Suicide prevention starts with stronger community bonds
Paul Yip attributes the fall in suicide numbers in Hong Kong to the joint effort by different sectors of the community to reach out to those at risk, including the vulnerable elderly and youths
Suicide is still a sensitive topic in Asian countries. Since 1997, Hong Kong has experienced one of the most drastic changes in suicide rates. From a rate of 12.5 per 100,000 in 1997, it hit a historical high of 18.6 in 2003, an almost 50 per cent increase in a seven-year period. Although we have yet to return to 1997 levels, the rate stood at 13.5 per 100,000 last year, representing a substantial reduction of 27 per cent.
Nevertheless, our suicide rate is still higher than the likes of the US (10), Britain (7) and Australia (11), and this fact underscores calls for community participation to tackle problems associated with suicide prevention.
In Hong Kong, where a majority of people live in high-rise buildings, jumping was the most frequent method of suicide for all age groups (52 per cent), with a fatality rate of over 90 per cent. The next most frequent methods were hanging (21 per cent) and charcoal burning (18 per cent).
The elderly have been the largest group to commit suicide over the years, and this has often been linked with symptoms of depression. These people were most likely to be living alone and widowed. Having children and support, including a wider social network, appears to be a protective factor against suicide.
Yet, our latest data also shows a significant rise in teenage suicides or attempted suicide. Among school dropouts, those who are underemployed or jobless, there was a 10- to 20-fold increase in the rate compared with those still at school. Youngsters today face more interpersonal and social difficulties (for example, family break-ups and academic stresses). Our next generation needs more help, especially those in new towns in northern districts like Tin Shui Wai and Yuen Long, which are remote and disconnected.
One life lost is one too many. In our aim to reduce the risk factors, we advocate a public-health approach to suicide prevention, promoting measures to reduce the risks rather than resorting to traditional symptom or disease-oriented treatment. Collaborating with professionals and frontline workers, including physicians, police and security guards, we have developed a community-based suicide prevention programme. We have held training sessions to enhance gatekeepers' understanding of how to prevent suicides as well as mental health literacy in local schools and introduced protocols to round-the-clock outreach crisis intervention.