TIME Asia | Suicidal Tendencies

CHINA: Almost unnoticed, the People's Republic has run up one of the highest suicide rates in the world	ASIA	January 26, 1998 VOL. 151 NO. 3
Suicidal Tendencies Researchers aren't sure why, but people in China have taken to killing themselves at an alarming rate By BRUCE W. NELAN he nurturing love suicide prevention Center was the first of its kind in China. Since opening its doors in the southern metropolis of Guangzhou almost 10 years ago, the center and its founder, Chen Yunqing, have been credited with saving several hundred people who otherwise would have killed themselves. Inevitably there have been some tragic failures as well, and among them was Chen. He hanged himself last September at the age of 53, leaving no suicide note. His puzzling death set off an intense round of debate and public introspection. Why would a successful man like Chen do such a thing? The Beijing Youth Daily concluded that he must have been depressed, observing that "a suicide expert cannot resist depression any more than a heart specialist can resist heart problems." The paper went on to provide some startling estimates. Every day, it said, 560 Chinese end their own lives. "The number of suicides in China," the Youth Daily reported, "makes up a third of the world's total." Both the calculation and its publication are eye-popping‹and the real figures are probably higher. Suicide is still a politically sensitive topic in China, and it is often reported as accidental death. As a result, there are no reliable figures. But estimates and research results suggest that China has one of the world's highest suicide rates‹perhaps two or even three times the international average. Researchers are scrambling to find out why. A 1995 World Mental Health Report put the overall suicide rate in China at 17.1 per 100,000 people, among the highest in the world (Hungary ranked No. 1). Last year a study by the World Bank, the World Health Organization and Harvard University put the rate at 30.3 per 100,000, compared with 10.7 for the rest of the world. That study estimates that China, with 21.5% of the world's population, accounts for a staggering 43.6% of the 786,000 suicides worldwide. Allowing for some of those officially listed as accidents, the study suggests that more than 300,000 Chinese kill themselves every year. In any case, says Michael Phillips, a Canadian researcher at Beijing's Hui Long Guan Hospital, "We're talking about pretty darn big numbers. It's a huge health problem." Particularly for women. China is the only country in which more women than men kill themselves, and by a huge margin. About 21% of the world's females live in China, yet 55.8% of the women who commit suicide worldwide are Chinese. "That's a phenomenal statistic," says Phillips. Across the land, women have fewer opportunities and lower status than men, and that is particularly true in the countryside. "In some rural communities, there is a sense that suicide is almost a normal response to certain types of stress," says Phillips. A significant number of suicides among rural women, studies have found, are impulsive acts, often in reaction to family conflicts over money or infidelity. Xie Lihua, editor of Rural Women Knowing All, a monthly magazine that runs a column on suicide in the countryside, says that 60% or more of such cases seem to be related to family problems and the women's sense of being trapped in lives with little value except for childbearing. "They see no alternatives," she says. "They can't find solutions to their problems." Is that what accounts for the propensity of Chinese, male and female, to end their own lives? Phillips has been working for a year and a half with Yang Gonghuan of the Chinese Academy of Preventive Medicine in an effort to find out. One thing they have learned: elderly Chinese are committing suicide in increasing numbers. Those deaths seem related to a breakdown in the country's health-care system and the rising cost of medical treatment. Rather than burden their families with expenses and worry, the old folks decide to end it. The Chinese government is becoming increasingly open about the suicide problem but has not yet done much to solve it. The mental-health system is geared toward treating severe disorders like schizophrenia. Funds are short, so there is only limited research on the causes of suicide. Because of low salaries and high stress, few doctors choose to go into the mental-health field. That means severely depressed patients, especially those outside the big cities, often go without treatment. Yet such conditions prevail in developing countries that have far fewer suicides. China's high rate can't be fully explained by poverty, poor public health or the low status of women either, because many other parts of the world suffer from those problems too. Indeed, China has enjoyed high economic growth for years, and so far it has largely escaped the financial woes that have hit its Asian neighbors. Is the condition a cultural anomaly in China, which historians say has long had a relatively high suicide rate? "Maybe," says Phillips. He hopes he will find some answers as he and Yang expand their research effort from three localities to 21. Meanwhile, the World Bank predicts that suicides in China will reach 534,000 a year by 2020. Reported by Mia Turner/Beijing
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Researchers aren't sure why, but people in China have taken to killing themselves at an alarming rate

