https://doi.org/10.1177/0020764020962146 International Journal of Social Psychiatry 1–3 © The Author(s) 2020 Article reuse guidelines: sagepub.com/journals-permissions DOI: 10.1177/0020764020962146 journals.sagepub.com/home/isp E CAMDEN SCHIZOPH The unprecedented impact of the COVID-19 pandemic has caused havoc in various realms of life. The psycho- logical impact of the pandemic has already presented in the form of fear and uncertainty, acute reaction to stress, distur- bances in sleeping and eating patterns, anxiety, depression, post-traumatic stress disorder and suicide attempts and completed suicides (Joseph, Gunaseelan, et al., 2020; Klomek, 2020; Nayar et al., 2020). Suicide is probably going to become an even more major concern as the pan- demic unfolds (Gunnell et al., 2020). Literature has pointed out towards the probability of increase in rates of suicide attempts and completed suicide during the pandemic, though exact numbers are not yet known (Sher, 2020a, 2020b; Thakur & Jain, 2020). Psychological issues which could lead to suicidal thoughts include social isolation, anxiety, fear and uncer- tainty (of getting infected/of infecting others/of availa- bility of specific treatment or vaccinations in the near future), poor sleep quality and eating habits (Sher, 2020a, 2020b). Exacerbation of mental health issues in those already diagnosed with mental health issues, relapse of illness due to disruption in treatment compli- ance and limitations in reaching to hospitals and, alcohol and substance use (Joseph, Shoib, et al., 2020), may also be responsible for the surge in suicidal behaviour. Social factors which could lead to suicidal thoughts currently include financial crisis, unemployment, restricted sup- plies of essential commodities, intimate partner violence, school closures (causing poor child growth/increased exposure of certain children to violence at home/missing mid-day meals for those dependent on it), being in vul- nerable groups (homeless/jobless persons/children/older adults), those diagnosed with COVID-19, burnout in frontline healthcare workers, family members of affected persons, hospitalization in COVID-19 critical care units, stigma and discrimination regarding the outbreak as well as, mental health issues due to it, restrictions to partici- pate in religious congregations or to visit religious places and, an ‘infodemic’ phenomenon including misinforma- tion, rumours and conspiracies (Gunnell et al., 2020; Joseph, Mishra, et al., 2020; Joseph, Singh Bhandari, et al., 2020; Sher, 2020b). Suicide prevention and timely intervention: consensus recommendations 1. Evidence-based suicide prevention strategies focusing on the COVID-19 pandemic have been laid out by the World Psychiatric Association (WPA). The strategies include – a) restricting access to lethal methods of suicide (restricting sales of – firearms, pesticides, medications per person); increasing awareness among the public about the safe storage of potentially lethal objects. b) Interventions to reduce the harmful use of alco- hol, restricting the sale of alcohol, at the same time, increasing awareness among both at risk and the general population about the effects of alcohol. c) Continue gatekeeper training through online mode and, increase the number of volunteers to participate in the program through awareness. d) Raising awareness about mental health and suicide among youths through school-based interventions as soon as school re-opens. e) Ensuring adherence to the World Health Organization (WHO) guide- lines for responsible media reporting and avoid- ing sensationalizing pandemic related suicide. e) Providing financial support to the mental health care services, ensuring accessibility to the ser- vices, developing telemedicine services and pro- viding mental health support to the frontline healthcare workers. f) Remote assessment and management (if not in person feasible) of both people with mental disorders and those who are at-risk and ensuring continuity of care of people with mental disorders. g) Increasing awareness Dealing with the rising tide of suicides during the COVID-19 pandemic: Strengthening the pillars of prevention and timely intervention Shijo John Joseph and Samrat Singh Bhandari Sikkim Manipal Institute of Medical Sciences, Sikkim Manipal University (SMU), Gangtok, Sikkim, India Corresponding author: Shijo John Joseph, Sikkim Manipal Institute of Medical Sciences, Sikkim Manipal University (SMU), 5th Mile, Tadong, Gangtok, Sikkim 737102, India. Email: shijojj90@gmail.com 962146ISP 0 0 10.1177/0020764020962146International Journal of Social PsychiatryJoseph and Bhandari letter 2020 Letter to the Editor