Freakanomics on suicide

It was originally broadcast in late August, but I only just now got around to listening to the Freakanomics podcast on why people commit suicide, "The Suicide Paradox." The transcript can be found here.

Just about anyone reading my blog knows that South Korea has a terrible problem with suicide being in the stratosphere. They also know that this is an issue I take very seriously, as I consider us to be in the middle of a veritable epidemic, largely thanks to suicide being normative.

Interestingly, though, the Freakonomics podcast did not mention South Korea at all. Instead, when they wanted to highlight a high-suicide country, they chose Hungary, which had had the highest suicide rates in the world.

But the podcast is worth a listen even for insight into how suicide plays out in South Korea, for there are many parallels in terms of acceptance, the notion that committing suicide is brave or even noble, and the existence of the Werther Effect (i.e., suicide contagion, copycat suicides), which I feel helps to make suicide seem so normal in South Korea.

For other good posts on suicide, see Cory in Korea and the series by The Korean.

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Korea top in the OECD... for suicide... again

The Voice of America has an article highlighting the latest news reports in what has long been an infamous, chronic problem in South Korea: the terribly high suicide rate.

South Korea has the highest suicide rate among the countries of the Organization for Economic Cooperation and Development (OECD).

South Korean news reports say about 15,500 people in South Korea committed suicide in 2009. This represents about 28 deaths by suicide for every 100,000 people, or about 42 people on average daily.

The country's suicide rate is the highest among 34 OECD member countries.

The Yonhap news agency quotes a new report by the Ministry of Health and Welfare, which says that suicide is the number one cause of death for people aged between 10 and 40 years in the southeast Asian country.

It says the second most frequent cause of death for South Korean people in that age bracket is traffic accidents, followed by cancer.

Yonhap quotes a ministry official saying the government is planning to open prevention centers throughout South Korea to help lower the suicide rate.

It says a new legislation on suicide prevention passed the National Assembly in March.

I am curious about how the centers will work out, including whether they'll get enough funding from the government and acceptance by the public. Perhaps I should investigate when I'm in Korea next, but in the meantime, past thoughts of mine on the suicide epidemic can be found here (with more links here and here, with some overlap).

UPDATE:
Cory in Korea has a fairly thorough post on the issue, the kind of thing I'd write right now if I had a bit more time. As I suggested in my link about the suicide epidemic just above, as well as in comments on other blogs, one of the biggest problems to overcome is that suicide has come to be seen as normative and even noble. From a public health perspective, this is a disaster of despair.

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Another English teacher suicide in Pusan?

Stories of suicide sadden me and piss me off at the same time. When they come about, I have little desire to write about them, and fortunately I can point to previous posts and have you read those.

In the wake of another apparent suicide by an English teacher in Pusan, I will just point you toward the post I wrote last April when the same type of thing happened, and ask you to read the links within that post.

I'll also direct you toward a post in ROK Drop that highlights efforts by ATEK to get help for people who need it. Ignore comment #2; that guy can be a dipshit sometimes.

Suicide remains a permanent solution to a temporary problem. There are people out there to help you get through whatever is tormenting you.

Korean actress Park Hyesang commits suicide

The epidemic continues.

It's too depressingly frustrating to rehash my thoughts on the string of celebrity suicides and their normative effect on suicide in general in South Korea, so I'll just direct you here and here.

WaPo on South Korea's "sympathetic suicides"

Blaine Harden of the Washington Post has an article talking about the wave of suicides that have followed notable celebrity suicides in South Korea. He starts by talking about the severity of the problem:

And so it ends for 35 South Koreans a day. The suicide rate in this prosperous nation of about 50 million people has doubled in the past decade and is now the highest in the industrialized world.

The rate of suicide in most other wealthy countries peaked in the early 1980s, but the toll in South Korea continues to climb. Twenty-six people per 100,000 committed suicide in 2008 (the most recent year for which data are available). That's 2 1/2 times the rate in the United States and significantly higher than in nearby Japan, where suicide is deeply embedded in the culture.

Before South Korea got rich, wired and worried, its suicide rate was among the lowest in the industrialized world. But modernity has spawned inordinate levels of stress. People here work more, sleep less and spend more money per capita on cram schools than residents of the 29 other industrialized countries that belong to the Organization for Economic Cooperation and Development.

At the end of the article he notes the imitative trend:

No studies have found a statistically significant increase in suicide among the nation's elite. Still, noisy news coverage of these deaths has caught the public's imagination, and that worries Ha, the psychiatrist.

Government data show that suicides can trigger copycat behavior. Choi Jin-sil's death triggered a 70 percent increase in the suicide rate. It lasted for about a month, resulting in 700 more deaths during that time than would normally be expected.

"Famous suicides have a really bad influence," Ha said.

Indeed, this is the same "veritable epidemic" I wrote about when I referred to the dire situation of suicide seeming normative and therefore a viable or even desirable course of action:

I have never seen "Boys Over Flowers," but I have heard plenty about the so-called "ubiquidrama." My greater concern is that suicide among these performers ends up modeling "acceptable" behaviors for everyday people in South Korea, where suicide is already at astronomical rates.

