The phones keep ringing at the Samaritan Befrienders' Hong Kong office, but there aren't enough people to answer the calls. The volunteer counseling operation, located in a drab public-housing estate in the city's Choi Hung district, is doing its best to cope with a recent spike in calls to its suicide hotline, but organizers say they're being stretched thin. "Every call is important," says volunteer Fefe Tang. "But we have no way to handle all of them."
Between August 2008 and January this year, the hotline, one of three in Hong Kong, received 500 more calls than in the same period the previous year an increase of 7%. That may not sound like a lot, but a new study charting the vast increase in regional suicides during the Asian economic crisis in the late 1990s might portend a much deadlier rise in the current recession. "In the short run, the effect won't be obvious," says the office's director, Agnes Chiu. "But in the long run, the problems will be more apparent." (Read "Suicides: Watching for a Recession Spike.")
Statistics for 2008 suicides in Asia are not yet available, but in historical terms, rates in some countries are already high. In Japan, South Korea and Hong Kong in particular, soaring stress levels and a reluctance to seek mental-health treatment have already contributed to some of the developed world's highest suicide numbers: 23.7, 21.9 and 17.4 suicides per 100,000 people, respectively, compared to 11.0 and 6.7 per 100,000 in the U.S. and the U.K. "A lot of Asian people just work without any other things to make life more interesting; if they lose their jobs, it throws their life into total disarray," says Paul Yip, director of the Centre for Suicide Research and Prevention in Hong Kong. "If the financial crisis is going to have an impact on suicide rates, it'll be more serious in Asia."
In the year following the 1997 Asian currency crisis, suicide rates among men rose 45% in South Korea, 44% in Hong Kong and 39% in Japan, according to the first comprehensive study of the effect of the crisis on suicide, released last month by researchers in the U.K. and Taiwan. (The impact in Taiwan and Singapore was less marked, and figures for other countries affected by the downturn, such as Thailand and China, were incomplete or unavailable.) Altogether, the spikes in South Korea, Hong Kong and Japan represented 10,400 more suicides in 1998 than in 1997. While the increase was most closely related to rises in unemployment, a co-author of the study, Shu-Sen Chang, points out that other factors, such as mental illness and ready availability of lethal substances like pesticides, interact with economic causes to contribute to the majority of suicides in any country. "The reasons behind suicide are complex," says Chang, a psychiatrist at the University of Bristol. "So it's very difficult to predict what will happen."
Yet other global economic crises have had similar effects. In 1929, the year the Great Depression struck the U.S., the suicide rate was 14 suicides per 100,000 people. By 1932, however, when national unemployment surged to 25%, the figure had increased to 17.4 per 100,000 the highest it has ever reached. With unemployment in Asia rising, particularly in Hong Kong, where joblessness has already reached 5%, social and mental-health workers are on high alert.
There are ways to control the damage. After the Asian currency crisis and after a disturbing rise in Internet-organized group suicides in the late '90s Japan and South Korea developed national suicide-prevention strategies. When suicides peaked at 24.7 per 100,000 in 2005, the South Korean government mapped out a five-year plan to bring the rate down to 18 per 100,000. Two years later, Japan's Cabinet passed measures to reduce the number of suicides from a 2005 high of 24.2 per 100,000 or nearly 31,000 suicides that year to around 19 per 100,000 by 2016. The measures included more flexible work patterns, job creation, mental-health counseling and outreach programs. In the Seoul and Tokyo subway systems, where many suicides take place every year, protective barriers will be installed at all stations by 2010 and 2017, respectively, to prevent passengers from jumping onto the tracks. Seoul's stations even play "suicide-prevention music" to dissuade any commuters thinking of ending it all. The South Korean government has also shut down blogs, Internet chat groups and Web postings that encourage suicide.
In Hong Kong, progress has been slower. While there are charity-run suicide hotlines and publicly funded research is being conducted, the government has yet to legislate a comprehensive strategy. "Suicide prevention is so multidimensional," says researcher Yip. "You have to come up with a more holistic plan." Until then, social workers like Chiu and her team of volunteers will answer one call at a time, trying to make sure the current crisis doesn't have the same grim consequences as the last one.