Preventing suicide among Hong Kong’s youth will take a collective effort, in school and beyond
Paul Yip says an approach that combines research, knowledge sharing, and training for teachers, would help prevent suicide among Hong Kong’s youth, amid academic and social pressure
“To those who have lost their lives in suicide, to those who struggle with thoughts of suicide, to those who have made an attempt on their lives, to those caring for someone who struggles, to those left behind after a death by suicide, to those in recovery, and to all those who work tirelessly to prevent suicide and suicide attempts in our nation. We believe that we can and we will make a difference.” – Dedication of the US 2012 National Strategy for Suicide Prevention.
According to the latest World Health Suicide Report, there are about 800,000 deaths by suicide worldwide every year; more than 60 per cent of these are in Asia. Reducing the suicide rate has been included as one of the 17 sustainable development goals proposed by the United Nations.
The increase in suicide among young people has become an emerging problem both in Hong Kong and globally. In Hong Kong, the overall suicide rate has decreased from its historical high of 18.8 per 100,000 people in 2003 to an estimated 12.4 per 100,000 people in 2017.
A few studies have indicated that our high-school students are showing signs of depression. Adolescence is a critical and sensitive stage of development as teenagers adapt to changes in life, learning environment, friends and for some, parental separation. They are more susceptible to being influenced by their external environment, and less emotionally stable, which may lead them to behave impulsively.
In the past, youth in the school system had a lower suicide rate than those who are working or unemployed for the same age cohort. However, the gap is disappearing and there is not much difference in the suicide rate among young people, regardless of whether they are in the school system or not.
In addition to the various difficulties teenagers face, students’ feeling of anxiousness and uncertainty about examinations and the future have become more intense. This reflects that the move to six years of free secondary education might not be the best fit for those who are not academically inclined. Parents regard academic achievement as the most important indicator of a child’s success, regardless of the child’s disinterest in, or struggles with, their schoolwork. Sometimes, it is the mindset of both students and parents that limit children’s pursuit of their own interests.
In addition, the exam-oriented learning environment is not aligned with the goal of cultivating and promoting students’ mental wellness. The school system needs a systemic change as well as an increase in individual support to promote the mental well-being of our youth and to cater to children with different talents and interests. If our young people can’t see any hope or find practical means to change their current situation, they will be prone to depression and anxiety.
Nevertheless, despite the acclaimed better learning environment in Finland, Australia and the US, the suicide rates among young people in those countries are higher than that of Hong Kong, especially among males. They also show a higher prevalence of activities that place them at increased risk, such as drug and alcohol abuse. This indicates that a better academic environment alone does not result in a lower student suicide rate.
It is unfortunate that most suicide prevention programmes in Hong Kong and in the region focus on clinical intervention. And, yet, there is an acute shortage of clinical resources to treat depression and mental illness.
However, recent developments in artificial intelligence and web-based programmes open a new window of opportunity to promote mental wellness. These include AI algorithms that help identify people who are stressed based on social media posts to trigger timely intervention and online programmes that enhance mental well-being. This requires the concerted efforts of an interdisciplinary team with expertise in youth development, mental health, e-learning design, psychological and educational assessment, big data and computer science.
It is important to promote research, knowledge exchange and training to enhance suicide prevention. Research on suicide will generate the much-needed information to help formulate effective, focused and evidence-based suicide prevention and wellness enhancement programmes. The findings of research on suicide can then be disseminated to the community to increase awareness of the importance of mental wellness, destigmatise suicide and encourage people to seek help.
Some of the barriers to students and teachers seeking help arise from stigma in the community and at school. Training and education are crucial to enhance the ability of teachers at all levels of the education system to promote mental wellness among youth. These programmes can help teachers understand the importance of such skills and encourage more positive perspectives. We need innovative and creative solutions. Prevention rather than cure, wellness over illness, are of the essence.
This year, the theme for World Suicide Prevention Day on September 10 is “working together to prevent suicide”. Given that suicidal behaviour is a complex interaction of individual factors and socioeconomic and environmental factors, and because our young people face increasing challenges, all stakeholders in the community must work together on suicide prevention.
Although there is no magic solution to suicide, prevention efforts would be more effective if the whole community works together to promote wellness for everyone.
Paul Yip is director of the Centre for Suicide Research and Prevention at the University of Hong Kong