Opinion: How can Korea reduce suicide?

SEOUL - A national epidemic, suicide claims almost three times as many lives as road accidents each year. More than 15,500 people here took their own lives in 2010, making suicide the leading cause of death for those under 40 and fourth-leading cause of death overall.

But unlike many social ills in this ever-evolving society, most indications are that the problem is getting worse: 2010 marked the country's highest-ever suicide rate, with 33.5 suicides per 100,000 people.

The question of how to steer the nation off this dark path has yet again been thrust into the spotlight following the Jan. 6 suicide of Cho Sung-min, a former baseball player and the ex-husband of actress Choi Jin-sil, who herself died by suicide in 2008.

Addressing the ignorance and stigma around the issue would go some way toward finding an answer, according to mental health professionals.

"Most Koreans believe that, generally speaking, most suicides are not preventable," said Ha Kyoo-seob, a professor at the Department of Neuropsychiatry at National University Bundang Hospital and director of Seoul National Hospital.

"It is a mistaken belief of the general population. And as a result, most Koreans, and especially government officials, think that investment in suicide prevention might not be fruitful, so they are very hesitant to invest in suicide prevention. That is one of the greatest barriers."


While attributing causes to suicide is both difficult and risks oversimplification, mental illness is recognised as a major contributing factor. One analysis in Canada of 27 studies involving 3,275 people who had committed suicide found that 87 per cent had been diagnosed with a mental disorder before they died. In Korean society, however, depression and mental health generally are poorly understood, said Ha.

"Most Koreans are still very reluctant to speak about mental illness and to manage mental illness," he said.

"There is a very strong negative stigma toward mental illness and also a very strong negative stigma to suicide.

"Most Koreans are very reluctant to correlate depression and suicide. From their own experience, they say, 'yeah, I knew someone who committed suicide but he was not depressed at all. So you know that I cannot say that depression is closely related to suicide.'"

While the general public might not be expected to appreciate the subtleties of mental health, the country's mental health services also fall short of requirements, according to some health professionals.

Park Han-son, a psychiatrist at Saint Andrew's Neuropsychiatric Hospital in Icheon, Gyeonggi Province, said that much of the current focus was on treating the problem after it had come to the surface.

"The current mental health system is focused on post-hoc management of suicide attempters," said Park, who attributes the rapid rise in suicide in recent years to breakneck industrialization and the weakening of traditional mores. "For prevention of suicide, we need to establish comprehensive measures beyond the treatment of suicide attempters.

"We need to adopt a 'select and focus' strategy. Suicide prevalence is different from group to group. Firstly, previous suicide attempters and suicide survivors should be managed by mental health professionals. And also, we have to focus on the aged poor, the homeless, North Korean defectors and the 'hikikomori' (reclusive youth) in school."

Officialdom's recent efforts to stem the rising tide of avoidable deaths have shown little success. Whereas the government's suicide reeducation strategy for 2004-2010 had targeted a 20 per cent decline in the number of people taking their own lives, the suicide rate rose more than 30 per cent over the period. In 2011, the National Assembly passed a law providing government funding for counseling and other suicide reduction efforts, the effect of which is yet to be borne out by statistics.

Response so far

In a statement to The Korea Herald, the deputy head of mental health policy at the Ministry of Health and Welfare, Moon Sang-jun, said the ministry's current goal was for a 20 per cent reduction in the suicide rate.

"To prevent suicidal people from actually going through with suicide, the ministry is taking account of the visits of suicidal patients who visit the emergency room, and with the help of the local community, the ministry is supervising suicidal patients along with the family of the deceased," said Moon.

The ministry was also was taking specific measures to prevent suicide among seniors and teenagers, he said.

"To prevent the elderly from committing suicide, the ministry is going to coordinate solutions to the problem with mental health centers and the welfare organisations for the elderly to make an early diagnosis of the problem ... (and) will provide counseling and welfare services for the elderly," said Moon.

"To prevent students from suicide, the ministry is going to coordinate solutions to the problem with schools, mental health institutions, and adolescent suicide prevention programs."

Despite the bleak trend of the last decade and the ignorance he perceives around the subject, Ha is optimistic for the future. He noted that the government budget to tackle suicide had increased 10-fold in just the last three years to about $5 million.

"I can say that most of the officers of the Ministry of Health are now having a more scientific and realistic understanding of the problem of suicide and the relationship between mental disorders and suicide. But the officers of the other departments of the government and media still do not know," said Ha.


In contrast to times past, a positive consensus on how to deal with suicide and mental issues had emerged among professionals in the field, he added.

"There is a long debate on whether the suicide problem of Korean society is a personal problem or a social problem; it means whether it is a problem related to depression or psycho-social stress including economic problems. But, nowadays, we have some consensus and we have reached some agreement to focus the prevention of the high-risk group which (includes) suicide attempters, the aged who live alone, depressed patients who are not managed adequately, and suicide survivors."