Suicide Prevention Strategies in response to economic Crisis: experiences from Hong Kong Paul Yip HKJC Centre for Suicide Research and Prevention The University of Hong Kong for the International meeting on Suicide Prevention in Taipei 13th May, 2010. - PowerPoint PPT Presentation

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Suicide Prevention Strategies in response to economic Crisis: experiences from Hong Kong Paul Yip HKJC Centre for Suicide Research and Prevention The University of Hong Kong for the International meeting on Suicide Prevention in Taipei 13th May, 2010.

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Title: Suicide Prevention Strategies in response to economic Crisis: experiences from Hong Kong Paul Yip HKJC Centre for Suicide Research and Prevention The University of Hong Kong for the International meeting on Suicide Prevention in Taipei 13th May, 2010.


1
Suicide Prevention Strategies in response to
economic Crisis experiences from Hong Kong
Paul Yip HKJC Centre for Suicide Research and
PreventionThe University of Hong Kongfor the
International meeting on Suicide Prevention in
Taipei13th May, 2010.
2
27 of decrease from 2003 to 2008(Hong Kong)
3
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4
Charcoal burning suicide
  • First case of charcoal-burning suicide in Hong
    Kong, 1998
  • Picture of the deceased and specific details of
    suicide method
  • 9 more cases in the following month
  • Charcoal-burning accounted for 24.8 of all the
    overall suicide cases.
  • Macau, Japan and Taiwan imitated the acts.

5
Suicide Deaths by Method (19972007)
1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007
Jumping 453 442 383 392 454 480 584 520 496 487 488
Hanging 240 287 231 232 219 255 246 220 215 203 206
CO poisoning (Charcoal) 1 16 145 176 253 276 321 228 213 165 143
Poisoning 46 56 53 49 38 42 51 31 30 30 31
Others 44 66 56 53 55 56 62 54 42 50 37
Overall 784 867 868 902 1019 1109 1264 1053 996 935 905
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7
Suicide rate Unemployment rate in HK (Male)
8
Suicide rate Unemployment rate in HK (Female)
9
Japan-Suicide rate and unemployment rate
suicide rate (per 100,000)
unemployment rate ()
1990
2000
1980
10
Suicide Rates in Japan, Taiwan, Hong Kong and
South Korea (1997-2007)
11
Proportion of Unemployment Rate in Youth (Age
15-29)
Source Census 1991, 2001 By-census 1996, 2006.
Census and Statistic Department
12
Deliberate self-harm in Hong Kong (2004-2008)
13
Economic statues vs Suicide rate
2003
No. of suicide No. of population Rate
Employed 349 3,042,500 11.5
Unemployed 355 249,300 142.4
Econ Inactive 111 942,000 11.8
815 4,233,800 19.2
No. of suicide No. of population Rate
Employed 225 3,236,300 7.0
Unemployed 304 154,900 196.3
Econ Inactive 65 994,500 6.5
594 4,385,700 13.5
2006
14
Suicidal risk in Hong Kong employed and
unemployed populations(vs. overall population)
Year 2002-2006
Relative Risk Relative Risk 2002 2003 2003 2004 2005 2006
(95 CI) (95 CI)
Employed population Employed population Employed population Employed population Employed population Employed population Employed population Employed population Employed population
Men Suicidal risk Suicidal risk 0.4 0.6 0.6 0.5 0.5 0.5
(0.4,0.5) (0.5,0.6) (0.5,0.6) (0.4,0.6) (0.5,0.6) (0.4,0.6)
Women Suicidal risk Suicidal risk 0.5 0.6 0.6 0.4 0.5 0.5
(0.4,0.6) (0.5,0.7) (0.5,0.7) (0.3,0.5) (0.4,0.6) (0.4,0.6)
Unemployed population Unemployed population Unemployed population Unemployed population Unemployed population Unemployed population Unemployed population Unemployed population Unemployed population
Men Suicidal risk Suicidal risk 6.4 5.8 5.8 6.2 7.5 10.4
(5.7,7.3) (5.1,6.5) (5.1,6.5) (5.4,7.2) (6.4,8.7) (9.0,12.0)
Women Suicidal risk Suicidal risk 6 8.6 8.6 10.9 13.8 21.0
(4.5,7.7) (7.0,10.6) (7.0,10.6) (8.9,13.3) (11.3,16.8) (17.3,25.2)
15
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16
Factors that differentiate the unemployed suicide
deaths and controls
Chan, W. S., Yip, P. S., Wong, P. W., Chen, E.
Y. (2007). Suicide and Unemployment What are the
Missing Links? Archives of Suicide Research, 11,
327-335
17
A series of lawsuits for suicide from over work
have been filed since 1990s.
18
Suicide rate among now-employed group
Type of occupation 1990-1994 1990-1994 1999-2003 1999-2003
suicide case (N) rate suicide case (N) rate
High M 55 2.31 278 8.48
F 23 2.25 109 6.13
Middle M 230 10.93 212 10.58
F 110 4.47 156 5.00
Low M 233 5.50 420 11.02
F 38 2.26 89 4.38
Working group M 518 5.94 910 10.00
F 153 2.97 354 5.11
Overall (15 59) M 1381 13.90 2432 21.80
F 900 9.57 1246 10.49

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Proportion of Unemployment Rate in Youth (Age
15-29)
Source Census 1991, 2001 By-census 1996, 2006.
Census and Statistic Department
21
Medical cost of deliberate self-harm
(Estimation average 3.1 days in 2008)
22
How many people in HK have thought about killing
themselves?
Suicidality Aged 15-59 (N 2,220) Aged 15-19 (N 715)
Life-time suicidal ideation 28.4 28.1
Past-year suicidal ideation 6.5 6.2
Had made a plan of attempting suicide 2.3 3.1
Had made past-year suicide attempt(s) 1.7 2.8
Had made a suicide attempt in the past year that required medical care 0.2 0.3
8.98 of the response suffers from serious
depression symptoms in general
23
Definition of Mental Health
  • The World Health Organization defines mental
    health as "a state of well-being in which the
    individual realizes his or her own abilities, can
    cope with the normal stresses of life, can work
    productively and fruitfully, and is able to make
    a contribution to his or her community.

