A Retrospective Review of Suicide by Self-immolation: Comparing Pre-, During, and Post-COVID-19 Data

Abstract Introduction The COVID-19 pandemic had a significant impact on mental health. With the increased incidence of mental health concerns, there has been an increase in the trends of suicide attempts and deaths globally. A small percentage of suicide cases included the rare method of self-harm and self-immolation. Previous research examining the incidence rates of self-immolation as a form of suicide during and after the COVID-19 pandemic is limited in the U.S. The objective of this study was to compare pre-, during, and post-COVID-19 pandemic rates of suicide through self-immolation by reviewing information entered and collected into a single institution’s burn registry data. Methods A retrospective review of burn registry data at a single ABA-verified burn center focused on data identified for patient admissions with self-immolation over ten years, which included the period of the pandemic (2014-2024). Three groups were created: pre-, during, and post-pandemic. ANOVA was used to compare the means between demographics, mortality, etiology, and increases of incidence in self-immolation. Results Of the total of 87 cases, significantly higher rates of mortality by self-immolation found after the pandemic. As well, the use of gasoline etiology subcategory was significantly higher during and after the pandemic. There was no statistically significant difference in self-immolation rates between all three periods. Conclusions The retrospective review at a single ABA-verified burn center did not see a significant increase in incidence rates for suicide by self-immolation. Changes in mechanism were seen during and after the pandemic, with the use of gasoline and higher mortality in self-immolation. Applicability of Research to Practice Understanding incidence rates, especially during an event as significant as the pandemic, would allow burn centers and other mental health organizations to develop programming addressing self-immolation as a mechanism of self-harm or suicide. Funding for the study N/A.