World’s Most Populous Nation Takes Steps to Stop Suicide

One day this month, three nurses will sit down at telephones in Beijing and do something that would have been unheard of in China just a decade ago: They’ll try to stop anyone who calls from committing suicide.

As 1.3 billion people cope with the most sweeping changes their nation has ever experienced, China’s first suicide research and prevention center is opening in the capital with a lengthy list of priorities -- everything from intervening in emergencies to changing outdated attitudes about mental health.

It’s a tall order for a populace accustomed to centuries of gritting their teeth through hard times and coping with “chiku” -- a traditional metaphor for enduring hardship that means, literally, “eating bitter.”

“The changing culture and society have given us an opening,” said Dr. Michael R. Phillips, executive director of the new Beijing Suicide Research and Prevention Center and a physician in China for 18 years.

“There’s such rapid social change that people are willing to think about things they haven’t thought about before,” he said.

The center employs 11 doctors and 13 nurses, most of them Chinese. It will offer a range of services, from the toll-free hot line, to counseling and crisis intervention, to comprehensive research -- already under way -- on suicide and attitudes toward it.

But doctors see an entirely non-clinical development as the most significant sign of changing attitudes: The center is at a public facility, Huilongguan Hospital, and is being funded quite willingly by Beijing’s city government.

“Suicide and depression, they’re definitely something that goes hand in hand with our fast development,” said Zhang Jianshu, an official at the Beijing Bureau of Health, which contributed $242,000. “As China develops, we have to pay more attention to this kind of health issue.”

Long before Deng Xiaoping’s reforms began two decades ago, suicide was a problem for China -- particularly among rural women plagued for generations by abuse, unrewarding lives and feelings of deep hopelessness.

These days, convulsive change is stirring things up even more. Financial upheaval -- a common contributor to suicide -- is rolling across the land as the opening of once-stable markets to foreign investment reconfigures the economy and puts millions out of work.

Although there is no standard reporting system for deaths in China, researchers using available figures extrapolate that 287,000 Chinese kill themselves each year, making suicide the No. 5 cause of death in the world’s most populous country. Some 2 million Chinese try to kill themselves annually.

Even more alarming to researchers: Suicide is the No. 1 cause of death for Chinese ages 15 to 34, and women have a 25% higher rate than men. In addition, rural suicide rates are three times as high as urban rates.

“Clearly, this is one of modern China’s most important issues,” said Dr. Liang Hong, the center’s clinical services director and head of the China end of the International Depression Project, a research consortium with fellow developing nations India and Colombia.

“Older people don’t know much about mental health. People in the countryside, they have no idea they can get help,” she said. “People in China don’t think this is something to see a doctor about.”

Although the center is new, its physicians have been doing research on suicide for years.

Their latest paper, on why and how Chinese kill themselves, was compiled from scores of interviews with suicide victims’ families and is being published in the British medical journal Lancet.

Beyond helping people directly, the center hopes to serve as a model -- first for Beijing’s 500 hospitals and eventually for the rest of the country.

It is surveying 50 top hospitals in the capital to determine how they can start anti-suicide programs and train doctors.

The most high-profile part of the center will undoubtedly be its hot line, advertised in newspapers, on television and over loudspeakers at major sporting events. Three celebrity spokespeople -- including Dashan, a Canadian comedian renowned in China -- will be endorsing it as well.

For a country that had no psychiatric hospital until 1898, it’s a major step -- and, if word does get out, a beacon of hope for millions of Beijing residents who never knew that they had anyone to turn to when times got tough.

“We’re just starting. Our knowledge will grow with each call,” said An Fengming, one of 20 mental-health staffers who will answer the hot line 24 hours a day. “I want to help people in their hearts.”