24
Discussions
  • Employment is very important
  • Unemployed mind set change, social support
  • Employed mental health among workers are
    important
  • Our local unemployed individuals are not
    benefiting from the recovery of Hong Kong
    economy. Even worse, their risks for suicide are
    markedly increased.

25
A public health approach
  • Universal
  • To raise awareness about suicide prevention in
    the general population
  • Family and/or community support system are
    essential
  • Mass media contagious effect self fulfilling
    prophency To provide training for gate-keepers
    and develop effective intervention programs to
    facilitate early identification and efficacious
    treatment of suicidal behaviour
  • Restriction of means

26
  • Selective Some particular high risk groups,
    mental health patients, unemployed, persons on
    parole, family and social support
  • The use of the Geographical Information system to
    track down high risk districts and deploy
    appropriate resources to tackle the problem.
  • A community network is an effective one how to
    mobilize the resources within the district, The
    local council, police, hospital, NGOs and school
    to work together.
  • Indicative To improve service provision for
    people at high risk of suicide, suicide attempts
    and discharge mental patients.

27
STAY CONNECTED


28
Population Pyramid (2009)
Age Group
Age Group
85 80 - 84 75 - 79 70 - 74 65 - 69 60 - 64 55
- 59 50 - 54 45 - 49 40 - 44 35 - 39 30 - 34 25 -
29 20 - 24 15 - 19 10 - 14 5 - 9 0 - 4
85 80 - 84 75 - 79 70 - 74 65 - 69 60 - 64 55
- 59 50 - 54 45 - 49 40 - 44 35 - 39 30 - 34 25 -
29 20 - 24 15 - 19 10 - 14 5 - 9 0 - 4
? Male
? Female
400 300 200 100
0 100 200 300
400
Thousand persons
29
Number of elderly population in future
Year Aged 65 All population
1981 344 300 (6.6) (1 in 15 Persons) 5183 400
2008 890 800 (12.7) (1 in 8 persons) 7 008 900
2021 1 413 900 (18) (1 in 6 persons) 7 784 000
2036 2 261 000 (26) (1 in 4 persons) 8 570 200
30
Rapidly growing number of oldest-old in future
Year Aged 80 All population
1981 46 300 (0.9) (1 in 112 Persons) 5183 400
2008 238 400 (3.4) (1 in 29 persons) 7 008 900
2021 342 000 (4.4) (1 in 23 persons) 7 784 000
2036 667 000 (7.8) (1 in 13 persons) 8 570 200
31
Age Group
Age Group
85 80 - 84 75 - 79 70 - 74 65 - 69 60 - 64 55
- 59 50 - 54 45 - 49 40 - 44 35 - 39 30 - 34 25 -
29 20 - 24 15 - 19 10 - 14 5 - 9 0 - 4
85 80 - 84 75 - 79 70 - 74 65 - 69 60 - 64 55
- 59 50 - 54 45 - 49 40 - 44 35 - 39 30 - 34 25 -
29 20 - 24 15 - 19 10 - 14 5 - 9 0 - 4
? Male
? Female
400 300 200 100
0 100 200
300 400
Thousand persons
32
Demographic Window
Source Yip et al. (2010) Asian Population
Studies
33
More HK people dying at advance age
48 people survive to aged 80 in 1971 75 in
2006 and 83.4 by 2036
Hong Kong Life Table female, 1971, 2006, 2036
34
WARNING!!!!
35
Limiting access to charcoal a pilot programme
in Tuen Mun
  • Limiting access to charcoal by relocating the
    charcoal pack from over-the-counter to closed
    shelf
  • A joint project with 7 Eleven, Circle K, China
    Resource Vanguard, ParkNShop and Wellcome
  • Preliminary evidence showing its efficacy
  • Good reference to Taiwan and Japan where are
    suffering from suicides by charcoal burning

36
Training for Media ProfessionalsProf. Keith
Hawton (University of Oxford)
37
Recommendations on Suicide Reporting for Media
Professional
38
Care for Suicide Survivor Project
  • Tailored for the physical and psychological needs
    of people bereaved by suicide, and investigates
    the efficacy of follow-up services
  • Support services including information, immediate
    psychological assistance, and medium-term
    counseling help.

39
?????? (2008)
40
???????????? (2004-2008)
Elderly DSH in Kwsi Tsing, 2004-2008
41
Adolescent DSH in Kwsi Tsing, 2004-2008
???????????? (2004-2008)
42
3rd Asia Pacific Regional Conference
(International Association for Suicide Prevention)
43
Visit of Selina Tsang
44
Meeting with WHO
45
what does it mean?
46
Thats what the present government is trying to do
47
Public Health Approach on Suicide
of population
Critical suicidal risk
Public health approach
µ1
Suicidal risk
48
  • Not every suicide is preventable
  • We all certainly can make a difference!

49
????????????????
50
STAY CONNECTED


51
(No Transcript)
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