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Suicide: What puts people at risk and what are the warning signs?

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Suicide is often a convergence of factors leading to a sudden, tragic event. What puts children, as well as adults, at risk and what are the warning signs to watch for? Sam Agars reports.

Suicide is something that for many is hard to comprehend and for those not directly affected, much easier to ignore than confront. But a recent spate of suicides in young people has brought the issue to the forefront in Hong Kong and some in the know believe it is time something more was done to help those in need.

What makes someone, of any age, decide that death is preferable to life? For Sam Kwok of Fresh Fruit Juice Paradise, DB, who took his own life in March, the triggers were, of course, intensely personal. The tragedy was that a man so beloved by the community felt that he had nowhere to turn and no other option.

Triggers and warning signs

Despite being a leading cause of death worldwide, there is little hard evidence to explain why people become suicidal. Most people do so for complex reasons, and suffer from feelings of hopelessness and worthlessness. Factors that affect the risk of suicide include psychological states (depression), lifestyle (drug or alcohol misuse), employment (high levels of stress), relationships (feeling socially isolated) and genetics.

In many cases, a stressful event pushes a person ‘over the edge’. It may only take a minor event, such as having an argument with a partner, or the trigger may be a high-stress event, such as the break-up of a significant relationship, a partner dying, or being diagnosed with a terminal illness.

“Suicide is the most difficult bereavement crisis for family or friends to face and attempt to resolve in any effective manner,” notes DB counsellor Kerri Gunthorpe of Recreating Relationships. She is quick to point out that it can be difficult for friends and family to realise that a loved one is feeling suicidal. “Sometimes, but not always, the person who suicides may have provided some signs that they were suicidal but they are not always easy to interpret.”

Kerri goes on to list some warning signs to be aware of. “These include expression or feelings of isolation (‘No one understands me’). Feelings of worthlessness (‘I am so useless’). Engaging in risky behaviours (‘I’m happy to try that. I’m not afraid to die’). Feeling like they are a burden to others (‘My family would be better off without me’). Aggressive and irritable behaviour that is extreme and may have increased over time. Giving away clothing, expensive gifts, or pets for no apparent reason. A sense of hopelessness about the future.”

Spike in student suicides

According to the World Health Organisation, Hong Kong is below the world average for suicides per capita. In general, suicide rates have been dropping in the city over the past decade and have remained relatively steady for those aged 24 and below in that time. But 22 student suicides since the beginning of the 2015-16 academic year is a damning statistic and one that cannot be ignored.

While in Discovery Bay there has not been a recent student suicide and in general students here, who are predominantly expats, receive strong support networks at school, this is not the case in other parts of Hong Kong and at local schools. Six of the 22 students attended Chinese University, but the majority of the rest were students of local schools – the youngest of whom was just 11 years old.

The notion that students are facing too much pressure from schools and parents is, in a large number of youth suicides, the predominant factor. However, DB-based psychologist and life skills coach at Mind Matters Hong Kong, Dr Melanie Bryan stresses that a number of factors can drive young children to take their own life.

“There are undoubtedly many factors that can contribute to a teen’s impulsive suicide in addition to academic pressures,” she says. “These include being bullied in person and via social media, being rejected or dumped by a girl/ boyfriend, as well as being gay or transsexual and feeling like a pariah.”

Academic pressures

If one thing is for certain, it is that being a kid now is not like it was in the past. What is supposed to be a carefree, fun time in these children’s lives is in many cases the opposite, with expectation to perform academically heaped upon them at an incredibly young age.

“I think there’s too much emphasis on academia,” says Aileen Valentine, founder of Tung Chung-based, English-language training company Wise Choice Education. “From age six months, kids are put in to some kind of activity, playgroup, nursery, or kindergarten. Every parent wants their child to succeed, but at what cost. There are 22 families out there now without a child and it’s not going to stop there – not until everyone steps back, stops pushing and slows down. Kids need to actually have a life.”

Aileen believes that the added workload created by after-school activities can be too much for children to handle. She believes they often don’t have a choice in what they do and that years of constant pressure and study can wear a child down. “I’ve had phone calls from parents worrying their three-year-old daughter cannot put a full sentence together,” she says.

According to Melanie, part of the problem is that many people do not fully understand that children’s intellectual capabilities vary. “I’ve thought for a long time that people just assume their children will get straight A’s if they study from dawn to dawn,” she says. “But some kids are better with their hands, they are better in sport, they are better in subjects that may not advance them as much academically.”

Like Aileen, Melanie is not surprised by the large number of recent suicides and is convinced the hard-line approach of parents is a big contributing factor. “I work a lot with people who are local and have been educated overseas and I have found that giving positive reinforcement is not part of the culture,” she says. “They think that they’ll give their kids a swelled head, so there’s a real deficit, if you like, of kids feeling good about themselves. If their only reference is getting good grades and they don’t, then they feel like utter failures.”

Support networks in schools

While a lack of funding and the fact that some local schools have different priorities have been highlighted as reasons for the lack of support networks in some schools, that is certainly not the case in the international system and in Discovery Bay. Schools here put a premium on pastoral care and ensuring students are developing as people, as well as academically.

“Pastoral issues are as important, if not more important, than academic issues for us because we are dealing with children who are growing up with a unique set of pressures upon them in Hong Kong,” Discovery Bay International School (DBIS) head of school Paul Tough says.

Paul explains that DBIS has a full-time counsellor available to all its students and access to a support network of agencies they can draw upon for specialist advice and support. Teachers are also well-equipped to help students if the need arises. “We put a lot of effort into the professional development of their skills to handle certain crises, such as bereavement or issues to do with stress students might be facing,” Paul says. “Equally, the role of the class teacher in Primary and Early Years, and the form tutor in Secondary, is crucial in providing one-to-one support as and when needed.”

The volume of recent student suicides has prompted the Education Bureau to put measures in place to ensure basic needs, like counselling and trained staff, are available to children in all schools. The Chinese University has done the same, providing increased counselling options to its students.

But there are many out there that maintain that for a lot of students, the damage may already be done by the time they get to the counselling stage. “The education department, the universities, need to start scaling things back,” Aileen says. “I also think we, as adults, and (as a result) kids, need to take a step back from all the technology to allow for proper interaction – there’s far too much of a focus on gaming and social media.” Side Bar:

Seeking help

There are many legitimate websites or organisations to contact for support both if you are having suicidal thoughts, or if you are concerned your loved one, friend or colleague may be at risk. To improve your understanding, Black Dog Institute (www.blackdoginstitute.org.au) and Beyond Blue (www.beyondblue.org.au) are both excellent online resources.

“Talking to someone who you believe may be having suicidal thoughts can be challenging but if you are unsure or concerned, simply ask them,” Kerri advises. “Before doing so it is useful to have a plan. Having a strategy in place makes you better able to handle the situation should the answer be yes. Contacting support agencies to develop prior knowledge can be useful.”

Find it:

• Mind Matters Hong Kong, www.mindmatters.hk

• Recreating Relationships, hkmediation@icloud.com

• Wise Choice Education, www.wisechoiceeducation.info

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