Suicide in Asia
March 11, 2007 4:32 AM   Subscribe

In South Korea the suicide rate is increasing. In recent years, it has also seen spikes in certain demographics in China, Japan, and India
posted by Gnostic Novelist (25 comments total) 4 users marked this as a favorite

If they're going to make a significant dent in the populations of those countries, they will have to try much harder.

Ironically, with its very, very low birth rate, Japan is not supposed to be making dents in its population. They need every able-bodied worker they can get.
posted by flapjax at midnite at 5:59 AM on March 11, 2007

Oh, and South Korea, too... their birth rate is way low.
posted by flapjax at midnite at 6:00 AM on March 11, 2007

Also a big issue here in Japan is the stigma involved with seeking therapy or counseling. For many it seems easier to suicide than to go through finding services and the possible embarrassment if anyone found out.
posted by gomichild at 6:02 AM on March 11, 2007

China is also one of the few countries in the world where more women kill themselves than men. This article considers some of the reasons why, and discusses suicide here in general.
posted by Abiezer at 6:15 AM on March 11, 2007 [1 favorite]

The overwhelming need to save face in many asian cultures seems to make life so much more complicated and unbearable in some ways. It seems like such an intense added pressure & some people really can't cope with it. It's better to die than lose face.

What struck me that I didn't expect was how many of the suicides were beautiful girls in their 20s. In their photos they just looked so sweet, and then I'd read the obituary about how their grandmother found them with slit wrists, hanging dead in a closet with a waistband around their neck or something. Very sad.
posted by miss lynnster at 7:13 AM on March 11, 2007

(Abiezer: The Last Psychiatrist made an interesting point about a study on suicide among the elderly. We tend to assume the elderly have a high suicide rate because they have reasons to want to die — but in reality, he points out, they might just have a higher success rate due to weak organs and poor healing. Sounds similar to what's going on in your second article, where the high "suicide rate" is described in part as a high success rate for attempts that wouldn't have succeeded elsewhere.

'Course, neither article claims the high success rate is the whole story, and I don't think it is either. I'm sure there must be plenty of unaddressed emotional problems among the elderly — and among rural Chinese women, by the sound of it.)
posted by nebulawindphone at 7:23 AM on March 11, 2007

Saving face has nothing to do with it.

I can't speak for China or S. Korea, but suicide is prevalent in Japan not for reasons of honor but because it is an acceptable thing to do. It's a cool way to make a statement. Unfortunately, people forget they won't be around to see people's reactions to their statement.

As well, I also question the grouping of South Korea, Japan, India and China together in this post. Finland's suicide rate (for men) is about the same as Japan's, according to the WHO (31 per 100K Finland males kill themselves). Do Fins also wish to save face?
posted by KokuRyu at 7:37 AM on March 11, 2007 [2 favorites]

That chimes with what I recall about the debate nebulawindphone. I'm anything but an expert on the issues, but basically it seems a lot of rural women have easy access to pesticides and are a long way from anything like medical care. I understand that tragically many may drink agrochemicals as a "cry for help", not really intending to die, but succumb to massive internal organ damage.
I was actually visiting a remote village as part of a project when an incident like this occurred once. Fortunately we had come by jeep; even then it took an hour to get the woman to the clinic in the county town. Without our fortuitous presence it may have been hours before she could have had even the dubious care of a county level hospital.
posted by Abiezer at 7:43 AM on March 11, 2007

China is also one of the few countries in the world where more women kill themselves than men.

In Canada, I believe that more women attempt suicide than men, but more men suceed. In Ontario - "Men commit suicide at a rate four times higher than that of women...[but women] make 3 to 4 times more suicide attempts than men do, and women are hospitalized in general hospitals for attempted suicide at 1.5 times the rate of men." In Quebec - "when women attempt suicide they often fail; men, who tend to use firearms rather than pills, tend to be successful in their suicide bids".

So the gender differences in China may be due to the choices of methods and availability of poisonous chemicals like pesticides.
posted by jb at 7:57 AM on March 11, 2007

And, as you point out, the difficulty of getting tratment quickly.
posted by jb at 7:58 AM on March 11, 2007

Poignant topic to think about.

Death by drinking a lethal dose of pesticide. ack. That seems the most common not only in China but South India too. Sri Lanka's most common poisoning, yellow oleander overdose.

"South Korea hopes it can follow the example of Finland - which cut suicides by a third in just over a decade."
posted by nickyskye at 8:34 AM on March 11, 2007

Abiezer : China is also one of the few countries in the world where more women kill themselves than men. This article considers some of the reasons why, and discusses suicide here in general.

From the South India link : The study conducted by the Vellore-based Christian Medical College on teenagers in Tamil Nadu, especially in the Vellore region, found that the average suicide rate for women is as high as 148 per 100,000, and 58 per 100,000 for men.

