Washington Uses Suicide-Related Health Data During Pandemic


  • During the COVID-19 pandemic, the State of Washington shared data to raise awareness of suicide risk and give behavioral experts data that could be used for prevention.
  • Concerned with the suicide risk and mental health, syndromic surveillance was conducted on five behavioral health conditions that can be detected in emergency department settings.
  • Syndromic data are now an essential part of the State of Washington’s monthly behavioral health impact forecast used for strategic planning and intervention.
A seated, masked male behavioral health professional talking with a seated, masked female patient.

Public health problem

Stress and anxiety during the coronavirus disease 2019 (COVID-19) pandemic were common. Isolation, unemployment, social distancing, worry about sending children to school, and frequent media coverage of the pandemic and related problems have contributed to growing mental and behavioral health problems. Managing such challenges can be stressful to those in some occupations and social roles, making self-care and public health interventions even more essential.

Concerned about mental health among Washingtonians, the Washington State Behavioral Health Strike Team (BHST), which leads and coordinates Washington's behavioral health response to COVID-19, examined de-identified health record data captured by syndromic surveillance. They began sharing the warning signs of behavioral health and suicide risk with behavioral health specialists and partner agencies skilled in designing population-level interventions to prevent potential suicides.

Actions taken

Suicide is a leading cause of death in the United States.‎

More than ever before, public health practitioners are using syndromic surveillance to detect people at risk of suicide and protect against it. Syndromic surveillance captures health data in near real-time, which can be used to identify people at risk of suicide when they seek care in emergency departments. By making the warning signs publicly accessible (e.g., reports, dashboards) for use by health care partners and communities, public health can raise awareness of the problem and put evidence-based response actions in place for people who need help the most.

BHST uses the Rapid Health Information NetwOrk (RHINO) for surveillance and dissemination of emergency department data on suicidal ideation and suicide attempts. Syndromic data from RHINO are included in weekly situation reports that describe the potential statewide behavioral health effects of COVID-19. Pandemic response staff, behavioral health agencies, and other healthcare organizations rely on situational reports to inform planning and intervention efforts. BHST makes reports available to the public through the Washington State Department of Health website, provides them to state response leadership, and routinely shares them with behavioral health system partners. De-identified data from syndromic surveillance are part of the monthly behavioral health impact forecast that health partners and state agencies use for population-level strategic planning and intervention.


In addition to providing weekly reports and monthly forecasts, BHST conducts targeted outreach in communities to help populations at greatest risk. For example, analysts in a local public health department grew concerned when syndromic data triggered alerts for more emergency department visits than expected for monitored behavioral health conditions. They contacted BHST, which then elevated concerns to local incident management leadership. The analysts provided supportive syndromic data and offered to help tailor a targeted response.

Data from syndromic surveillance have enabled Washington behavioral health partners and response teams to respond quickly when they observe suicide-related outcomes of the COVID-19 pandemic. Recent examples of public health actions include issuing provider alerts on suicide and overdose risk, a youth-focused report on behavioral health, and creating county-specific maps to guide local health jurisdictions' response efforts. Lessons learned from the COVID-19 response can also be used to prepare for the behavioral health impact of other emerging threats to public health. At the national level, BHST continues to coordinate closely with CDC on the topic of suicide risk and provides valuable input that is advancing the agency's syndromic surveillance of nonfatal suicide-related outcomes.

Information found in the Behavioral Health Impact Situation Report

An example is shown here. This report shows potential behavioral health impacts of the COVID-19 pandemic for Washington state and can be used to inform planning efforts. The report includes suicidal ideation and suspected suicide attempts, substance use (drug overdose and alcohol-related emergency visits), symptoms of anxiety and depression, care seeking behaviors, statistics on how services are being used, and more.


Rapid Health Information Network
Washington State Department of Health
syndromic.surveillance@doh.wa.gov (or rhino@doh.wa.gov)

Centers for Disease Control and Prevention
Office of Public Health Data, Surveillance, and Technology
Detect and Monitor Division

The findings and outcomes described in this syndromic success story are those of the authors and do not necessarily represent the official position of the National Syndromic Surveillance Program or the Centers for Disease Control and Prevention.