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A social psychiatric approach to suicide prevention

Article information

J Korean Med Assoc. 2019;62(2):93-101
Publication date (electronic) : 2019 February 21
doi : https://doi.org/10.5124/jkma.2019.62.2.93
Sung-Wan Kim, MD1,2,3orcid_icon, Min Jhon, MD1,4orcid_icon, Mina Kim, RN3,5orcid_icon, Jong-Woo Paik, MD6orcid_icon, Jae-Min Kim, MD1orcid_icon, Jin-Sang Yoon, MD1orcid_icon
1Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea.
2MindLink, Gwangju Bukgu Mental Health and Welfare Center, Gwangju, Korea.
3Gwangju Mental Health and Welfare Commission, Gwangju, Korea.
4Gwangju Metropolitan Mental Health and Welfare Center, Gwangju, Korea.
5Department of Nursing, Graduate School, Chonnam National University, Gwangju, Korea.
6Department of Psychiatry, Kyung Hee University School of Medicine, Seoul, Korea.
Corresponding author: Sung-Wan Kim. swkim@chonnam.ac.kr
Corresponding author: Jong-Woo Paik. paikjw@khu.ac.kr
Received 2019 January 24; Accepted 2019 February 09.

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.

Keywords: Suicide; Depression; Alcohol; Case management; Mental health

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Figure 1

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.

Figure 2

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 [1824]: the average of recent 3-year data from 2015 to 2017.

Figure 3

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.

Figure 4

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.

Figure 5

Figure 5

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