Suicidal Behavior Before and After Hurricanes Irma and Maria in Puerto Rico: A Descriptive Analysis of Crisis Hotline (Línea PAS) Calls, 2015–2021
Ricardo Laboy, Sebastian Hernandez, Ricardo Vazquez, Raymond Tremblay, Yaritza Inostroza-NievesAbstract
Objective
Natural disasters can increase the risk of suicidal behavior, particularly in resource-limited settings. We characterized suicidal ideation and attempts before and after Hurricanes Irma and Maria (September 2017) in Puerto Rico using crisis-hotline surveillance data.
Methods
We conducted a retrospective descriptive analysis of suicide-related calls to Línea PAS , Puerto Rico’s 24/7 government crisis hotline, from January 2015 through December 2021 (84 months). Monthly counts of suicidal-ideation and suicide-attempt calls were aggregated, stratified by sex and age group, and displayed as a time series with September 2017 as the index event, with exact Poisson and Wilson 95% confidence intervals.
Results
Total suicide-related calls rose sharply about 2 months after landfall, peaking from November 2017 through January 2018 (maximum 4,548 calls in January 2018) before returning toward baseline by February 2018. Working-age adults (21-59 years) and women accounted for most calls. The surge coincided with prolonged power and telecommunications outages and with an independent rise in recorded suicide deaths.
Conclusions
These descriptive, ecological findings are consistent with a substantial mental-health burden following catastrophic hurricanes and coincided temporally with prolonged infrastructure disruption; the design cannot establish causation. They support integrating crisis-hotline-based behavioral-health surveillance and rapid utility restoration into disaster preparedness for climate-vulnerable regions.