Child suicides: is it just a moral panic?
THE other morning I was walking down a flight of stars leading from my home when a young woman in front of me stumbled and fell quite heavily.
I did what I could to help, but her ankle was swollen and it was obvious that she needed first aid. I ran back to the nearby reception area and explained that a young person had fallen nearby.
Did she fall on purpose, I was asked. I was lost for words until I made the connection with the media attention in the six weeks I have been in Hongkong, devoted to the level of suicide among young people.
I thought how awful the situation must be if my search for first aid could be seen as a possible report of someone attempting to take their own life.
So I have developed a picture of the incidence of suicide in Hongkong. My conclusions, although they cannot be the whole story, indicate more about the possible feelings of the general public than young people in particular.
Official statistics show that there were more suicides in Hongkong in 1980 than in 1990. However, this is a bit misleading. The average yearly number of suicides from 1980 to 1984 was just over 521 per year. From 1985 to 1990 the yearly average number went up, to more than 640.
But the comparison is distorted by a population expansion of nearly one million over the decade. The rise per 100,000 of the population was from about 10.5 to just over 11.0. This is hardly significant, given the advances in scientific and investigativeprocedures related to causes of death.
From 1980 to 1990 the number of people under 25 committing suicide actually fell slightly. Between 1980-84 the annual average comes out as 69.2 per year, while in the 1985-90 period the yearly suicide rate averages 69.1 per year. But again, the population profile of this group needs to be considered. There was a fall of more than 300,000 (mostly in the 15-24 age range), or 12.5 per cent, in this sector of the population.
Taking this into account, a slight rise in the incidence of suicide among the under 25s is indicated throughout the 80s, approximating to 0.1 per 100,000. However, when figures for youth and child suicide from elsewhere are studied, it seems that Hongkong's statistical profile in this area is perhaps more hopeful than one might expect, given recent local coverage of the phenomenon.
FOR instance in Canada in 1988, 0.02 per 100,000 of five-to nine-year-olds died as a result of suicide. No incidents of suicide were recorded for this category of the population in Hongkong in 1988.
In the same year those in the Canadian 10-14 age range had a rating of 1.51. In this period, two of Hongkong's 10 to 14-year-olds committed suicide, about 0.5 per 100,000. The figures for the 15-19 age group provide a similar message. In Canada this category had a suicide rate of 12.75 per 100,000; Hongkong had a total of 18, or around 3.5 per 100,000. Hongkong figures for 1992 do show an upward trend; in the under 19-age group 38 deaths by suicide were reported (all from 10 to 19). This approximates to a little under 4.8 per 100,000.
Cause for concern, perhaps, but this does not rank highly in terms of trends in other parts of the world. At the same time, these figures might reflect the sharper focus on youth and child suicide, rather than an actual rise in the incidence of the same.
Death, previously recorded as the result of other causes, may now, in an environment where the issue has been the subject of constant and searching debate, be more likely to be recorded as suicide. This could be the result of more accurate investigationand/or unconscious bias.
Although even one child death by suicide is one too many, when these figures are compared to recent figures for one Australian city - indicating that one in seven young people had attempted suicide at one time or another, and one in 20 succeeded - one must question the current attitude towards child and youth suicide in Hongkong.
So what is the source of concern? We need to be very careful when thinking about this. Blaming parents or schools and highlighting suicide as a kind of ''cause'', may not be helpful.
There are a number of examples of suicide ''epidemics'' including ''out-breaks'' in the United States, Germany and Japan. Once suicide is seen as a way of dealing with things, a form of amelioration, it can grow as chosen option. We need to be sure that we are not propagating a moral panic or promoting self-fulfilling prophesies.
The child and youth elements of the population of Hongkong have fallen dramatically over the past 30 or so years. Records show that between the 60s and 70s, the proportion of the population under 15 remained fairly stable at just over 40 per cent. However, this group declined to barely 20 per cent by 1992.
In short, young people in Hongkong, in the 80s, became something of an endangered species, relative to the previous 15 to 25 years. This is also a low figure regionally.
THE same group account for around 31 per cent of the population in Singapore, 36 per cent in Cambodia and 47 per cent in Thailand. South-east Asia as a whole has an under-15 population of approximately 38 per cent.
As such, Hongkong has a 50 per cent historical decline in its youth and child population and achieves about half of the geographical average for this grouping (despite its relatively favourable rate of child mortality). What is suggested by these figures is that, both in geographic and historical terms, children in Hongkong are relatively precious. When looked at through adult experience of the world, children are rare. This being the case, any threat to the well-being of a child is going to be attended to in proportion to the seeming scarcity of children. The fewer children the stronger will be the focus on potential ''predators''. Other considerations must also affect this situation. Compared to surrounding states, Hongkong is a very densely populated area. One suicide, or rumour of suicide, spreading around an area is picked up by many more people than in a comparable district in Australia or Thailand.
We might also do well to remember that many of the people of Hongkong have very little idea of what the future holds for them. We often express our unconscious concerns for the future through our children. We can project our fears into our children, and try to deal with these through attention to their welfare.
We may be creating an environment that we label as causing suicide; ''this is a place where suicide is a problem, more of a problem than elsewhere'' (even though there is no concrete evidence to support this).
At the same time, mortgages become harder to obtain, housing becomes less accessible. As a consequence, people start families later, perhaps financial difficulties even discount the possibility of having children at all. The younger population falls again, the child becomes rarer. Failing to see the nature of our concern, we voice our worries louder, through the medium of our children, the most immediate receptacle for our projections.
We thus manufacture a spiralling rate of suicide that increases as our concern heightens. This takes up a huge area of focus that prevents full attention to issues that may feed underlying anxieties. Please do not see this as an effort to negate child and youth suicide as a problem. It is a most serious and intractable problem worldwide. But we need to be very sure of our contentions in this area. It is a phenomenon that grows from within.
The question about how much adult insecurity and unexpressed fear is creating an environment that unintentionally promotes, even, given my recent experience, expects suicide, needs to be asked. Children represent the future in all communities. Our feelings about the our future are made manifest in them. Hope and possibilities are framed in their presence. If the trend of the past 30 years continues into the morning of the new century, that presence will constitute less than 15 per cent of Hongkong's population. Brian Belton is a visiting lecturer in social work at the University of Hongkong. He is based at the YMCA National College in London, Britain's leading trainer of youth and community workers.