Suicide is one leading cause of death for those aged 15 - 24 in Hong Kong. This age group also has the highest admission rate for attempted suicide at the Accident and Emergency Departments of the Hospital Authority. Reported prevalence rates for adolescent suicidal ideation in Hong Kong range from 20 - 42% (Chan, 1995; Fong, 1993; Stewart, Lam, Betson, 1999; Yip et al., 2004). Our latest findings from a representative sample of 715 respondents show that 28.1% of youth aged 15 - 19 have experienced life time suicidal ideation (CSRP, 2005). Hence, the problem of youth suicidality warrants attention.
Our Centre has been conducting research on suicide of secondary school students. Evidence based research indicated that suicide is caused by multiple interactions of many different suicidal risk factors. That is why we cannot say that a school or a particular academic environment directly leads to suicide. Since most adolescents attend secondary schools, this makes the school an appropriate venue to implement suicide prevention measures. The following are our suggestions to schools on ways to prevent student suicide or its contagious effect in case the tragedy has occurred:
- Design a comprehensive response plan to manage the consequences of suicide including counselling for family and friends of the student who committed suicide.
- Establish guidelines for teachers and parents on ways to identify, communicate, and make referrals for students who are emotionally distressed, thinking about suicide, and/or exhibiting self harm behaviours.
- Provide counselling to teachers who are dealing with suicides so as to support them in their endeavours. This also helps to build their confidence in dealing with the complex issue of suicide.
- Conduct extensive screening and assessment on the mental status of students. Early identification of students with emotional distress is crucial in providing them with the immediate interventions and help.
- Increase mentoring channels for students to encourage them to seek help.
Long Range Measures
- Strengthen studentsˇ¦ awareness and understanding of mental health by introducing school-based health programmes and initiatives. This includes promoting positive attitude towards life, increase self esteem, resilience, and confidence.
- Avoid activities or programmes that only address suicide awareness. There is a lack of evidence that school suicide awareness programmes are effective in reducing suicides. Experts in the area of suicide prevention are concerned that such programmes may mislead students to perceive suicide as a common response to adolescent stress.
- Avoid publicizing studentsˇ¦ suicide rates of particular schools. A research in Vienna showed a significant reduction in the number of suicides after the media improved the way they report suicide. Suicides occurred at the underground transit stations reduced by 80% in one year. The number of suicides was also kept at a low figure after such changes in media reporting.
- Training for teachers on knowledge and skills in dealing with student suicide.
- Provide training for mentors and/or "big brothers or sisters" so as to provide support to students via peer support groups. Examples of training include life skills training, and listening skills training.
- Collaborate with mental health professionals and establish closer contact with community agencies to promote students' mental health.
- Review existing related procedures in school and revise protocols.
- Enlist support from the school management and parents, and allocate the necessary resources.
- Evaluate the effectiveness of school programmes and efforts in reducing suicidal risks among students.
In order to tackle the complex issue of suicide, a collaborative approach is needed in the work of suicide prevention. Suicide prevention does not only concern teachers and social workers. School administrators and members of the School Board, parents, students themselves, mental professionals, researchers, media professionals, and government officials all play an important role in preventing suicide. The father of suicidology, Edwin Shneidman once said, Suicide prevention can be everybody's business.
- Chan, D. (1995). Reasons for living among Chinese adolescents in Hong Kong. Suicide and Life-threatening Behaviour, 25, 347 - 358.
- Fong, S.Y. (1993). A study on suicide ideation and attempted suicide in 316 secondary school students. Hong Kong Journal of Mental Health, 22, 43 - 49.
- Stewart, S. M., Lam, T. H., Betson, C., & Chung, S. F. (1999). Suicide ideation and its relationship to depressed mood in a community sample of adolescents in Hong Kong. Suicide and Life-threatening Behaviour, 29, 227 - 40.
- Yip, P. S. F., Liu, K. Y., Lam, T. H., Stewart, S. M., Chen, E., & Fan, S. (2004). Suicidality among high school students in Hong Kong, SAR. Suicide and Life-threatening Behaviour, 34, 284 - 97.