Category Archives: Suicide Prevention

Troubling Increase in Suicide Rate in Prosperous South Korea

Choi Jin-young hanged himself last month with an electrical cord. The 39-year-old actor wasn’t getting any work in local TV, police said, and he had been depressed since the suicide of his famous older sister.

The sister, Choi Jin-sil, was known as the “nation’s actress.” When she hanged herself in her bathroom in October 2008, a wave of sympathetic suicides swept South Korea and 1,700 people took their lives the following month.

Seven months later, former president Roh Moo-hyun jumped off a cliff to his death. “I can’t begin to fathom the countless agonies down the road,” he wrote in a note.

Daul Kim

Daul Kim

Then 20-year-old Chanel model, Daul Kim, killed herself, posting a blog entry that said: “Mad depressed and overworked.” Another said: “The more I gain, the more lonely it is.”

In 2008, there were 35 suicides per day; which is a suicide roughly every 40 minutes. The suicide rate in a nation of 50 million people has doubled in the past decade and is now the highest in the industrialized world.

The suicide rate in 1982 was 6.8 per 100,000 people, similar to rates reported in Spain, Greece and Italy. The countries did not see their suicide rate spike during periods of economic difficulty like Korea did in 1997.  The rate of suicide peaked in the 1980s for other wealthy countries, but the numbers in South Korea continue to climb. Twenty-six people per 100,000 committed suicide in 2008 (the most recent year for which data are available); 2 1/2 times the rate in the United States and significantly higher than in nearby Japan, where suicide is deeply embedded in the culture.

The government is hoping to decrease the rate to below 20 per 100,000 people by 2013, but there has been little progress. Korean society considers suicide and depression personal matters.

“This is the dark aspect of our rapid development,” said Ha Kyooseob, a psychiatrist at Seoul National University College of Medicine and head of the Korean Association for Suicide Prevention. “We are unwilling to seek help for depression. We are very afraid of being seen as crazy.”

Many leading hospitals have created departments of “neuro-psychiatry” in hope that the public perceives treatment as a medical condition and not a public admission of “crazy.”

Attempts by the Ministry of Health and Welfare and suicide prevention to interview families of suicide victims has yielded little information. “When we go to the families and ask questions about why it happened, they say to us, ‘Do not kill him twice,’ ” Ha said. “We have tried to interview hundreds of families, but we have only been allowed to talk to a few of them. If one is dead from suicide, everything is a secret.”

Suicide is the leading cause of death among South Koreans in their 20s and 30s, and it is the fourth leading cause of death overall, after cancer, stroke and heart disease.

Incidents of suicide are increasing among the rural elderly that is probably driven from isolation, illness, and poverty. Police investigators say that the long hours young South Koreans spend online provides opportunity for young people to meet and plan group suicides, even if they live in different cities.

Finland was once seen as the suicide capital of the world and was the world’s first country to take a concerted approach for suicide prevention. The suicide rate in Finland rose continuously for 30 years since 1950 but a nationwide program between 1986 and 1996 reduced the rate from 30.3 per 100,000 people in 1990 to 20.4 by 2004. The Korean government is hoping to decrease the rate to below 20 per 100,000 people by 2013.

Korean celebrity suicides have caught the eye of the public and the news media is caught up in a flurry of chain reaction suicides among the famous.

Former President Roh Moo-hyun leaped to his death in May 2009. The former democracy activist whose term had ended in 2008 was said to be under intense pressure and allegations that he and his family had accepted $6 million in bribes when in office. After his death, Justice Minister Kim Kyung-han announced the investigation would end.

Roh Moo-hyn

Roh Moo-hyn

Roh faced police allegations regarding if him or his wife had taken money from a wealthy shoemaker. Roh said they took $1 million, which was to settle a debt and was not a bribe. He said he believed the $5 million given to a relative was a legitimate business investment.

The note of the suicide text, released by the Yonhap news agency, said: “The rest of my life would only be a burden for others. I can’t do anything because I’m not healthy. I can’t read books, nor can I write. Don’t be too sad. Isn’t life and death all part of nature? Don’t be sorry. Don’t blame anybody. It’s fate. Please cremate me. And please leave a small tombstone near home. I’ve long thought about that.”

The soap actor Choi Jin-young’s suicide generated front-page headlines, reminding the public of the suicide of his beloved sister, who killed herself after becoming distressed over Internet rumors that linked her to the suicide of another celebrity, comedian Ahn Jae-hwan.

No studies have found a statistically significant increase in suicide among the nation’s elite. However, the news’ fixation on the suicides worries Ha.

Government data show that suicides can trigger copycat behavior.

Choi Jin-sil’s death triggered a 70 percent increase in the suicide rate. It lasted for about a month, resulting in 700 more deaths during that time than would normally be expected.

“Famous suicides have a really bad influence,” Ha said.

