Macau Matters | The hidden tragedy of suicide

Richard Whitfield

I was recently reading that, in general, suicide rates are falling in most parts of the world. Reflecting on this issue, I feel that suicide in Macau may be significantly under or miss-reported. The only suicide I can remember in recent history was the very implausible case of a government employee who supposedly suffocated herself with a plastic bag while cutting her own throat. As I always tell students the first step in solving any problem is recognizing that a problem exists, and this begins with having reliable data. I suspect that a lot of medical and related data is missing or miss-reported in Macau and we need to do better if we want to improve our healthcare system.

Globally, suicide is a significant cause of death that wastes many otherwise productive lives and leaves  major family and personal trauma in its wake. Globally, around 10/100,000 people commit suicide each year, implying that there are around 1-2 suicides each week in Macau (among residents and tourists), which is many more than I have ever heard reported.

Suicide seems to be more prevalent among young adults and the elderly and while both genders think about it, men seem to be more successful at killing themselves. Globally, suicide has fallen 29% since 2000, most notably among three different groups. Because of urbanization and changing cultural and economic circumstances young women in China and India now seem to have other ways of avoiding or getting out of abusive marriages and other bad personal situations without resorting to suicide.

Greatly reduced alcoholism and more healthy lifestyles among middle-aged Russian men has also led to reduced suicide there. And finally, better economic circumstances and better government support services has significantly reduced suicide rates among the elderly in many places. The exception to the general decline in suicide is white/native, poorly educated, middle-aged men in America’s “rust belt”, where suicides have risen by about 18% since 2000.

Easy access to guns is often used to explain why suicide rates in America are relatively high. Studies show that in many cases suicide is an impulsive act that is successful if a means to end your life is readily accessible. And, contrary to popular belief, most people who fail at suicide do not later repeat the attempt.

One of the most effective means for governments to reduce suicide rates is to reduce access to strong pesticides, large quantities of lethal drugs, charcoal and guns. For example, South Korean researchers found that when paraquat (a strong pesticide) was banned there in 2011 it accounted for ½ the big fall in the suicide rate in the following 2 years. The EU has already banned this pesticide, and China is planning to ban it; I am not sure of its availability in Macau.

Newspapers and other media can also reduce suicide rates by voluntarily limiting their reporting to not go into details about how people have killed themselves. After it was reported that Robin Williams hanged himself in 2014 the subsequent rise in death by hanging among middle aged men in the following months was very noticeable. Similarly, when Ahn Jae-hwan (a Korean actor) killed himself with the details widely reported, 8% of Korean suicides in the following years used the same method (up from 1% before his death).

Support services – suicide hotlines, emergency funds, and low cost health, food and housing – are also crucial to reducing suicide rates.

I am sure that problem gamblers and others in Macau who have missed out on the economic growth here in the last several years often feel very stressed and think about suicide and they need and deserve our support to ensure that these thoughts do not turn into action. I suspect that we can and should be doing more but without reliable data I cannot be sure.