In other words, these public suicides of well-known figures have the disturbing effect of making the killing of oneself seem favorable and normative. And for people already not thinking straight, normative and normal seem to overlap.

In all seriousness, the entertainment industry in Korea needs to face this problem head on. Set up a task force or something and make sure that all the people who go on stage are checked for psychological problems and have easy and non-judgmental access to mental health care.

That last part is the hard part. Even more so than in the West, there is a tremendous stigma associated with seeing a mental health professional. The solution itself may have to rely on media images to make this brave act itself normative: Perhaps get a celebrity who knows she/he needs help and do a reality program where she/he seeks and gets the help that is needed and comes out the other end much better.

This is a national tragedy that needs more attention paid to it. Now.

Sheesh. This is my second post on suicide today.

And now a mini-rant on suicide and Tokto

KoreaBeat has his hebdomadal list of Naver's most-read stories last week, including these two:

5. Three girls from the same high school committed suicide.

6. Seoul will soon hold a festival to celebrate the nation's love of Dokdo.

South Korea would be better with less of stories like #5 and #6.

Although I firmly believe Japan's 1905 terra nullius claim to the islands is a throwback to its illegitimate imperial expansionism and Korea is the rightful owners of the islands, I've been saying for years that the response must not be so shrill and overblown.

We've got 'em, we own 'em, end of story. That's the way it should be in terms of response. Really, if there is that much extra money floating around to have a festival over Tokto, maybe it should be funneled into suicide prevention and promotion of treatment for depression and anxiety. Hmm?

UPDATE:
I wonder if perhaps I relied a bit too much on the KoreaBeat's simple headline. Upon actually reading the link, it appears that the Tokto story is about the Seoul Metropolitan Government not allowing (or canceling) the use of Seoul Plaza for the Tokto-ya Sarang-hae ("Tokto, we love you!") Festival. In fact, the cartoon below seems to suggest that. Hmm...

In fact, this is suggested by the headline (‘독도야 사랑해’ 행사 서울광장서 하지 마!, or, 'Tokto-ya Sarang-hae' Sŏul Kwangjang-sŏ hajima!), which reads "Tokto-ya Sarang-hae event, don't use Seoul Plaza!"

If I am right (and I concede that I could be completely misinterpreting things in my groggy state on this blustery Sunday morning in Honolulu, then this is part of a growing trend of politicos growing a backbone on this issue, where they were once afraid to say anything that would give fuel to the pro-Pyongyang chinboistas or right-wing nationalists who would use their Tokto unorthodoxy as a club to beat them with later.

UPDATE 2:
KoreaBeat agreed with my point and changed the headline:

6. Seoul denied use of Seoul Plasa to a festival to celebrate the nation's love of Dokdo.

Kwangju student kills herself after "sexual harassment" during MT

Brian formerly in Chŏllanam-do reports on the suicide of a college student in Kwangju who became distraught after being "sexually harassed" during "MT" (i.e., membership training, a kind of retreat for people in the same major or club or other organization).

In the comments section I wrote that I hope more schools in Korea will take a cue from their American counterparts and use these deaths — and make no mistake, drinking deaths during various forms of hazing are an annual outcome in the US — to crack down on organizational binge drinking.

My assertion is that MTs and other drinking-oriented activities exist, in many circles, as a way for sŏnbae to force their hubae get shit-faced, done tacitly or explicitly with the intent of sexual harassment or worse. Forced binge-drinking is directly putting vulnerable people in harm's way.

While others make the valid point that there are other factors that contribute to such things, the binge drinking situation is a common circumstance in which things like this happen, without which they likely would not happen. These MT situations force people who do not drink, don't want to drink, can't handle themselves or others when they drink, etc., to be placed around people with poor judgement and sexist ulterior motives essentially without choice. They don't risk upsetting the punwigi (atmosphere), the kibun of their club members, and risk ostracism later on.

Schools should provide a way for anonymously offered complaints to be investigated, and if evidence is found of wrongdoing — things like forcing people to drink — then they should lose their funding and/or ability to meet on campus. This group-drink group-think is serious stuff, as I've written before:

A KoKo friend of mine worked as a CPA for a major American firm in Los Angeles that happened to hire a lot of Korean CPAs (those on H-1 visas supposedly worked harder and cheaper than people with green cards or citizenship). Every now and then they would go out drinking, and they would engage in the drink-until-you can't-see-straight behavior common in Korean colleges and corporations.

Well, one other woman began to pass out while they were all at a noraebang in L.A. Koreatown. My friend noticed what seemed like shallow breathing, but she wasn't sure. She asked some of her sŏnbae ('senior') if the passed-out hubae ('junior') seemed all right. She actually got barked at that she was ruining the punwigi (mood/atmosphere) of the party. After a couple minutes, still nagged by concern for the passed-out friend, she decided to call 911.

According to my accountant friend, the call saved the woman's life. She was rushed to a nearby hospital and her stomach was pumped. The E/R doctor told them that if they had waited another twenty minutes, the friend might have died of alcohol poisoning. Her blood alcohol level was stratospheric, having downed all these "one-shot" drinks, egged on (without any real choice without being ostracized) by her supposed friends.