Choi Jin-Sil, Actress

Choi Jin-Sil, the "nation's actress"

Suicide Prevention on Campus

“Our Campus Suicide Prevention grantees are generating critical new ideas for reaching students and helping them lead safe and healthy lives.”                           

  -Richard McKeon, Ph.D., Special Advisor for Suicide Prevention

Innovation in Gatekeeper Training

Avatar – the word is all over the media; but can technology help people learn how to identify someone in distress?

Wii Avatar

Wii Avatar

That’s the strategy Joy Himmel, Psy.D., Director of Health and Wellness at Penn State Altoona, is employing to train campus faculty, staff, and students to recognize when someone needs help.

In 2008, Penn State Altoona received a Campus Suicide Prevention Grant from SAMHSA and is using the funds to set up an innovative Web-based gatekeeper trainings for faculty and staff. Next on the list is reaching the 4,100 students who live on campus.

Dr. Himmel plans to use a gaming plan to reach them. Similar to the online world of Second Life and video game consoles like the Nintendo Wii, students will use an avatar. But they won’t be playing a game – they’ll be learning to communicate with at-risk students.

Using a product developed by Penn State University Park, Dr. Himmel adapted a faculty and staff gatekeeper training for the Altoona Campus; the product went live in fall 2009.

“Worrisome Student Behaviors: Minimizing Risk,” features three vignettes that focus on school violence, trouble between classmates, and a student’s erratic behavior, as well as commentary from Penn State counselors.  Faculty and staff can visit the Web site whenever it’s convenient for them – 24 hours per day. The program takes under an hour to complete.

Also included are links to campus-based resources as well as information on how to refer a student to the Health and Wellness Center. More than 100 people have taken the training since October 2009. “We’ve seen great success in terms of university involvement,” Dr. Himmel said.

Currently in development and set for launch in May 2010 is a pilot program that allows students to enter a virtual environment of peers via the technology of avatars.

Two out of five students in the virtual space are identified as having difficulties in academic progress, attitudes, or behavior. Users can communicate to these students and learn skills in identifying students at risk, approaching them, and referring them to resources. “It’s very interactive,” said Dr. Himmel. “If you ask one question, the student will give a certain answer, and then you have to decide how to respond.

If users chose an answer that may not be the best thing to say in a given situation,  the program will give cues for better options.

Students especially are familiar with these types of online environments, Dr. Himmel said. “And critical information is brought directly to them, eliminating the need to carve out several hours for in-person training. I think this kind of technology is where we need to be.”

Cultural Competency Matteres

When they applied for a SAMHSA Campus Suicide Prevention Grant for Tufts University, Michelle Bowdler, M.S.P.H., and Bonnie Lipton, M.P.H., already had cultural competency on their minds.

“As an institution, Tufts really values diversity,” said Ms. Bowdler, Senior Director of Health and Wellness Services. The university operate six culture centers: Asian American, LGBTQ, Latino, Women’s, Africana, and International.
Tufts University

Tufts University

“When we wrote the grant proposal, we informed the center directors about our plans for cultural competency focus groups,” said Ms. Lipton, Program Coordinator and Evaluator for Tufts Community Cares. “We asked them what mental health topic would resonate with their students.”

In spring 2009, Tufts held focus groups with each center, speaking to more than 50 students in total.

“We wanted to learn more about what mental health issues students are facing, how they cope, who they turn to for help, and what else the university can do to help,” Ms. Lipton said.

Focus group questions related to five different areas:

  1. Perceptions regarding student mental health problems on campus
  2. Attitudes about informal help-seeking
  3. Attitudes about counseling services
  4. Beliefs about helping peers
  5. Ideas for enhancing help-seeking behavior for mental health problems.

All six groups discussed how much stress students experience. “Tufts is a rigorous school, so the students are under a lot of academic stress,” Ms. Lipton said. “They also may feel they need to compete with their classmates.”

As a result of this feedback, Tufts Community Cares sponsored stress management sessions at the Africana Center during finals in fall 2009. More sessions are planned, focusing on ways students can take better care of themselves.

“The focus groups allowed us to talk to students about what their culture, race, ethnicity, or religion might lead them to think about mental health care. That information is helping us to create programs and products that will be effective for suicide prevention,” said Ms. Bowdler.

For example, the Latino Center will hold a discussion with first-generation students about their experiences. Planning is under way for discussions open to all first-generation students at Tufts.

In addition, some members of the Asian American focus group expressed concern about how positive and negative stereotypes affect them. A general presentation and another focusing on women’s mental health will be held in spring 2010.

The focus groups had another positive effect on the students. In their evaluations, many students indicated that the discussion helped make them more willing to talk to someone.

Ms. Bowdler feels that Tufts is on the right track. “The simple act of inquiring how to respond to the needs of a specific community helps people feel more comfortable asking for help.”