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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)

http://www.cheu.gov.hk/b5/professional/index.htm

World Health Organisation – Suicide Prevention Resource Series

http://www.who.int/mental_health/resources/preventingsuicide/en/index.html

National Institute of Mental Health, USA

http://www.nimh.nih.gov/health/topics/suicide-prevention/index.shtml

b) Materials for general public

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

http://www.cheu.gov.hk/b5/info/mental_06.htm (Chinese)

http://www.cheu.gov.hk/eng/info/mental_06.htm (English)

Social Welfare Department

http://www.info.gov.hk/swd

Committee on Family Life Education Publicity Campaign

http://www.family-land.org/centre/book.htm

The Samaritans Befrienders HK

http://www.sbhk.org.hk

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)

Useful telephone numbers for clients in distress (in English)

(Issued in 2002)

18 Dec 2015