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J Korean Med Assoc > Volume 62(2); 2019 > Article
Kim, Jhon, Kim, Paik, Kim, and Yoon: A social psychiatric approach to suicide prevention

Abstract

Suicide is the fifth-leading cause of death in Korea, accounting for 4.4% of all deaths. Therefore, suicide is a serious medical problem, as well as a social problem. In this paper, we provide a social psychiatric perspective on suicide and recommend suicide prevention strategies based on programs with roots in the Gwangju mental health pilot project and an analysis of suicide patterns in Seoul. First, early intervention and active case management are mandatory to prevent suicide among individuals with mental illnesses such as depression, schizophrenia, and alcohol use disorder. To this end, mental health and welfare centers, addiction management centers, suicide prevention centers, and care program after a suicide attempt in the emergency department of general hospitals should collaborate via a multidisciplinary approach. Second, crisis intervention should be provided in collaboration with the police, government officials, and mental health agencies to people who are at immediate risk of suicide. Additionally, case management services should be expanded for individuals who are treated at hospitals for psychiatric illness. Third, social welfare services should be offered to low-income individuals at risk of suicide. Fourth, the mass media should restrict reporting about suicide and follow the relevant reporting guidelines. Finally, access to methods of committing suicide, such as charcoal for burning and agrichemical poisoning, should be regulated by the government. Proactive psychosocial strategies implemented with government support will prevent suicide-related deaths and decrease the suicide rate in Korea.

References

1. Statistics Korea. 2017 Annual report on the cause of death statistics. Daejeon: Statistics Korea; 2018.

2. Ministry of Health and Welfare. 2016 The Survey of Mental Disorders in Korea. Sejong: Ministry of Health and Welfare; 2017.

3. Kessler RC, Berglund P, Borges G, Nock M, Wang PS. Trends in suicide ideation, plans, gestures, and attempts in the United States, 1990-1992 to 2001-2003. JAMA 2005;293:2487-2495.
crossref pmid
4. Korea Psychological Autopsy Center. Psychological autopsy analysis result 2015-2017 [Internet] Seoul: Korea Psycholo-gical Autopsy Center. 2017;cited 2018 Dec 14. Available from: http://www.psyauto.or.kr/sub/data_02.asp

5. Schaffer A, Sinyor M, Kurdyak P, Vigod S, Sareen J, Reis C, Green D, Bolton J, Rhodes A, Grigoriadis S, Cairney J, Cheung A. Population-based analysis of health care contacts among suicide decedents: identifying opportunities for more targeted suicide prevention strategies. World Psychiatry 2016;15:135-145.
crossref pmid pmc
6. Gusmao R, Quintao S, McDaid D, Arensman E, Van Auden-hove C, Coffey C, Varnik A, Varnik P, Coyne J, Hegerl U. Antidepressant utilization and suicide in Europe: an ecological multi-national study. PLoS One 2013;8:e66455.
crossref pmid pmc
7. Zalsman G, Hawton K, Wasserman D, van Heeringen K, Arensman E, Sarchiapone M, Carli V, Hoschl C, Barzilay R, Balazs J, Purebl G, Kahn JP, Saiz PA, Lipsicas CB, Bobes J, Cozman D, Hegerl U, Zohar J. Suicide prevention strategies revisited: 10-year systematic review. Lancet Psychiatry 2016;3:646-659.
crossref pmid
8. Kim H, Hong JE, Oh MJ, Lee JY, Kim JM, Shin IS, Yoon JS, Kim SW. Attitude towards psychiatric treatment and prejudice against psychiatric medications in general population. Korean J Schizophr Res 2018;21:51-58.
crossref pdf
9. Mann JJ, Apter A, Bertolote J, Beautrais A, Currier D, Haas A, Hegerl U, Lonnqvist J, Malone K, Marusic A, Mehlum L, Patton G, Phillips M, Rutz W, Rihmer Z, Schmidtke A, Shaffer D, Silverman M, Takahashi Y, Varnik A, Wasserman D, Yip P, Hendin H. Suicide prevention strategies: a systematic review. JAMA 2005;294:2064-2074.
crossref pmid
10. Paik JW, Jo SJ, Lee S, Ong JY, Park JI. The effect of Korean standardized suicide prevention program on intervention by gatekeepers. J Korean Neuropsychiatr Assoc 2014;53:358-363.
crossref
11. Choi YJ, Won MR. Effects of tailored case management using a gatekeeper for the depressed single-household elderly population: focusing on the mental health case management. J Korean Acad Community Health Nurs 2012;23:376-385.
crossref
12. Henriksson S, Isacsson G. Increased antidepressant use and fewer suicides in Jamtland county, Sweden, after a primary care educational programme on the treatment of depression. Acta Psychiatr Scand 2006;114:159-167.
crossref pmid
13. Szanto K, Kalmar S, Hendin H, Rihmer Z, Mann JJ. A suicide prevention program in a region with a very high suicide rate. Arch Gen Psychiatry 2007;64:914-920.
crossref pmid
14. Luoma JB, Martin CE, Pearson JL. Contact with mental health and primary care providers before suicide: a review of the evidence. Am J Psychiatry 2002;159:909-916.
crossref pmid pmc
15. Wasserman D, Hoven CW, Wasserman C, Wall M, Eisenberg R, Hadlaczky G, Kelleher I, Sarchiapone M, Apter A, Balazs J, Bobes J, Brunner R, Corcoran P, Cosman D, Guillemin F, Haring C, Iosue M, Kaess M, Kahn JP, Keeley H, Musa GJ, Nemes B, Postuvan V, Saiz P, Reiter-Theil S, Varnik A, Varnik P, Carli V. School-based suicide prevention programmes: the SEYLE cluster-randomised, controlled trial. Lancet 2015;385:1536-1544.
crossref pmid
16. Wasserman C, Postuvan V, Herta D, Iosue M, Varnik P, Carli V. Interactions between youth and mental health professionals: the Youth Aware of Mental Health (YAM) program experience. PLoS One 2018;13:e0191843.
crossref pmid pmc
17. Nah G, Choi S, Kim H, Lee JY, Kim JM, Shin IS, Yoon JS, Kim SW. Characteristics of patients who died by suicide in a community mental health center. Korean J Schizophr Res 2017;20:55-60.
crossref pdf
18. Korean Statistical Information Service. Korea health statistics: cause of death [Internet] Statistics Korea. cited 2018 Dec 14. Available from: http://kosis.kr/statisticsList/statisticsListIndex.do?menuId=M_01_01&vwcd=MT_ZTITLE&parmTabId=M_01_01#SelectStatsBoxDiv

