and that economic downturns and infectious outbreaks seem to increase suicide rates ⁸8. Oyesanya M, Lopez-Morinigo J, Dutta R. Systematic review of suicide in economic recession. World J Psychiatry 2015; 5:243.^,99. Cheung YT, Chau PH, Yip PSF. A revisit on older adults suicides and severe acute respiratory syndrome (SARS) epidemic in Hong Kong. Int J Geriatr Psychiatry 2008; 23:1231-8., we could be facing a potential “perfect storm” ¹⁰10. Reger MA, Stanley IH, Joiner TE. Suicide mortality and coronavirus disease 2019: a perfect storm? JAMA Psychiatry 2020; [Online ahead of print]..

Crisis situations, as COVID-19 outbreak, highlight the longstanding social inequalities in our continent. Thus, when implementing strategies to minimize SAH adverse effects, governments should consider self-isolation impact on populations’ mental health ¹¹11. Gonzalez Diaz J, Lozano-Lesmes L, Campo-Arias A. Comment on "Mental health: why it still matters in the midst of a pandemic". Braz J Psychiatry 2020; [Online ahead of print].. Yet more concerning is the fact that 79% of Colombian households depending on informal jobs are considered ineligible for the wage subsidies provided by the government’s relief measures during the current COVID-19 lockdown ¹²12. Jaramillo ID, Londoño D, Rodríguez P, Garzía-Suaza A. La vulnerabilidad del mercado laboral colombiano al COVID-19. https://www.labourosario.com/post/la-vulnerabilidad-del-mercado-laboral-colombiano-al-covid19 (accessed on 22/Apr/2020).
https://www.labourosario.com/post/la-vul... .

Government’s priority during the current pandemic must be to implement an integrative approach for mitigating adverse mental health outcomes and providing accessible mental health services. Suicide prevention should be at the forefront of these preventive efforts. In this regard, we suggest strengthening public health surveillance for mental health focusing on vulnerable groups, educating our communities in psychological first aid, limiting mental health professionals redeployment, creating and maintaining hotlines for suicidal crisis, and resorting the roles that primary healthcare and social leaders play in our communities ¹³13. Ransing R, Adiukwu F, Pereira-Sanchez V, Ramalho R, Orsolini L, Schuh Teixeira AL, et al. Early career psychiatrists' perspectives on the mental health impact and care of the COVID-19 pandemic across the world. Asian J Psychiatr 2020; 51:102085.^,1414. Gunnell D, Appleby L, Arensman E, Hawton K, John A, Kapur N, et al. Suicide risk and prevention during the COVID-19 pandemic. Lancet Psychiatry 2020; 7:468-71.. Besides, media-outlets must keep combating fake news and misinformation, following good practice in suicide reporting, and providing information on mental health, well-being and suicide prevention ¹⁵15. Reidenberg DJ, Niederkrotenthaler T. Reporting on suicide during the COVID-19 pandemic. https://save.org/wp-content/uploads/2020/04/Reporting-on-Suicide-During-COVID19-Pandemic-Apr20.pdf (accessed on 22/Apr/2020).
https://save.org/wp-content/uploads/2020... . Finally, during and after COVID-19 pandemic, mental health professionals should look for and apply evidence-based and culturally-adapted interventions to assist their patients and communities, providing a real-time response using the available digital means ¹⁶16. Smith K, Ostinelli E, Cipriani A. Covid-19 and mental health: a transformational opportunity to apply an evidence-based approach to clinical practice and research. Evid Based Ment Health 2020; 23:45-6.^,1717. Chevance A, Gourion D, Hourtel N, Llorca PM, Thomas P, Bocher R, et al. Ensuring mental health care during the SARS-CoV-2 epidemic in France: a narrative review. Encephale 2020; [Online ahead of print]..

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