By BRUCE W. NELAN

he nurturing love suicide prevention Center was the first of its kind in China. Since opening its doors in the southern metropolis of Guangzhou almost 10 years ago, the center and its founder, Chen Yunqing, have been credited with saving several hundred people who otherwise would have killed themselves. Inevitably there have been some tragic failures as well, and among them was Chen. He hanged himself last September at the age of 53, leaving no suicide note. His puzzling death set off an intense round of debate and public introspection. Why would a successful man like Chen do such a thing? The Beijing Youth Daily concluded that he must have been depressed, observing that "a suicide expert cannot resist depression any more than a heart specialist can resist heart problems."

The paper went on to provide some startling estimates. Every day, it said, 560 Chinese end their own lives. "The number of suicides in China," the Youth Daily reported, "makes up a third of the world's total." Both the calculation and its publication are eye-popping‹and the real figures are probably higher. Suicide is still a politically sensitive topic in China, and it is often reported as accidental death. As a result, there are no reliable figures. But estimates and research results suggest that China has one of the world's highest suicide rates‹perhaps two or even three times the international average. Researchers are scrambling to find out why.

A 1995 World Mental Health Report put the overall suicide rate in China at 17.1 per 100,000 people, among the highest in the world (Hungary ranked No. 1). Last year a study by the World Bank, the World Health Organization and Harvard University put the rate at 30.3 per 100,000, compared with 10.7 for the rest of the world. That study estimates that China, with 21.5% of the world's population, accounts for a staggering 43.6% of the 786,000 suicides worldwide. Allowing for some of those officially listed as accidents, the study suggests that more than 300,000 Chinese kill themselves every year. In any case, says Michael Phillips, a Canadian researcher at Beijing's Hui Long Guan Hospital, "We're talking about pretty darn big numbers. It's a huge health problem."

Particularly for women. China is the only country in which more women than men kill themselves, and by a huge margin. About 21% of the world's females live in China, yet 55.8% of the women who commit suicide worldwide are Chinese. "That's a phenomenal statistic," says Phillips. Across the land, women have fewer opportunities and lower status than men, and that is particularly true in the countryside. "In some rural communities, there is a sense that suicide is almost a normal response to certain types of stress," says Phillips. A significant number of suicides among rural women, studies have found, are impulsive acts, often in reaction to family conflicts over money or infidelity. Xie Lihua, editor of Rural Women Knowing All, a monthly magazine that runs a column on suicide in the countryside, says that 60% or more of such cases seem to be related to family problems and the women's sense of being trapped in lives with little value except for childbearing. "They see no alternatives," she says. "They can't find solutions to their problems."

Is that what accounts for the propensity of Chinese, male and female, to end their own lives? Phillips has been working for a year and a half with Yang Gonghuan of the Chinese Academy of Preventive Medicine in an effort to find out. One thing they have learned: elderly Chinese are committing suicide in increasing numbers. Those deaths seem related to a breakdown in the country's health-care system and the rising cost of medical treatment. Rather than burden their families with expenses and worry, the old folks decide to end it.

The Chinese government is becoming increasingly open about the suicide problem but has not yet done much to solve it. The mental-health system is geared toward treating severe disorders like schizophrenia. Funds are short, so there is only limited research on the causes of suicide. Because of low salaries and high stress, few doctors choose to go into the mental-health field. That means severely depressed patients, especially those outside the big cities, often go without treatment.

Yet such conditions prevail in developing countries that have far fewer suicides. China's high rate can't be fully explained by poverty, poor public health or the low status of women either, because many other parts of the world suffer from those problems too. Indeed, China has enjoyed high economic growth for years, and so far it has largely escaped the financial woes that have hit its Asian neighbors. Is the condition a cultural anomaly in China, which historians say has long had a relatively high suicide rate? "Maybe," says Phillips. He hopes he will find some answers as he and Yang expand their research effort from three localities to 21. Meanwhile, the World Bank predicts that suicides in China will reach 534,000 a year by 2020.

Reported by Mia Turner/Beijing