19. Ministry of Health and Welfare. Registered disabled persons [Internet] Sejong: Ministry of Health and Welfare. 2017;cited 2018 Dec 14. Available from: http://www.mohw.go.kr/react/policy/policy_bd_vw.jsp?PAR_MENU_ID=06&MENU_ID=06370501&CONT_SEQ=344588&page=1

20. Jhon M, Lee JY, Hong JE, Yoo T, Kim SY, Kim JM, Shin IS, Yoon JS, Kim SW. Addictive behavior and personality among workers with hazardous alcohol drinking. J Korean Neuropsychiatr Assoc 2017;56:175-180.
crossref pdf
21. Nakaya N, Kikuchi N, Shimazu T, Ohmori K, Kakizaki M, Sone T, Awata S, Kuriyama S, Tsuji I. Alcohol consumption and suicide mortality among Japanese men: the Ohsaki study. Alcohol 2007;41:503-510.
crossref pmid
22. Darvishi N, Farhadi M, Haghtalab T, Poorolajal J. Alcohol-related risk of suicidal ideation, suicide attempt, and completed suicide: a meta-analysis. PLoS One 2015;10:e0126870.
crossref pmid pmc
23. Kim SW, Kim JM, Shin IS, Yoon JS. Suicide and crisis intervention. J Korean Med Assoc 2012;55:341-348.
crossref
24. Korean Statistical Information Service. Korea health statistics: community health survey: health behavior [Internet] Daejeon: Statistics Korea. cited 2018 Dec 14. Available from: http://kosis.kr/statisticsList/statisticsListIndex.do?menuId=M_01_01&vwcd=MT_ZTITLE&parmTabId=M_01_01#SelectStatsBoxDiv

25. Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 2005;62:593-602.
crossref pmid
26. Cedereke M, Ojehagen A. Prediction of repeated parasuicide after 1-12 months. Eur Psychiatry 2005;20:101-109.
crossref pmid
27. Vaiva G, Vaiva G, Ducrocq F, Meyer P, Mathieu D, Philippe A, Libersa C, Goudemand M. Effect of telephone contact on further suicide attempts in patients discharged from an emergency department: randomised controlled study. BMJ 2006;332:1241-1245.
crossref pmid pmc
28. Owens D, Horrocks J, House A. Fatal and non-fatal repetition of self-harm: systematic review. Br J Psychiatry 2002;181:193-199.
crossref pmid
29. Jung WY, Park JM, Kang CJ, Lee BD, Lee YM. Clinical characteristics of completed versus non-completed suicide and re-attempt rates in 2-4 years. J Korean Neuropsychiatr Assoc 2009;48:488-495.

