P3.H145: A Retrospective Study of Youth Suicide in Ecuador Before and During the Coronavirus Pandemic

Background: Suicide presents a significant global public health issue, affecting people of diverse backgrounds and ages. However, there is limited information about its occurrence in developing nations like Ecuador, particularly amid the COVID-19 pandemic. Suicide is a leading cause of death worldwide among young patients, and rates have been rising. Understanding the impact of the COVID-19 pandemic on suicide rates is crucial for developing effective interventions and promoting mental health policies of prevention and early treatment. The pandemic has heightened levels of stress, anxiety, and social isolation, all of which are known risk factors for suicidal tendencies. Furthermore, it has complicated the assessment and diagnosis of mental health disorders. Our objective is to study the prevalence and methods of suicide among Ecuadorian children and adolescents before and after the COVID-19 pandemic.

Methods: Public access data from the National Institute of Census and Statistics (INEC) database from 2017 to 2022 was analyzed, in people under 19 years. Methods of suicide were classified according to the International Classification of Diseases (ICD-10) codes X60 to X84 and variables like age, sex, education, ethnicity, year, residential area and methods of suicide were analyzed.

Results: The study examined intentional self-harm deaths of Ecuadorian children and adolescents from 2017 to 2022, considering age, sex, education, ethnicity, and methods. 4.47% of all pediatric deaths (1132 out of 25352) were due to self-harm, with the most cases in 2018 (n=239) and the least during 2022 (n= 158).

Age groups were divided between children (0-13 years old) and adolescents (14-19 years old). Throughout the studied period, self-inflicted deaths occurred more frequently in urban settings, with the highest number of cases in children in 2020 (N=28) and among adolescents in 2020 (N=104). Higher numbers of cases were found among mixed race individuals (mestizos), although indigenous youngsters had a high number considering their lower percentage in relation to mestizos. Secondary school adolescents (13 to 19 years) accounted for 374 deaths by self-harm, while younger children in elementary schools had a total of 645 cases, with no reports in 2021 (probably due to technical problems of INEC). Other levels of education tallied 115 suicides.

Hanging (n = 888) was the most common method used to inflict self-harm and death in the six years studied, followed by poisoning( n= 140) and the use of firearms (n=18).

Conclusion: We observed a decreasing trend in suicides despite COVID-19, with most suicides happening in males. Possible explanations are increased family support, reduced stress from external factors or underreporting during lockdown. Nonetheless, investment in mental health assistance is crucial for the pediatric population being that there is a high incidence of self harm resulting in death among the pediatric population of Ecuador.