I wonder if this points to any similarities between the Chinese and South Indian cultures.
posted by Afroblanco at 8:46 AM on March 11, 2007

I remember at the time of the death of Korean actress Lee Eun-ju (she was just 24) and that there was a lot of blame put towards the stigma against seeking psychological therapy in Korea.
posted by bobo123 at 9:50 AM on March 11, 2007

Saving face has nothing to do with it.

Speaking from personal experience it does have something to do with it.
posted by gomichild at 10:23 AM on March 11, 2007

I think it does too. Especially if people are desperately unhappy & depressed but cannot seek help without feeling shame.

Many asian cultures are also not as based on individual needs as ours is. Decisions and behavior are often based upon what will be considered acceptable by society. From my experience, you do not want to shame your family & asking for help or admitting when you are wrong (as well as other things) may cause the loss of face & show weakness or selfishness. It's so very very ingrained in some cultures that it constantly can appear even in the most subtle of ways. My observations, YMMV.
posted by miss lynnster at 11:33 AM on March 11, 2007

Whether or not saving face has to do with it is sort of beside the point, I think. Suicide is highly personal, wouldn't you say?

apparently (this is how I read the article) it's a failure of S Koreas to adopt a Western attitude towards work -- cynicism? A deep-seated sense of defeat, accepting the fact that no matter how hard you work, it amounts to nothing? all-consuming materialism?

now I don't want to go to work tomorrow.

here's what I'm wondering: if S Koreans are committing suicide because they can't provide for their kids, why are students and young girls killing themselves? Who are they providing for?

also: is therapy the solution? Psychology is a western science, maybe it's not the fault of Asians who are incapable of accepting psychology, but that psychology has not considered the Asian psyche.

just sayin'
posted by kitalea at 12:22 PM on March 11, 2007

People are just people - and most of us feel better being able to talk about our problems.

Suicide is of course a personal thing - but it's an issue discussed a lot here because on average 30,000 people a year do it.

While it is also true that suicide does not have the same history in regards to being verboten in many Asian countries as it does in Western - and in fact was considered an appropriate "out" in Japan for failure in the past (which has now been replaced by having a good cry on TV) - it is true that help is not as accessible as perhaps it should be.

The media are currently focusing a lot on how this relates to school kids suiciding from being bullied at school. There aren't any solutions for why - or options on how these kids can get counseling.

It's not to do with whether Asians are incapable of accepting Western psychology - but more to do with what services are available, how easy they are to access, and how the person feels about opening themselves up to asking for help. And what they think the consequences of seeking this help will have on their family and friends - and those outside of this group.

As an aside things are changing here in some respects - not to suicide but on handling the hikkikomori - the people who hide themselves away. Several programs have started up on tackling this issue and it's being more reported about.
posted by gomichild at 12:46 PM on March 11, 2007

But you're arguing against yourself. The reason it happens to students and young adults is the same reason is happens to older people. It's not that Asians have different minds. gomichild is right. People are people. The problem is that these societies put enormous pressure on you to succeed, to be good, and above all to fit in. He notes that a large problem is that services are not available to people in need. I think this is a double-ended problem: the authorities won't provide them, and people have enormous pressure on them not to go. Imagine if you feel like a failure and are depressed, but can't do or say anything about it because trying to get help would just make everyone else think you're a failure too. How would you feel?
posted by Sangermaine at 2:11 PM on March 11, 2007

This OhMyNews piece has a more complete take on it.

For my part, although I agree that mental health services are effectively non-existent, which certainly exacerbates the problem, I think the underlying issue is fundamental unresolved tensions at the core of Korean society that have come as a result of the rapid changes in the past couple of decades and the uneven collision of 'traditional' and more western values. These conflicts manifest themselves in a lot of unhappiness, individually and collectively. Freedom and duty, confucian hierarchy and western egalitarianism, collective and individualist attitudes towards society, insularity and globalization, shame and the catharsis of 'truth and reconciliation', education and the meaning of success, wealth and poverty, and a whole lot more.

Maybe I'll write a longer thing about this for one of my sites. If so, I'll link it here.
posted by stavrosthewonderchicken at 5:28 PM on March 11, 2007

One thing worth observing is that suicide rates are natoriously difficult to really pin down. In cultures where suicide is widely viewed as sinful suicides are often classified as accidental death, or even "natural causes" simply to spare the family the possible societal disapproval.

Religion also plays a factor, if a suicide won't get the same religious services, or possibly even be barred from burrial in the family plot, there is also a large incentive to misreport suicide.

According to the WHO's figures, none of the East Asian nations are in the top 10 highest suicide rate nations [1] for males. Japan is number 11 for men, Korea is in 38th place, and is 49th.

Female suicide is higher in those nations apparently, China is in 3rd place, Japan in 4th place. But female suicide is lower per thousand in almost all nations which brings up questions of whether women really do kill themselves less frequently or if, for whatever reason, female suicide is more frequently misreported than male suicide.

