Aim of the study:
The COVID-19 pandemic has adversely affected the mental health of most populations and communities. This study sought to investigate the impact of COVID-19 on the likelihood of engaging in self-harm behaviors in a high-risk group.

Subject or material and methods:
Participants (N = 659) were recruited to a multilingual depression/suicide screener. Counts of self-harm behaviors with intent to die, with ambivalent intent, and with no intent to die were examined in two time periods – mid-COVID-19 (March 15 to July 15 of 2021) and pre-COVID-19 (March 15 to July 15 periods of 2018-9).

Results:
Regarding self-harm behaviors with the intent to die, pre-COVID-19, men were less likely to self-harm than women, whereas mid-COVID-19, the rates of these behaviors were similar for both genders and higher than pre-COVID-19. Regarding self-harm behaviors with ambivalent intent, a 3-way (cohort*gender*age group) interaction was noted, with younger men reporting fewer behaviors mid-COVID-19 compared to pre-COVID-19 and other men – more such behaviors; for women, these behaviors increased somewhat regardless of age group.

Discussion:
The COVID-19 pandemic may have altered the pattern and likelihood of engaging in self-harm behaviors. The effect of COVID-19 on these behaviors may be different for men and women, depending on their age and the type of behavior.

Conclusions:
Providers should be mindful of the potential of self-harming in the pandemic era, especially among those with existing risk factors.