Statement of purpose Suicide is a leading cause of death in the United States and Kentucky. Precipitating suicide circumstances in Kentucky between 2005 and 2017 most often included depressed mood; mental health, intimate partner, and physical health problems; and substance misuse. These known risk factors will likely intensify as the risk of spreading the virus continues, indefinitely.

Methods/Approach Finkel’s I-cubed (I³) model, not previously applied to suicide, is a novel and validated meta-theoretical framework that can model multiple and interacting risk and protective factors. This theory allows for the incorporation of the pandemic dimension, in order to understand suicidal behaviors and guide future research in this new way [encompassing intrapersonal (eg, comorbid physical and psychiatric illnesses), interpersonal (eg, relationship), and extrapersonal (eg, community, cultural, geographical) determinants].

Results Preliminary data show that suicides in Kentucky during March were about 50% lower than the average of the previous four years. Overall, suicides have continued to be lower through August. The lower rate does not imply that the pandemic will not impact state and national suicide rates. Historically, suicide rates decrease during the early phase—or ‘honeymoon’ period—of a crisis and during periods of high community cohesion. Following the honeymoon period, however, rates will likely increase. According to the Substance Abuse and Mental Health Services Administration, the next phase in a disaster is disillusionment, as people realize the limits of assistance. As the crisis becomes chronic, increasing gaps between those that return to business as usual and those that have continued needs lead to feelings of abandonment. This phase can last months and even years.

Significance As we acclimate to a new way of life, we must be proactive and innovative in understanding the effects of the pandemic and then developing targeted pandemic suicide prevention efforts and messages aimed at our most vulnerable populations.