Tackling youth suicide in Hong Kong: the role of parents and educators

The trigger may seem trivial to most of us; his teacher accidentally used a rude word in class. But Yeung, now 19, had to endure the taunts of his classmates because the word in question rhymes with his Chinese name and had become the cruel nickname bestowed on him by classmates.

The bullying was incessant, and Yeung says it left him alienated for five years and with no friends among the girls at his school. Worse, he found little support from his parents, growing distant from them as they devoted much of their attention to his brother, 13 years his junior.

"My parents considered their job done after paying for my tuition, clothes and food," said Yeung. "When I complained to my mother about the bullying at school, she never took it seriously and said it didn't hurt being ridiculed once in a while."

Yeung is by no means the only Hong Kong teenager to have contemplated taking his own life. In the first six weeks of this year, eight students and six school-leavers took their own lives, while four further suicide attempts were reported in the media.

While the overall suicide rate has been declining for the past decade, the number of suicides among boys and men aged 15 to 24 has edged upwards. Meanwhile the number of calls to the Suicide Prevention Service hotline in the past year was up 16 per cent year on year to 34,426.

Fortunately, Yeung chose to reach out before taking his own life. He called Samaritan Befrienders, a local voluntary organisation, as it was the first place he thought of turning to for help.

After calling their hotline, he agreed to a face-to-face chat with a social worker the same day and was talked out of taking that last, fateful step.

The problem for organisations like Samaritans Befrienders is that most troubled teenagers  are deeply withdrawn, often preferring to spend their time in cyberspace rather than out in society.

But addictive use of the internet is an indicator, rather than the cause, of the problems these young people face, according to Heung Mo-yan, head of the Suicide Crisis Intervention Centre which was established by Samaritan Befrienders.

"Parents should be mindful that their children  don't consider the internet or technology as their only source of happiness," Heung says, adding that websites have  encouraged individuals with mild suicidal thoughts to act and helped spread myths about "painless" suicide methods.

The effect is particularly evident among teenagers 15 to 17 years old, a time when many are prone to act on impulse, Heung says. The number of suicide attempts among teenagers in that age range increased 40 per cent year on year between January and September this year, she says, citing media reports.

Heung says the evidence suggests young people are more likely to make an impulsive decision to take their own life. She cites figures from the government's Child Fatality Review Panel which show that more than 70 per cent of under-18s who killed themselves in the years 2008 and 2009 did so by jumping from a height.

"It would require more time and thought if one chose to hang him or herself," Heung said, adding that the figures point to the need for timely support for troubled teenagers.

Professor Paul Yip Siu-fai, director of the Centre for Suicide Research and Prevention at the University of Hong Kong, says it is perhaps unfair to draw the conclusion that young people today are worse at handling adversity than previous generations had been.

"Don't forget that many youngsters today have no siblings. Many of them, unlike their parents, never really master the ability to deal with difficult interpersonal relationship problems," Yip says, adding that this helps explain why many choose to seek comfort in the virtual world.

A person's ability to handle adversity also depends on whether they have adequate social support in the real world, Yip says, adding that the biggest problems for many teenagers and young people involve family or other interpersonal relationships.

That's one of the reasons why suicide prevention efforts have increasingly focused on educating the general public on how to react to people at risk of suicide. Naturally, that process starts by teaching how to identify a person in need of help.

"One would not consider suicide as a way out unless one thinks the sufferings one endures in life are beyond one's limit," says Ho Wing-hung, assistant head of the Suicide Crisis Intervention Centre.

"There are very few cases in which a young person shows no or very few signs before committing suicide. The urge to commit suicide is so profound a feeling that it's hard to keep to oneself and most would confide it to the people they feel close to, which is not necessarily their parents," Ho says.

The Child Fatality Review Panel's report on youth suicide, which draws from police reports, says that in eight out of ten cases, young people who kill themselves shows signs of being suicidal before the act.

Boys tend to express their feelings not through words but in the form of "abnormal" behaviour, Ho says. That could mean they become more introverted, or act violently.

Girls at risk of suicide are often troubled by family problems, says Luk Yu-yan, a counsellor at the Youth Outreach Crisis Centre for Girls. They may self-harm or begin acting like a completely different person, picking up new habits such as drinking.

Now, in view of the generally low awareness of suicide risk and the stigma attached to it, suicide prevention bodies are actively promoting the concept of people close to those at risk of suicide acting as "gatekeepers". In other words, teaching educators, family members and classmates what to do around those at risk of suicide - or at least making clear what not to do.

"Youngsters need more than emotional support in cyberspace; what we are doing is to provide them with more support links in real life," Heung says. She hopes the idea of life education - described by the Education Bureau as a curriculum instilling positive values and attitudes towards life and teaching how to deal with emotions in different situations - will one day be as common as sex education in schools.

"Life education should start once children begin to understand the concept of empathy, and it can be as early as at the primary school stage," Ho says. "It can be as simple as teaching children what not to say to schoolmates who are visibly feeling miserable."

Last year, the Suicide Prevention Service began offering intensive workshops - on how to handle disputes and the emotional problems of others - to teachers and selected pupils at eight secondary schools. The workshops were recently extended to parents, programme officer Tam Ka-kin says.

One factor that has added to student stress is the introduction of the Diploma of Secondary Education, Tam says. The new exams, which pupils must excel in to get a government-%subsidised university place, replaced the better-known A-level and HKCEE programmes.

"There may be more options available now for those who cannot get into local universities," Tam said. "Having said that, most still consider securing a place in the government-subsidised programmes the only viable option."

Lu Chan Ching-chuen, president of Youth Outreach, says "distorted" social values which limit the definition of success to securing a high-paying job with "respectable" social status is a key contributor to the mental health problems of young Hongkongers. Her organisation works with at-risk youngsters.

Three decades as a senior psychologist at the Correctional Services Department taught Lu that children often feel unloved at home, feeling that the only thing their parents care about is their academic performance so that they wouldn't "fail at the starting line".

"Parents must not forget that their children are human too, not merchandise, and they too have emotional needs," Lu says.

For Yeung, at least, the story has a happy ending. The once pessimistic and passive teenager is now a second-year social science student at a local university. He's taking charge of his life, and the Chinese name that caused him such pain is history, replaced by a name he chose for himself.

Asked why he chose to study social science, Yeung says he has decided to devote the rest of his life to helping others, and hopes to work in community service. He is already an active volunteer.

He wishes he had taken the initiative to change his name earlier, and had the courage to demand that his peers stop making a laughing stock out of him.

And he has a simple message for other troubled souls: "Always give yourself a chance even though you may feel you're giving yourself the last chance. There will always be someone to help if you let others help you."

Suicide prevention resources in Hong Kong

Samaritans Hong Kong
24-hour hotline - 28960000 (English available)

www.help4suicide.com.hk
Busting myths around suicide, with a social worker available for live chats from 8pm to midnight (Cantonese)

Samaritan Befrienders
Advice hotline for individuals who think people close to them may be at risk of suicide - 23191177 (Monday to Friday, 9am to 1pm, 2pm to 6pm, Cantonese)

Suicide Prevention Service
24-hour hotline - 23820000 (Cantonese)