My point is simply that I'd bet that differences in *reporting* are greater than differences in actual suicide rate. Iran, for example claims a suicide rate of 0.3 per thousand (male) and 0.1 per thousand (female). There's a few nations which claim to have no suicides at all (Jordan, the Dominican Republic, Honduras, etc). Significantly the nations with high reported suicide rates are also the nations which tend to have a relatively low number of people who strongly identify with religions that prohibit suicide and vice versa.

The increasing suicide rate seen in the East Asian nations could be a genuinely growing number of suicides, or it could be the suicide rate remaining rougly the same while accurate reporting increases. Since there isn't as much stigma attached to suicide in those nations as there is in other nations it could very well be that the suicide rate is genuinely increasing, but I'm still somewhat doubtful.

[1] Source: WHO. Also, for those who don't feel like copying and pasting to a spreadsheet, the top ten nations for suicide are: lithuania, russian federation, belarus, latvia, ukraine, slovenia, hungary, kazakhstan, estonia, sri lanka.
posted by sotonohito at 7:31 PM on March 11, 2007

Sorry, forgot to add. The simple fact that reported male suicide is higher in various European nations than it is in some European nations would tend to argue against the idea that "oriental" notions of face and honor are responsible for the suicide rates in those nations.
posted by sotonohito at 7:35 PM on March 11, 2007

Korea's overall rate of increase is what is worrisome to some people: from 4rth in the OECD in 2002 to first more recently.

Japan is number 11 for men, Korea is in 38th place, and is 49th.

Interesting. The researcher quoted in that second link claims that the majority of suicides are men, which surprises me, if true. I would also be interested in numbers for young people, which I suspect (but with less certainty that I had before) are higher in Korea than other OECD countries, if not globally.
posted by stavrosthewonderchicken at 7:47 PM on March 11, 2007

Male suicide might just be higher in European countries for the same reason it is higher in North America - a preference for methods like firearms which are more deadly.

If we are talking about psychology, we should be talking about numbers of suicide attempts, not actual suicides, which only counts those with sucessful methods. It's very hard to track attempts, of course.
posted by jb at 9:26 PM on March 11, 2007

jb Yup, but for the same reason that even tracking actual suicides is neigh impossible, tracking suicide attempts is an even more daunting task. Since attempted suicide is a crime in most places (which still astonishes me) there is an even stronger desire to not report such things; in all likelihood all that winds up reported as attempted suicides are jumpers and other people who's sucide attempt cannot be misclassified.

starvosthewonderchicken I'd be interested in a breakdown by age as well, but the WHO doesn't seem to track info on a level that fine grained, and I'm too lazy to dig around and find out if there is a group that does.

Also, I'm relatively sure that the difference between actual suicides and reported suicides will probably vary widely depending on age, as well as economic factors, etc, even within a nation.

As for men having a higher suicide rate than women, that is what the statistics show. According to the WHO in Liithuania the suicide rate among men is 75.6 per thousand, while the highest suicide rate for women its 16.8 per thousand (Sri Lanka). You have to go down to 45th place to find a male suicide rate that is on par with the highest recorded female suicide rate.

Whether this actually indicates that men kill themselves more often than women, or that suicide in women is more likely to be misclassified than suicide in men is an interesting question. I recall reading somewhere that in the US the most common suicide method for men was firearms, while among women it is poison. If that's the case then in the absence of a note it might be more difficult to identify a female suicide as such even if there weren't a desire to misidentify.
posted by sotonohito at 5:01 AM on March 12, 2007

the Asian psyche

Yes, but not in the way you mean.

It has little to do with saving face, in my experience, because Korea is a culture where a housebound woman in her seventies can be hounded literally to death by loansharks trying to recover her son's debts.

It's not her psychological state that's somehow "Asian," it's the social arrangements and agreements that allowed people to put her in that state. I'd argue that this woman's sense of desperation, hopelessness and helplessness are pretty universal - and, in fact, pretty rational - responses to the conditions she experiences.

Although, I'll grant you, the debt-ridden son killing himself in shame upon discovering his mother's cooling body might have something to do with saving face.

I guess my point is that it's easy to try and imagine how things "must be" in different cultures, and make conjectures as to cause and effect, and much more difficult to allow people the full nuance of their humanity. A pat formulation like "saving face" may not technically be wrong, but simply uttering it and moving no further is to guarantee that you'll remain a million light years from the truth.

Speaking from personal experience, there is no troubled psyche so "Asian" that therapy with the right practitioner is inappropriate, however inarguably Western the ultimate provenance of the therapeutic idea. I have seen it save lives and - far more importantly - allow people to come to some kind of peace with their decisions, whatever those decisions ultimately might entail.
posted by adamgreenfield at 7:32 AM on March 12, 2007

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