27% of decrease from 2003 to 2008 (Hong Kong)

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)

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 (1997–2007)

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 (%) 1980 1990 2000

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 2006

14. Suicidal risk in Hong Kong employed and unemployed populations（vs. overall population）　Year 2002-2006

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 1990’s.

18. Suicide rate among now-employed group

20. 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? *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 男 Male 女 Female 400 300 200 100 0100200300 400 Thousand persons

29. Number of elderly population in future

30. Rapidly growing number of oldest-old in future

31. 1988 1998 2008 2021 1978 2036 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 男 Male 女 Female 400 300 200 100 0100200300 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. 標準差的分佈(2008)

40. 葵青區老人自我傷害的分佈 (2004-2008) Elderly DSH in Kwsi Tsing, 2004-2008

41. 葵青區少年自我傷害的分佈 (2004-2008) Adolescent DSH in Kwsi Tsing, 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. That’s what the present government is trying to do

47. Public Health Approach on Suicide Reduction in number of suicides μ2 % 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. 社區在防止自殺工作中扮演重要角色

50. STAY CONNECTED