Suicide is murder by society

Korea needs to break social taboo of not visiting psychiatrists

South Korea's suicide rate remains the highest among OECD members despite the government's efforts to counter it. Dozens of people take their own lives every day, leaving those left behind to suffer the loss and severe depression. The following is the last in a three-part series on suicide. - ED.

By Kim Tae-jong

Is suicide preventable? The answer to this question from most people might be negative, given a steady rise in suicides here despite various countermeasures by the government. They believe suicide is not something that can be prevented as it is a matter of individuals with different personal problems.

However, experts say suicide is preventable using more systematic approaches.

"I believe it is preventable", Dr. Tadashi Takeshima, director of the state-run Center for Suicide Prevention in Japan, said in an email interview. "Most suicide cases involve unfortunate incidents triggered by various problems they have experienced. There are many intervention methods for tackling these risk factors, and by strengthening these methods, I think we can reduce the number of suicide deaths".

Like Korea, Japan also has one of the highest suicide rates in the world. To tackle the issue, Japan enacted the Basic Act on Suicide Countermeasures in 2006 as one of first steps and also has introduced various programs.

He said that major risk factors include personality characteristics, early traumatic life events, psychiatric disorders, physical disorders and psychosocial crises, and therefore it is essential to strengthen public enlightenment activities of the mental illnesses and the development of mental health care services.

He said protective factors such as mental health care and a social safety net should also be taken into account.

"When preventing suicides, we need to take into account not only risk factors but also protective factors which cushion risk factors", he said. "Both Korea and Japan are now experiencing rapid structural social changes like aging, and this might have undermined the protective factors and led to increases in the numbers of suicide deaths".

Stopping social taboo

One of the biggest obstacles to preventing suicides is the fear of visiting psychiatric institutes here, experts say.

With depression being one of the major causes of suicide, experts believe it is critical to properly take care of those with related symptoms, but the trouble is that people with depression are reluctant to seek help from professionals.

They shun getting proper help for psychiatric problems as it is considered a social taboo in Korea.

According to a survey by the Seoul Child & Adolescent Mental Health Center (SCAMHC), about 17 percent of 30,786 secondary school students in Seoul turned out to have symptoms of depression in a survey last year. Of them, 4.6 percent were in a serious stage, requiring medical treatment. But less than 0.5 percent of teenagers received medical treatment.

"It's not like going to see a pediatrician. It is taboo to visit psychiatric hospitals here. Teenagers also need approval from their parents to see a doctor for depression, but some parents forbid this for fear of stigmatization", said Park Yun-ok, an official from SCAMHC. "We need more practical and effective measures to help people with mental illness receive proper aid from experts".

Systematical approaches

To provide people in need with proper help, experts stress the importance of developing educational programs on suicide prevention for physicians and other health care providers.

That's because they are likely to meet people considering suicide or vulnerable to suicide attempts.

"A lot of people visit general practitioners or physicians before they commit suicide", said Lee Yu-jin, professor and psychiatrist at Gacheon University of Medicine and Science. "Many of them do not know they suffer from depression and merely complain about other symptoms such as headaches, muscle pain or insomnia. Even if they show various signs of committing suicide, they fail to receive proper help because physicians and other health care providers don't know what to do".

Citing recent research supported by the Seoul National Hospital, she said one third of surveyed physicians have experienced the loss of at least one of their patients to suicide.

She also mentioned that about 90 percent of people visit general practitioners or physicians within a year and over 70 percent within a month before they commit suicide. But less than 20 percent of general practitioners or physicians have received suicide prevention education.

"They receive very basic training and that's not enough. By having practical suicide prevention education for them, we can reduce the suicide rate by up to 22 percent annually", she said.

Social awareness

Experts also argue it is necessary to understand the high suicide rate in a broader context in order to come up with systematic solutions.

"You can't say suicide is simply a problem of each individual and society has nothing to do with it", said psychiatrist Park Jong-ik from Kangwon National University Hospital. "Because it is a social problem we need to solve it together, similar to the problem of the nation's low birthrate".

As the government aims to provide more benefits to parents and try to make society a better place for children in solving the low birthrate problem, people also need to work together to help those who consider suicide, he said.

The Law for Suicide Prevention was legislated last March and details of the law have been under preparation before the full implementation in March, 2012.

Park is one of the experts who are preparing for enforcement ordinances in the law, which will include limited access to suicide methods such as agricultural pesticides, more welfare programs and training for professional consultants.

"You need to teach people the value of life, create a better welfare policy to help the marginalized, and continue to hold various campaigns under a longer-term plan instead of announcing sporadic, makeshift plans whenever someone famous kill themselves, and media reports draw public attention", he said.

He also emphasized suicide can be seen as murder by society if it fails to address the issue properly.

"The lack of social safety net and polarization of the rich and poor, fast-aging society, high unemployment and fierce competition are reasons that push people to choose the extreme method. Therefore, it's our responsibility to solve these issues to prevent people from committing suicide. So, the law itself represented major progress and it's important that the country recognizes the suicide epidemic as a national crisis".

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