A Clarion Call to Action: An interview with Dr. Roger McIntyre to discuss COVID-19, unemployment, and suicide. in interview with our Editor We sat down over the safe distance of video conferencing recently with Dr. Roger McIntyre, M.D., FRCPC, Professor of Psychiatry and Pharmacology, University of Toronto and Head of the Mood Disorders Psychopharmacology Unit at University Health Network to discuss his assessment of the state of mental health in amidst the current COVID-19 pandemic. Here are some thoughts he shared with us: PSY Hello, Dr. McIntyre. Thank you for joining us today. You recently co-authored a letter to World Psychiatry highlighting the correlation between employment and suicide (McIntyre & Lee, 2020). Could you highlight for us the concern you addressed? RM It begins with this current situation we’re in with respect to the global threat to mental health. I’ve often referred to it as a “triple threat”: anxiety about the virus, insecurity concerning finances, and the (impact of) quarantine and physical distancing. When we began to see this unfold in the early months of this year, it appeared to me that this was not only a viral pandemic, this was going to be a mental health pandemic. The reason why is that I began to think of lessons (we can take) from history. I specifically wanted to focus on the relationship between (mental health and) the economic shock, which is a consequence of unemployment. We’ve seen about 15 years of job creation eliminated in about six weeks in Canada, which is an unthinkable statistic, and the Statistics Canada unemployment rate is now approaching 14 percent. When we look at mental health broadly, the most robust association between macro-economics and mental illness is the link with suicide. If we go back to the Great Recession (2007–09), the Asian financial crisis (1997-99), and, of course, the Great Depression (1929-33), what we’ve observed is a fairly consistent relationship. 12
I call it the “one percent rule”; for every one percent increase in unemployment during these times that I mentioned, around the world in disparate economies there is a commensurate increase in suicide of one percent. Again, association, not causation, but highly replicated. PSY
It’s that consistent, is it?
RM It’s really consistent. And to add further merit to the association, interventions that governments put in place in some economies of Europe and also in Asia, like Japan, to mitigate some of the broader health risks of the economic shock during the Great Recession showed that government expenditures in specific areas reduced mental illness and suicide. So that provides further strength to the association.
