We have gone through some basic understanding of broad
suicide situations and risk factors, and compared between the West and Asia suicides,
we can now focus on issues specific to Hong Kong, and our target groups youths
and young adults. Hong Kong has
experienced a roller coaster cycle of suicides rates with a 50% increase from
12.5 per 100,000 in 1997 to a historical high of 18.6 in 2003, followed by a
23% decrease to 13.8 in 2009. The peak rate
from 1997 to 2003 can be attributed to the 1997 Asian financial crisis coupled
with the SARS disease outbreak in 2003.
What worth our attention is that youth
suicide is the leading cause of death among the 15-24-year-old age group. Figures showed that more teenagers attempted
suicide (completed and uncompleted) than other age groups. The suicide rate of male teenagers (15-24)
has experienced a 30% rise from 8.9 to 11.7 per 100,000 between 2008 and 2009. In addition, among school drop-outs, the
underemployed and unemployed, these young people are experiencing a 10 to
20-fold increase in suicide rate compared to those who are at school for the
same age group. Some of the common reported
probable risk factors include lack of problem-management skills, low
self-esteem, low need for achievement, depression, general anxiety, poor
help-seeking tendencies and withdrawal from life. I will discuss these in the later posts. For now, I would like to explore a basic
question, namely what are the attitudes of Hong Kong youths and young adults
towards suicide.
First and foremost, it is interesting to
note that there is no mastery theory that adequately explains how Chinese
people perceive suicide. Rather, suicide
might be endorsed and/or condemned by particular individuals under a variety of
life situations. Of special interest
here is the type of stressful life events perceived by Hong Kong Chinese that
may trigger them to consider suicide. I
have suggested in my earlier post that an underlying cause that explains the differences
of the nature in stressful life events between Asian and the West is the
Confucian notion of hierarchy and familial relationships. Lee, Tsang, Li, Phillips and Kleinman (2007)
reported that the top six difficult life scenarios that respondents might
consider suicide were: (i) “being terminally ill”, (ii) “having a chronic
psychiatric illness,” (iii) “being severely depressed”, (iv) “being a burden to
others and feeling hopeless about the future”, (v) “being heavily indebted
because of gambling” and (vi) “not having anyone to provide financial or
emotional support in old age.” In my
personal view, these six scenarios reflect a strong tendency of Hong Kong
Chinese not want to bring trouble or burden to their family members. This is consistent with the collectivist
Chinese culture in which people are more willing to consider others’ feelings
and avoid arousing negative emotions.
Nonetheless, there are four findings from
my readings about youths and young adults’ attitudes that caught my attention. First, “negative appraisal and fatalistic
view of suicide decreased with age.” (Lee et al., 2007, p.568). Second, findings from a cross-cultural study
between Chinese and Norwegian respondents reported that Chinese demonstrated
more agreement to “suicide happens without previous warnings” and less
agreement with “suicide can be prevented”.
Third, there are other studies that found “superstition was positively correlated
with anxiety level among adolescents” (Okebukola in Wong, 2012, p.58). Fourth, young people tend to have more fears
of deaths than older adults. How do I
make sense from these findings?
To me, I would interpret that since youths
have strong death anxiety and fear of death, coupled with the fact they do not
want to bring trouble or cause their family to lose face, they regard suicide
as a form of their fate / destiny. This
echoes with the frequent reports that the youths commit suicide because they feel
hopelessness. They do not see there is
an alternative since Chinese tend to disagree that “suicide can be prevented”,
this goes back to the fatalistic view.
Moreover, despite the high level of fear / anxiety of death, even in
Hong Kong, death is a taboo topic. Chinese
may be considered among one of the most superstitious nations in the
world. In Hong Kong, we have “Feng Shui”
and “Tong Sing” which lists a person’s luck in that year. It is a commonly held superstitious belief
that discussing death and dying will bring bad luck or consequences. This in turn supports the above-mentioned view
held by Chinese that “suicide happens without previous warnings” because
Chinese including youths, just do not talk about it. Choosing suicide as their ultimate solution also
coincides with the strong support of the Chinese to follow the terror
management theory (TMT). This theory suggests that culture is the
crucial factor in explaining and giving meaning to death. In the presence of terror, a Hong Kong
Chinese youth or young adult may well interpret the “misfortunes” of his/her
present life is due to the wrong deeds of their previous lives which they do
not have control. By ending their lives
may well benefit to their parents as a repent for their wrong deeds. As a result, following such cultural beliefs
help the youth / young adults legitimize their suicidal acts.
From the above analysis of the attitudes of
youths and young adults towards suicide, I am of the opinion that an effective
means of suicide prevention is to let them know there is hope. Encouragement and positive psychology I
believe can be one avenue to explore. I
would like to end this post by borrowing the words from a very touching video
from Nick Vujucic “Failure is not the end.
It matters how you finish. Are
you going to finish strong?” I am still very
touched and inspired every time I watch this video. I show this video in my class with
undergraduate students when we talk about courage. A few of them told me this video changed
their perspectives of how they see failure.
I hope you will spare two minutes to watch it.
References
Lee, S., Tsang, A., Li, X.Y., Phillips,
M.R. & Kleinman, A. (2007). Attitudes toward suicide among Chinese people
in Hong Kong. Suicide and
life-threatening behavior, 37(5), 565-575.
Wong, S.H. (2012) Does superstition
help? A study of the role of
superstitions and death beliefs on death anxiety amongst Chinese undergraduates
in Hong Kong. Journal of death &
dying, 65(1), 55-70.
Yip, P. & Chak, S. (2011) Suicide in
Hong Kong: epidemiology, changing patterns, associated phenomena and
prevention. Irish Psychiatrist, 12(1),
23-24.
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