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Caring for Clients with Suicidal Tendency

Dear Doctor,

Suicide is not new to us. It is defined as an intentional and self-inflicted death. In Hong Kong, suicide is an important public health problem. It causes more deaths than road traffic accidents and homicide. Besides causing death, suicide also costs profoundly to society due to significant potential years of life lost and distress suffered by family members and friends of the deceased.

In 2000, the death rate due to suicide was 13.4 per 100 000 population. The death rate due to suicide increases significantly after 60 years of age. The trend has been comparable to those of other industrialized countries. Recently, suicide has become a much-discussed issue in Hong Kong as reflected by wide coverage in media. Although the increase in media reporting may not represent a true increase in suicide incidence, lack of solid evidence is definitely not a reason for not taking the right actions to prevent suicide, as one is already too many.

The causes of suicide

The causes of suicide are many and varied. Although some of the cases are related to mental illness such as depression, suicide is not necessarily a result of mental illness. The factors contributing to suicide can be summarized as follows:

a) mental or chronic illnesses,

b) depressed and negative attitude,

c) family disputes or events, such as loss of family members, marital disharmony and domestic violence,

d) poor interpersonal relationship, and

e) economic hardship.

Health care professionals play an important role in suicide prevention

Suicide is relevant to clinical practice regardless of its underlying causes. You, as a health care professional, can contribute a lot to suicide prevention by providing professional and continuous care to your clients. Moreover, study revealed that half of the elderly people committing suicide had presented themselves to doctors in the month before they killed themselves. Thus, you are in a very important position to help people out.

The following measures are very useful in preventing your clients from committing suicide:

a) have high index of suspicion about suicide among your clients,

b) provide care and support to clients in psychosocial distress and ensuring that his/her family members are aware of the problem,

c) give appropriate treatment and referral, and most importantly,

d) be confident in asking about suicide. Discussing with clients about suicide will often reduce their anxiety and thus provide relief to them.

Useful resources and information

You may like to visit the following websites for further information and educational materials:

a) Materials for health care professionals

Materials of the seminar on suicide prevention in elderly for health care staff in the Department of Health (powerpoint presentations and lecture notes in Chinese)

这连结会以新视窗打开。 http://www.cheu.gov.hk/b5/professional/index.htm 这连结会以新视窗打开。

World Health Organisation–Suicide Prevention Resource Series

这连结会以新视窗打开。 http://www.who.int/mental_health/resources/preventingsuicide/en/index.html 这连结会以新视窗打开。

National Institute of Mental Health, USA

这连结会以新视窗打开。 http://www.nimh.nih.gov/health/topics/suicide-prevention/index.shtml 这连结会以新视窗打开。

b) Materials for general public

Fact sheet for general public by the Central Health Education Unit, Department of Health

这连结会以新视窗打开。 http://www.cheu.gov.hk/b5/info/mental_06.htm 这连结会以新视窗打开。 (Chinese)

这连结会以新视窗打开。 http://www.cheu.gov.hk/eng/info/mental_06.htm 这连结会以新视窗打开。 (English)

Social Welfare Department

这连结会以新视窗打开。 http://www.info.gov.hk/swd 这连结会以新视窗打开。

Committee on Family Life Education Publicity Campaign

这连结会以新视窗打开。 http://www.family-land.org/centre/book.htm 这连结会以新视窗打开。

The Samaritans Befrienders HK

这连结会以新视窗打开。 http://www.sbhk.org.hk 这连结会以新视窗打开。

The telephone list in the Annex may also be useful to your clients.

Although it may not be realistic to aim at preventing all suicide, I am sure that your efforts in helping your clients do foster positive attitude towards life and contribute to the control of suicide in Hong Kong.

Yours faithfully,

(Dr Monica Wong)

for Director of Health

Annex

Useful telephone numbers for clients in distress (in Chinese)

热线名称	服务对象	服务时间	电话号码
社会福利热线电话 服务	公众人士	星期一至六(上午9:00-晚上10:00)，星期日及公众假期(下午1:00-晚上10:00)当值社工会亲自解答问题、提供辅导服务和处理及转介紧急个案，其余时段、则有留言服务，社工会于当值时间尽快与查询者联络。 查询者亦可全日24小时透过录音或传真获得所需福利服务资料。	2343 2255
明爱向晴热线	面对家庭危机/冲 突或情绪受困扰 的个人及家庭	24小时	18 288
香港撒玛利亚防止自杀会-求助热线	有自杀倾向及情 绪受困扰的人士	24小时	2389 2222
珍爱生命预防长者自杀热线	有自杀危机/情绪 困扰之长者	上午11:00至下午5:00	2382 0881
生命热线	有自杀倾向及情 绪受困扰的人士	24小时	2382 0000
香港青年协会 关心一线	受困扰的青少年	星期一至六 下午2:00至凌晨2:00	2777 8899
撒玛利亚会24小时多种语言热线	有自杀倾向及情 绪受困扰的人士	24小时	2896 0000
人间互助社联热线	公众人士	24小时电话录音系统/ 社会服务热线转驳系统	1878 668

Useful telephone numbers for clients in distress (in English)

Name of Hotline	Target	Service hours	Telephone number
Hotline Service of Social Welfare Department	General public	From 9:00 am to 10:00 pm Monday to Saturday, and from 1:00 pm to 10:00 pm on Sundays and Public Holidays, there are social workers on duty to answer enquiries or handle emergency cases. You can leave your message on the recording machine outside their duty hours for the social workers to call back. Comprehensive information on welfare services in the form of recorded voice message or facsimile transmission can be provided to the public on a 24-hour basis.	2343 2255
Family Crisis Support Centre	Individuals or families with family crisis, disputes or emotional disturbance	24 hours	18 288
The Samaritan Befrienders HK–helpline	People with suicidal tendency or emotional disturbance	24 hours	2389 2222
Hotline Service, Live Life - Joint Project on Prevention of Elderly Suicide	Elderly people in suicidal crisis or with emotional disturbance	11:00 am to 5:00 pm	2382 0881
Youthline, The Hong Kong Federation of Youth Groups	Young people in crisis	From Monday to Saturday, 2:00pm to 2:00 am	2777 8899
The Samaritans 24-hour hotline	People with suicidal tendency or emotional disturbance	24 hours	2896 0000
Mutual Aid Helpline, Hong Kong Council of Social Service	General public	24-hour recorded voice message/ call diverting function to other social service hotlines	1878 668

(Issued in 2002)