No easy solutions to the problem of suicide and self-harm

Alice Wu says these are painful and complicated issues that are easy to oversimplify – and throwing ‘blood-stained’ exam papers at the education minister, as some lawmakers did, is hardly the best approach

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Storm clouds gather over Hong Kong. If we consider why people resort to self harm – as a way of coping, releasing negative emotions, for example – we can perhaps also better understand why destructive behaviour occurs in society. Photo: Ricky Chung

Published: 2:31pm, 1 May 2016Updated: 2:31pm, 1 May 2016

Coming to terms with suicide – especially the spate of student suicides this year – is difficult. And a recent survey, released last week by the Paediatric Society and Paediatric Foundation, that found 27 per cent of Hong Kong pupils had contemplated suicide or self-harm in the past six months, is shocking.

The Paediatric Society’s president, Dr Lilian Wong, is absolutely right: the problem has always been here but not noticed by the public. One 2011 published study, by Daniel T.L. Shek and Lu Yu of Hong Kong Polytechnic University, said 32.7 per cent (of the 3,328 secondary school students) reported having engaged in deliberate self-harm, 13.7 per cent of respondents had suicidal thoughts, 4.9 per cent devised plans to kill themselves, and 4.7 per cent had actually attempted suicide. The scholarly works can help us put the problem and the inherently complex issues in perspective.

Eden Yeung, 19, a second-year local university student, thought of committing suicide three years ago before reaching out for help to Samaritan Befrienders. Photo: May Tse

To prevent student suicides, all of Hong Kong has to fight the battle – each and every day

These are important issues, deserving ongoing study, research and policymaking. Hormonal changes, academic pressures, lack of mental health support, environmental factors, circumstances at home, school and social circles, media reporting, and many other things come into play.

To blame one thing, or suggest any quick fix, would be counterproductive

There is a danger of oversimplifying the issues. The 2011 study cited above makes the distinction between deliberate self harm (DSH) and suicidal behaviour, and it is important that we understand why that is so. The authors of “Self-Harm and Suicidal Behaviours in Hong Kong Adolescents: Prevalence and Psychosocial Correlates” wrote, “Although DSH and suicidal behaviours are closely associated, they are qualitatively different.” In other words, those who self-harm do not necessarily have a suicidal intent. There are many areas of overlap. No singular “root cause” has been identified. And thus, to blame one thing, or suggest any quick fix, would be counterproductive.

From the 2011 study, we learn that female students scored “significantly higher” than males in both DSH and suicidal behaviour, suggesting gender can be a predictor. Another predictor is marital status of parents. Immigrant and local students had different scores. Positive youth development lowers the risk of self-harm. Surprisingly, those who self-harm have a high ability to organise and adapt thoughts, and have control over their behaviour. Basically, they’re fully aware and in control of their self-harming.

While some results may not be conclusive, the study identified areas for further studyand also areas where policymakers could commit more resources – like reducing family conflict, bettering family communication and providing support for vulnerable families. The authors’ emphasis on the need to develop students’ emotional competence, resilience and bonding are helpful for policymakers, educators, public health professionals and families.

We should avoid oversimplifying the cause of student suicide, such as only blaming academic pressure. Photo: SCMP Pictures