30. Parra Uribe I, Blasco-Fontecilla H, Garcia-Pares G, Giro Batalla M, Llorens Capdevila M, Cebria Meca A, de Leon-Martinez V, Perez-Sola V, Palao Vidal DJ. Attempted and completed suicide: not what we expected? J Affect Disord 2013;150:840-846.
crossref pmid
31. Sinclair JM, Harriss L, Baldwin DS, King EA. Suicide in depressive disorders: a retrospective case-control study of 127 suicides. J Affect Disord 2005;87:107-113.
crossref pmid
32. Barr B, Taylor-Robinson D, Scott-Samuel A, McKee M, Stuckler D. Suicides associated with the 2008-10 economic recession in England: time trend analysis. BMJ 2012;345:e5142.
crossref pmid pmc
33. Ministry of Health and Welfare. Basic livelihood security recipients [Internet] Sejong: Ministry of Health and Welfare. 2017;cited 2018 Jul 31. Available from: http://www.mohw.go.kr/react/jb/sjb030301vw.jsp?PAR_MENU_ID=03&MENU_ID=032901&CONT_SEQ=345562&page=1

34. Real Estate 114. Real estate statistical analysis solution 2018 [Internet] Seongnam: Real Estate 114. 2018;cited 2018 Dec 14. Available from: https://www.r114.com/?_c=solution&_m=solutiondefault&_a=reps

35. Chen WJ, Chen CC, Ho CK, Lee MB, Lin GG, Chou FH. Community-based case management for the prevention of suicide reattempts in Kaohsiung, Taiwan. Community Ment Health J 2012;48:786-791.
crossref pmid pdf
36. Mann JJ, Michel CA. Prevention of firearm suicide in the United States: what works and what is possible. Am J Psychiatry 2016;173:969-979.
crossref pmid
37. Korea Suicide Prevention Center. Suicide death statistics [Internet] Seoul: Korea Suicide Prevention Center. 2018;cited 2018 Dec 14. Available from: http://www.spckorea-stat.or.kr/

38. Ji NJ, Hong YP, Stack SJ, Lee WY. Trends and risk factors of the epidemic of charcoal burning suicide in a recent decade among Korean people. J Korean Med Sci 2014;29:1174-1177.
crossref pmid pmc pdf
39. Sinyor M, Schaffer A, Nishikawa Y, Redelmeier DA, Nieder-krotenthaler T, Sareen J, Levitt AJ, Kiss A, Pirkis J. The association between suicide deaths and putatively harmful and protective factors in media reports. CMAJ 2018;190:E900-E907.
crossref pmid pmc
40. Amos T, Appleby L, Kiernan K. Changes in rates of suicide by car exhaust asphyxiation in England and Wales. Psychol Med 2001;31:935-939.
crossref pmid
41. Law CK, Sveticic J, De Leo D. Restricting access to a suicide hotspot does not shift the problem to another location: an experiment of two river bridges in Brisbane, Australia. Aust N Z J Public Health 2014;38:134-138.
crossref pmid pdf
42. Pirkis J, Spittal MJ, Cox G, Robinson J, Cheung YT, Studdert D. The effectiveness of structural interventions at suicide hot-spots: a meta-analysis. Int J Epidemiol 2013;42:541-548.
crossref pmid
43. Yip PS, Law CK, Fu KW, Law YW, Wong PW, Xu Y. Restricting the means of suicide by charcoal burning. Br J Psychiatry 2010;196:241-242.
crossref pmid
44. Hawton K, Bergen H, Simkin S, Dodd S, Pocock P, Bernal W, Gunnell D, Kapur N. Long term effect of reduced pack sizes of paracetamol on poisoning deaths and liver transplant activity in England and Wales: interrupted time series analyses. BMJ 2013;346:f403.
crossref pmid pmc
45. Morgan OW, Griffiths C, Majeed A. Interrupted time-series analysis of regulations to reduce paracetamol (acetaminophen) poisoning. PLoS Med 2007;4:e105.
crossref pmid pmc
Figure 1

Relationship between suicide rate and the proportion of residents with mentally disabled persons in administrative districts of Seoul. Pearson r=0.563, P=0.003. Suicide rate: the average of recent 3-year data from 2015 to 2017 [18]. Proportion of residents with mentally disabled persons [19] = (number of residents with disability registration for mental disorder / number of total population in each administrative district) × 100.

jkma-62-93-g001-l.jpg
Figure 2

Relationship between suicide and problem drinking rates in administrative districts of Seoul. Pearson r=0.606, P=0.001. Suicide and problem drinking rates [18,24]: the average of recent 3-year data from 2015 to 2017.

jkma-62-93-g002-l.jpg
Figure 3

Relationship between suicide rate and proportion of basic livelihood security recipients in administrative districts of Seoul. Pearson r=0.797, P<0.001. Suicide rate: the average of recent 3-year data from 2015 to 2017 [18]. Proportion of basic livelihood security recipients [33] = (number of basic livelihood security recipients / number of total population in each administrative district) × 100.

jkma-62-93-g003-l.jpg
Figure 4

Relationship between suicide rate and average prices of apartment in administrative district of Seoul. Pearson r=−0.664, P<0.001. Suicide rate: the average of recent 3-year data from 2015 to 2017 [18]. Average prices of apartment [34]: the average of apartment sale price per 3.3 m2.

jkma-62-93-g004-l.jpg
Figure 5

Rates for specific method of suicide for recent 10 years in Korea [37].

jkma-62-93-g005-l.jpg


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