I do contend that the problem is lessening to a significant degree. I've worked for several companies and attended one school where these things went from mandatory to optional, and in some cases (in some departments) disappeared altogether. But there's still a long way to go.

Requiescat in pace, Miss Chŏng.

English teacher in Pusan reportedly commits suicide

The Korea Times is reporting that a thirty-five-year-old teacher, identified only by his family name of Kim, is believed to have killed himself in the southeastern city of Pusan:

A Korean-Canadian, who worked in Busan as a native English teacher, was found dead in an apparent suicide, police said Thursday.

Police said the teacher identified by his surname Kim, was found hanging at home near Haeundae, a scenic beach in the nation's second largest city, at 5:20 p.m. Wednesday. The head of a private language institute where the 35-year-old Canadian worked first reported it to police.

He told them that he found the teacher hanging in the living room when he visited the apartment, as the teacher missed work and did not respond to repeated phone calls, Wednesday.

"We believe it's a suicide because no signs of foul play were found on the body," a detective familiar with the case said. "But we will continue to investigate to find the exact cause of death."

I have no idea who this person is, but these kinds of stories always just break my heart. Of course, in the general population of South Koreans, suicide is at epidemic levels, with the notion of killing oneself as a means to escape having reached the status of normative behavior, even to the point of being considered brave and courageous.

While there certainly are personal hazards in South Korea for anglophones and other international residents, including actual deaths due to fires, drownings, car accidents, and other situations, suicide among the expatriate population is not so commonly heard. The death in China of Shawn Matthews, a well-known blogger who had once lived and blogged in Korea, is a case that sticks out in my mind. There may be others and we just simply don't hear about them.

And this brings up that age-old question of what we anglophones in South Korea can do if we ourselves are feeling depressed, suicidal, or just simply emotionally distraught over our lives or some event, or if we know someone else who is feeling this way. Back in 2006, I wrote this comment about that very topic:

I think you may be right, but whether the number is higher, about the same, or even lower than with the same group “back home,” I think getting help is not just a matter of stigma, but also of access to someone here (in Korea; perhaps in China and Japan, too) who can properly diagnose you and then properly treat you.

Even if an international resident might be able to cut through the stigma that Korean-Koreans often can’t, the question is: who can you go to who will know that it’s bipolar disorder that you’ve got? Among the things possibly in play, there’s a language barrier, a cultural barrier, plus a knowledge barrier (frankly, since psychiatric doctors have so few cases to work with — particularly non-native Korean-speaking patients — they might not always see the signs).

I really didn’t read Shawn’s blog more than once or twice, so I don’t know if he sought treatment or not, but I know of people with serious problems who sought help and were eventually told, “Oh, this is just the stress of being in a new culture,” or “Give it time, and you’ll get over him/her.” Needless to say, it didn’t always help, and it certainly wasn’t what was needed.

A lot of people assume that with so many suicides in South Korea that there must not be a lot of mental health resources. In my opinion, the opposite is true: there are loads of resources but they are underutilized. This is something even psychiatrists themselves (people I meet in my own public health research) have told me.

Simply put, the stigma is just too great; ironically, that shame is greater than suicide itself in all too many cases. And that disgrace and dishonor extends not just to the individual, but to the family as well. A new national narrative must be put out there that most problems people face are actually quite manageable.

I'm not sure how much the stigma extends to those living in Korea who did not grow up here. Many Koreans from overseas, especially 1.5 and second generation kyopo, hold some of the same dysfunctional views on mental health stigma that their Korea-born and -raised counterparts do. Some non-Koreans living in Korea may also find themselves subject to the same social strictures that prevent the majority population from getting help.

But even if one were to overcome such stigma, where are the resources? In Seoul there used to be a counseling center associated with the Lutheran Church in Hannam-dong, but it was a bit costly. I imagine the various international clinics can put patients in touch with Korean psychologists and psychiatrists, but will the language barrier prove a barrier to treatment? Are there English-fluent mental health professionals and other counselors who can help out anglophones and other foreign residents?

I encourage my readers to share their ideas here. Maybe at some point we can make a FAQ, if one does not already exist. And for the love of God, if you are feeling any kind of depression or suicidal feelings, please talk to someone, even if it's not a mental health professional. The expat community is full of caring individuals who will bend over backward to help someone in need, and there is no shortage of Koreans who are also willing to do the same. And please, if you suspect a friend, colleague, or relative of having such dark thoughts, please go talk to them.

Requiescat in pace, Mr Kim. It's too late for you to seek help and I'm very sorry you felt you could not escape whatever demons you faced, but I hope at least your own death can provide a wake-up call to others.

UPDATE (February 23, 2011):
In the wake of another English teacher's apparent suicide in Pusan, ATEK is putting the word out about how to get help.

Another celebrity suicide

The epidemic continues: Actress Woo Seung-yeon (U Sŭng-yŏn; 우승연) apparently hanged herself. It is believed she committed suicide following depression after failing a number of auditions.

I have nothing to say I didn't already say in the first link. Always a waste, always a tragedy.