Although mental health experts have raised alarm about the impact of coronavirus-related shutdowns, preliminary data from Hawaii health regulators show that fewer people died by suicide in the islands last year.

The finding is in some ways counterintuitive. Hawaii health care workers reported a surge in psychiatric symptoms in people with and without a history of mental illness in 2020 when the COVID-19 pandemic began to undermine residents’ financial and emotional wellbeing.

As a result, many psychiatrists said they increased their patients’ medication dosages or started to see them more often. Hospitals across the state said they were admitting a greater number of patients with psychiatric symptoms.

But a new report released by the Hawaii Department of Health on Friday found that none of these alarming trends translated to an increase in suicide deaths in 2020.

All told, there were 124 documented suicides in Hawaii during the pandemic period of April through December 2020, according to preliminary mortality data.

That compares to an average of 150 suicides in the same nine-month period from 2015 to 2019 and an average of 138 suicides in the comparable period from 2010 to 2014.

People who die by suicide often have mental health concerns. A growing body of research also links the problem to financial struggles — including debt, job loss and home foreclosure.

But it’s possible, according to the state health department report, that economic suffering has been mitigated by government safety nets, although it is uncertain how long that will continue.

Early decisions to increase medication and the rapid expansion of the use of telemedicine for psychotherapy as well as an increased awareness about the need to seek help also may have contributed to the decline, experts say.

The data, however, 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.”

It can also take several months to determine a cause of death when a toxicology report is required.

The report 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.