According to the first ever World Suicide Report by the World Health Organisation, over 800,000 people kill themselves each year. Globally, suicide was the fifth leading cause of death among people aged 30-49, and the second leading cause of death among those aged 15-29 in 2012. In Hong Kong, the suicide rate has fallen from its historical high of 18.8 per 100,000 in 2003 to around 12.3 per 100,000 last year. However, those aged 60 or above still show a relatively high suicide rate (around 21.6 per 100,000), and the recent increases in suicide among the young are of particular concern. World Suicide Prevention Day falls today and this year's theme is "Suicide Prevention: One World Connected". It reflects the fact that connections are important in many aspects of suicide prevention. According to our studies, many suicides are associated with some sort of disconnection - people were disconnected from social support, from mental health care, or even from society as a whole. Yet, in contrast, thanks to the development of technology and social media, the world has never been so connected; it took only a few days for the ice bucket challenge to spread across countries, for example. However, the "digital divide" means that people unfamiliar with new media, for instance some of the elderly, can be largely disconnected from the world. A household survey in 2011 found that about 13 per cent of respondents aged above 60 were living alone and half of them seldom talked to their neighbours. Compared with other elderly respondents, this group reported significantly lower levels of life satisfaction. How to reach out to these senior citizens and link them up to support services is a significant challenge for today's ageing society. Meanwhile, people who spend too much time using social media also risk disconnecting themselves from daily life. A recent study by the Centre for Suicide Research and Prevention on the internet use of young people in Hong Kong raised concerns. The survey of those between 12 and 29 years old, carried out by mobile phone, found that a small number of respondents mostly stayed at home and had avoided social situations and social relationships for more than six months. We have also observed that, while everyone may be susceptible to harmful or pro-suicide information on the internet, the vulnerable in society do seem more affected by such information. Take burning charcoal as a method of committing suicide, for instance. This method has spread from Hong Kong to neighbouring regions such as Taiwan, Japan and South Korea over the past 15 years. It seems to have been fuelled by sensational and detailed media reporting and online information. One study conducted by our centre found that, in Taiwan from 2008 to 2011, every 10 per cent increase in a Google search of "burning charcoal" or "charcoal-burning suicide" in any given week was associated with a 3.8 per cent increase in the incidence of such suicides the following week. This online disconnect reflects a lack of adequate social support. Our current mental health care and social services rely more on users actively seeking help rather than proactively reaching out to those potentially in need. Yet, it takes great courage for people in need to seek help. People are concerned about the long waiting time, sometimes more than a year, to see mental health professionals including psychiatrists in the public hospitals. Community support for the mentally ill is neither sufficient nor easily accessible, either. To make matters worse, individuals suffering from mental illness or who are at risk of committing suicide are often portrayed by the media as being potentially violent or dangerous to the community. This only further alienates them, and stops them and their caregivers from seeking help. The International Association for Suicide Prevention and the WHO say that "the right service or individual clinician must be available at the right time for someone with mental health problems, and must be able to offer and deliver effectively the full range of treatment options". Hong Kong need to improve a lot to meet these international standards. Faced with these challenges, we have to be creative in developing strategies that can identify at-risk individuals and reconnect them with the appropriate help and support. Policymakers and stakeholders from different sectors have to work together to make suicide prevention more sustainable, strategic and focused. More resources and training should be provided to mental health care providers, while more public campaigns should be conducted to remove the stigma of mental health problems and encourage people in need to seek and accept help. Appropriate and timely support should be available to family or friends who look after people with mental health issues. Promoting healthy living and a work-life balance is also important. We are delighted to see more professional organisations developing new support services, activities to engage people, intervention strategies and therapy programmes. Some online service providers are also showing an interest in joining suicide prevention efforts. Yahoo Hong Kong, for example, automatically shows suicide prevention hotline numbers at the top of its search engine results list when people seek out suicide-related information. Google has a similar feature in the US but, unfortunately, has yet to launch it in Hong Kong. A good step would be for policymakers or industrial associations to develop regulations or codes of practice to push all new and traditional media companies to see suicide prevention and the promotion of mental health as part of their social responsibilities. At 83 per cent, Hong Kong has one of the world's highest internet penetration rates, while each person in Hong Kong has, on average, more than two mobile phones. It may therefore seem that society is one of the most connected in the world. But are we ready to make the connections among ourselves, to enhance people's well-being and ultimately save lives? Paul Yip is director of the Centre for Suicide Research and Prevention at the University of Hong Kong, where Qijin Cheng is a post-doctoral fellow
