Attitudes toward suicide among Chinese people in Hong Kong.

Since suicide in Chinese people exhibits certain distinctive characteristics, it is important to develop indigenous measures to assess Chinese attitudes toward suicide that may be used to inform suicide reduction programs. Combining qualitative and quantitative methods, we developed a Hong Kong version of the Chinese Attitude toward Suicide Questionnaire (CASQ-HK) which assesses attitudes toward suicide, suicidal inclination under 12 hypothetical scenarios, and prior suicidal experience. A convenience sample of 1,226 people completed the self-report questionnaire. In keeping with Chinese tradition, respondents revealed both tolerant and condemning attitudes that varied with their sociodemographic characteristics. Generally, they were not strongly inclined to consider suicide in the presence of difficult scenarios. Female gender, older age, and the presence of suicidal ideation were associated with more contemplation of suicide.

[Current attitudes and knowledge about suicide in community members: a qualitative study].

OBJECTIVE: Understand the public's current attitudes and knowledge about suicide and, thus, provide essential information to the development of targeted public education programs-important components of the suicide prevention effort. METHODS: Seventeen mental health professionals who were extensively trained in the methods of conducting focus groups used a pre-tested focus group outline on attitudes and knowledge about suicide to conduct 101 focus groups and 18 individual in-depth interviews with a total of 842 community respondents from 6 regions in northern China. The focus groups and in-depth interviews were audio-taped, transcribed and analyzed using the QSR Nvivo text analysis software. RESULTS: Most respondents believed that suicide was a greater problem in rural areas and among women and identified physical illnesses, economic problems and interpersonal conflicts (particularly family conflicts) as the main causes of suicide. Rural residents and women were believed to exhibit impulsive suicidal behavior because of their personal limitations and over-sensitiveness. Most thought that suicide was understandable and a small proportion felt that it was acceptable behavior in certain circumstances. Almost all felt that suicide resulted in the stigmatization and a loss of 'face' for the family. Most believed that one should show concern for persons who have suicidal behavior and their family members and expressed a willingness to have superficial social relationships with them but were unwilling to establish close personal relations with them. The vast majority believed that suicide was either very difficult or impossible to prevent. CONCLUSIONS: In China the community is tolerant, sympathetic and, in some cases, accepting of suicide but there remains a substantial underlying stigmatization of suicide. Community members have some misunderstandings about suicide; the most obvious misunderstanding is the underestimation of the importance of mental illness as a cause of suicide. The content of public health messages used in suicide prevention programs should be developed by combining findings from both qualitative and quantitative research.

[Comparison of the characteristics of suicide attempters treated in general hospitals with and without prior suicide attempts].

OBJECTIVE: We compared the characteristics of persons who had made multiple versus single suicide attempts to determine whether or not these are two independent subgroups and, thus, should be provided with different preventive services. METHODS: We administered a 2 - 3 hour interview that included a structured psychiatric examination to 325 individuals with suicide attempts who were treated at four city and county-level general hospitals. RESULTS: The age, gender, years of education, marital status, work status, and family economic status of the 52 persons who had made more than one suicide attempt were similar to those of the 273 persons who had made a single attempt. But repeaters were less likely than non-repeaters to live in rural villages and to attempt suicide by ingesting agricultural poisons. Moreover, repeaters considered suicide prior to the attempt for a longer time, had a lower quality of life in the prior month, had a stronger suicidal intent, had more chronic life events, had a higher chronic stress score, and were more likely to have mental illness (P's all < 0.05). CONCLUSIONS: Major differences in the characteristics of suicide attempters with and without a prior history of suicide attempts suggest that these are independent subgroups of attempters. These two types of attempted suicide require different preventive approaches.