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Tuesday, Nov. 20, 2007
SUICIDE IN JAPAN
World's suicide capital — tough image to shake
Japan has attained a reputation as the suicide capital of the world. A 2007 international comparison of suicide rates (per 100,000 people) by the World Health Organization ranked Japan sixth for females, at 12.8, behind Sri Lanka, South Korea and Lithuania, and 11th for males, at 35.6, well below Lithuania, Belarus and the Russian Federation. Although total suicides actually dropped slightly last year, entrenched cultural mores, the pressures inherent to a modern economy and alarming rates of youth depression are likely to continue driving tens of thousands of citizens to self-destruct every year.
Following are questions and answers about Japan's struggle with suicides:
How does Japan's suicide rate compare with other industrialized countries?
Among the Group of Eight countries, Japan ranks top in the female category and behind only the Russian Federation for males, according to suicide rates announced by the WHO. Suicide rates are calculated by the number of suicides divided by population multiplied by 100,000.
What are characteristics of suicides in Japan?
Japanese culture has a history of condoning and even glorifying suicide.
During the Edo Period (1603-1867), a samurai was often forced to atone for wrongdoing by slicing open his belly in the highly formalized ritual of seppuku, or harakiri.
After Japan's surrender in 1945, suicide became an act of contrition when many people committed seppuku in front of the Imperial Palace. In 1970, novelist Yukio Mishima committed seppuku amid great fanfare in a vain effort to spark a revival of nationalism. The act secured his legacy among many rightwingers.
Star-crossed lovers in kabuki plays often resolve their tribulations with double-suicides. So, too, did the middle-aged, 20th century husband and his beautiful mistress in the 1997 film "Shitsurakuen" ("Lost Paradise").
Demographically, how do Japan's suicides play out?
According to the National Police Agency, 32,155 people killed themselves in 2006, down 1.2 percent from the previous year.
Among key statistics: Seven out of 10 victims were men; people aged 60 or older accounted for a little more than a third, the largest portion; and people killing themselves were most likely to be unemployed, including retirees.
The most common methods were hanging or other forms of suffocation, poisonous gas or jumping from high places or in front of trains, according to the Health, Labor and Welfare Ministry.
While the suicide rate of 24.2 is slightly below the all-time peak of 25.7 in 1958, it has obstinately resisted significant decline.
Why is that?
People aged 19 and younger mainly kill themselves over health or school problems, people in their 40s due to economic woes, and seniors because of health problems, police statistics suggest.
But Yukio Saito, a veteran suicide-prevention counselor with Tokyo-based suicide hotline Federation of Inochi no Denwa, said the main immediate cause boils down to depression.
The 71-year-old retired Methodist minister cautions against viewing the problem in overly simplistic terms.
"One shouldn't make categories such as 'suicide from bullying' or 'suicide from corporate downsizing,' " he said. "In the background are depression or other mental illnesses . . . personal character and family relations."
The persistent stigma against sufferers of mental illness only makes matters worse, he said.
"So when people become mentally ill, they tell nobody and seek no help. Even their families don't acknowledge the problem. So sufferers just turn inward, sinking ever deeper," he said.
Since suicides dropped last year, does that mean things are getting better?
In some ways, yes. In 2000, the government set out to reduce the yearly suicide figure by a third by 2010. Two years later, a committee laid out proposals for suicide prevention, emphasizing preventive screening. It also created guidelines to help people spot depressed coworkers or neighbors.
Perhaps due to such efforts, suicides in 2006 fell dramatically among people aged 40 to 59 and among the general male population, compared with the previous year.
The bad news is 3.6 percent more women committed suicide, as did 3.4 percent more young males during the same period.
Suicide was in fact the largest cause of death that year among people aged 20 to 39, according to figures from the health ministry.
A study by Hokkaido University released earlier this year found that up to 4.2 percent of students between the fourth grade and the first year of junior high school struggle with either depression or manic-depression.
According to the study, Japan's first large-scale epidemiological research involving interviews, the rate reached 10.7 percent for first-year junior high students. Suicides among the 19-and-under set jumped 2.5 percent year-on-year to 623 last year. Still, they were well below the 720 in 1998, the highest level in the past decade.
As suicide-prevention counselor Saito noted, people kill themselves for a variety of reasons and the exact causes are tough to isolate. Indeed, the Hokkaido University study found no causal relationship between young depressed people's lifestyles and their mental conditions.
All the same, experts do point to eroding family ties and growing social competition as contributing factors and, in the case of youth suicides, to vicious bullying at school.
How can I tell if somebody close to me is at risk?
Experts say people who are highly conscientious and meticulous, who love to work and who are very sensitive to others' feelings are particularly vulnerable to depression, and thus are at higher risk of suicide.
Telltale symptoms are feelings of gloom, loss of interest in life, loss of appetite, difficulty sleeping, fatigue, strong feelings of guilt, difficulty concentrating and, naturally, thoughts of suicide.
Saito said that when offering support to people at risk, it is important to do so "unconditionally," without criticizing them for harboring negative thoughts.
"People in psychological crisis aren't receptive to other people's values. (And) their own value system isn't functioning," he said. "What's important, when depression is at the root . . . is to accept that person unconditionally" and help find them expert help.
What groups offer help?
One option is the Federation of Inochi no Denwa, at (03) 3263-6165. (Japanese only), www.find-j.jp/zenkoku.html for a list of call-in centers nationwide.
There is also the Tokyo English Life Line, offering free, anonymous phone counseling at (03) 5774-0992 daily from 9 a.m. to 11 p.m., or at www.telljp.com
TELL Community Counseling Service (TCCS) offers face-to-face counseling. Call (03) 3498-0231 (English) or (03) 3498-0232 (Japanese) for an appointment.