Although experts have warned about the coronavirus pandemic’s eroding effect on mental health, new data from Hawaii health officials shows no signs of a pandemic-related increase in deaths by suicide in the islands.

Hawaii's Mental Health Crisis Special Report badgeAll told, there were 195 documented suicides in Hawaii in 2021, according to data analyzed by Daniel Galanis, an epidemiologist at the state Department of Health. That compares to 180 suicides in 2020, 217 suicides in 2019, 171 in 2018 and 221 in 2017.

Taken together, the five years of annual statistics reveal no clear trends and “definitely not an apparent increase related to the pandemic,” Galanis said in an email.

The data is likely incomplete because it’s not always clear when a death is a suicide. For every nine suicides in Hawaii, there is approximately one death that’s ruled to be of “undetermined intent.”

The data also does not take into account attempted suicides. For every suicide in Hawaii there is an average of four or five non-fatal attempts, according to data from state health regulators.

Aaron Hoff, Keala Foundation, Kauai, Suicide, Youth, Prevention, Mental Health, Crossfit
The Keala Foundation on Kauai aims to engage Kauai youth in healthy lifestyle choices as a method of suicide and drug use prevention. During the worst days of the pandemic, the organization’s free after-school fitness programs moved online to accommodate social distancing requirements. Courtesy: Keala Foundation/2020

Despite the relative good news that the despair born of a more than 2-year-old public health emergency has not translated into an increase in suicide deaths, Kathleen Merriam, who works on suicide prevention for the DOH, cautioned that people are still grappling with Covid-19 mental health impacts.

“This is a really risky time,” she said. “Yes, we are recovering from Covid a bit, but there’s a lot of people that are also recovering from grief and loss and shock.”

As the pandemic starts to wind down, Merriam said societal pressures to return to a semblance of normalcy can trigger anxiety, depression and thoughts of suicide — especially in people who feel changed by the experience of the last two years and find it difficult to now simply resume their pre-pandemic life.

“Maybe we once were very sociable and really fun-loving, and as we venture back out, maybe we’re realizing — wait — I’m not finding myself to be that fun-loving, sociable person anymore. I actually want to go run back to my house,” Merriam said. “Or maybe now I’m back at work, at my desk, in my office and I wish I was back home teleworking, I wish I was at home with my children.”

New Hotline

Access to help is about to get easier — or, at least, that’s the vision for a new three-digit national suicide prevention hotline set to launch on July 16.

In 2020, Congress passed legislation to establish a 988 hotline similar to 911, but for mental health support and emergencies. The simplified number aims to make it easier to reach the National Suicide Prevention Lifeline, which currently requires dialing 800-273-8255.

When the 988 line debuts this summer, callers with an 808 area code will be routed to the Hawaii Coordinated Access Resource Entry System, also known as Hawaii Cares, a local call center operated by Care Hawaii that provides around-the-clock access to emotional support, mental health resources and substance abuse treatment services.

The confidential hotline, which is free to use by phone, text or online chat, is first and foremost a crisis and suicide hotline staffed by counselors who can dispatch the state’s crisis mobile outreach team immediately to anyone in need, from urban Honolulu to rural Molokai. It’s also a one-stop-shop for help with any mental or behavioral health issue, including addiction and substance abuse.

Although the 988 line is a national undertaking, its success locally will largely depend on the ability of the Hawaii crisis call center to keep up with an expected 30% increase in call volume when the new number goes live.


When it comes to beefing up call center staffing, “Hawaii is ahead of the game,” according to Belinda Danielson, who’s overseeing the state’s 988 transition.

The call center already has augmented its staff with about eight new positions and a half-million dollar grant from the national Substance Abuse and Mental Health Services Administration that will help the call center add even more staff to its team of about 20 employees, Danielson said.

All told, the DOH has allocated more than $2 million in federal and state funds to operate the crisis line through the end of next February, according to department spokeswoman Katie Arita-Chang.

At the start of the pandemic, there was a marked drop in calls to Hawaii’s crisis hotline. That’s because the pandemic had essentially shut down a major source of calls to the hotline: mental health care providers, including those working in schools, Danielson said.

The hotline received about 94,000 calls in 2020 and about 90,000 calls in 2021. This year the call center has fielded about 7,000 monthly calls from January to March. April brought a spike of about 9,700 calls, Danielson said, but call volume has still not returned to pre-pandemic levels. The 988 launch, however, could change that.

Another factor in determining the success of the 988 transition will fall on the ability of Hawaii’s fragmented treatment system for people with mental illnesses and addiction to keep up with demand for treatment.

Due to a shortage of psychiatric doctors and treatment programs, the state’s unique island geography and poor coordination of available resources, people with serious mental illness often don’t receive adequate help. Instead, people in crisis are routinely directed to hospital emergency rooms or police departments lacking in the appropriate resources tailored to meet the needs of someone grappling with mental illness.

The benefit of the crisis line call center is that counselors who answer the phone don’t have to travel to meet callers face to face, Danielson said.

“The beauty of it is they don’t have to be in Hana. They don’t have to be on Molokai,” she said. “The service is still there and it’s the same for everyone and you’ll always have someone here in Hawaii available to take that call and provide that support regardless of where you are in the state.”

Civil Beat’s health coverage is supported by the Atherton Family Foundation, Swayne Family Fund of Hawaii Community Foundation, Cooke Foundation and Papa Ola Lokahi.

Help power our public service journalism

As a local newsroom, Civil Beat has a unique public service role in times of crisis.

That’s why we’re committed to a paywall-free website and subscription-free content, so we can get vital information out to everyone, from all communities.

We are deploying a significant amount of our resources to covering the Maui fires, and your support ensures that we can pivot when these types of emergencies arise.

Make a gift to Civil Beat today and help power our nonprofit newsroom.

About the Author