Lisa swallowed about 20 pills and washed them down with a bottle of water. "The kind in the square plastic bottle. It's more expensive, but it was going to be the last drink of my life," she said of her suicide attempt two years ago.
"It's probably good that I don't like liquor -- liquor probably would have done the job." Taiwan's suicide rate is one of the worst in Asia. According to the Department of Health's data for 2001 -- the last year for which a full accounting is available -- suicide was the ninth-biggest killer of Taiwanese, claiming 2,781 lives, or 2.2 percent of all fatalities. As with most other countries, the suicide rate among the elderly was the highest, with nearly 38 people in every 100,000 taking their own lives. But even with this high number, suicide ranked 14th among the biggest killers of those over age 65.
Far more alarmingly, suicide was the third leading cause of death for those between the ages of 15 and 24. One hundred eighty people in this age range killed themselves in 2001. That number increases five-fold for the next highest age group, those between 25 and 44, for whom suicide was the fourth leading cause of death. More than a thousand people in this age bracket committed suicide that year, 699 men and 304 women.
But statistics tell only part of the story and mask many of the real problems. Many more suicides are attempted but fail -- Taipei's Mackey Memorial Hospital alone treated more than 400 people who attempted suicide in 2001 -- and countless others threaten or contemplate the act without receiving counseling. WHO data indicate that the number of suicide attempts by young people in particular may be up to 20 times higher than the number of completed suicides.
Insurmountable problems
Lisa, who agreed to recount her story on condition that her real name not be used, smiles when talking about the most painful time in her short life. Now 20, she recounts her brush with death during her senior year of high school with blushing embarrassment. "I thought the problems I had then were going to stay with me for the rest of my life," she said. "I thought I'd already messed up everything before I was even out of high school." Although depression is the most cited reason for attempting suicide, it is far from the only one. Terminal disease, divorce, the death of a loved one, unemployment, insurmountable debt, unrequited love and, for Asians, "loss of face" are all common reasons. In March 2001, one Taiwanese man even killed himself out of anxiety over where the Mir space station might crash.
When your world exists within the walls of a high school, however, the reasons are usually related to intense but fleeting psychological trauma -- problems that seem like the end of the world for someone who, a decade earlier, had just stopped teething.
For her part, Lisa had just terminated a pregnancy and was then dumped by the father, her boyfriend of three years. "I was always a good student and had been preparing for college for years. Then right before the Joint College Entrance Exam my life became a nightmare. ... You see suicides reported on the news every night and I envisioned my boyfriend learning about my death on TVBS. They always show it when kids kill themselves."
She's right. Media coverage of individual suicides has been cited as a main cause for subsequent suicides. Glamorization of suicide often leads to imitation. The media can actually assist in preventing suicides, according to the WHO, by limiting graphic and unnecessary depictions and by deglamorizing news reports of suicides.
"In a number of countries, a decrease in suicide rates coincided with the media's consent to minimize the reporting of suicides and to follow proposed guidelines," the health body stated in a 2001 fact sheet on suicide.
This is not the case in Taiwan, where satellite news trucks cruise the island looking for anything that might draw an audience. In 1999, the press reported on a man who killed himself with a cocktail of painkillers and liquor. The next day, there were five suicides using the same method.
Similarly, in Hong Kong in 1998, a 35-year-old woman killed herself by burning charcoal in her small apartment, which she had sealed with tape, quickly creating a high level of carbon monoxide. There were nine more charcoal-burning suicides in Hong Kong within the month and the method has since become popular in Taiwan.
Local media had a field-day when Taiwanese pop star Yu Feng (于楓) killed herself in 2000. Having had a child with a married man who refused to divorce his wife, the diva was rumored to have hung herself while wearing a red dress with matching fingernails. Chinese superstition holds that if you take your own life while dressed in red your spirit will stay to haunt those who did you wrong.
While local news agencies unabashedly report suicides and stick cameras in the faces of grieving family members, authorities have begun clamping down on gratuitous suicide "news" -- albeit flaccidly. Article 275 of the Criminal Law prescribes a seven-year jail term for anyone posting suicide methods on the Internet. No official effort has been made to bring other media -- namely television -- within the bounds of tasteful reporting.
Although several Web sites containing such information have been brought to the attention of the police, the elusive nature of Web postings have made it difficult for authorities to track down offenders. One such site, with the headline "Do you want to die? Here are some common methods," listed 19 ways to kill yourself and recommended jumping off a building as the surest method. "Jumping from the 13th floor is less painful," it advised.
Bungling bureaucracy
While authorities in Taiwan chase down Internet pranksters, the suicide rate continues to climb. Although suicide accounted for 2.2 percent of all fatalities in 2001, that figure was nearly double the previous year's percentage. The rate for 2002 is also expected to rise. To address the problem, the island has a mere six counseling hotlines, including the two most commonly called centers, Teacher Chang (張老師) and Lifeline (生命線). All are understaffed and overworked.
"We have several phone lines that are busy all the time. We have more phone lines than we have people to answer them," said Liu Shu-ying (劉恕穎), a youth counselor at Teacher Chang.
"We need more staff and volunteers, but I understand that this isn't the type of work that most people would be interested in. It can be depressing -- is usually depressing -- and you never meet the people you actually help."
"I knew there were counseling services," Lisa said. "I called Teacher Chang, but the phone was busy. I tried again the next day and it was busy again. I figured it was a sign. I took the pills and called a friend."
Busy phone lines are more than common for these centers. Two Taipei City counselors conducted an "investigation" in 2000 by repeatedly calling three of the six hotlines over a four-day period to see what percentage of their calls would go through. They reported that only 20 percent of all the calls they made reached a counselor.
Of course, for every one of their calls that went through, someone like Lisa's didn't. A far easier and less intrusive approach might have been to enlist the help of the telephone company, where computers route and track every call made on the island.
This type of government bungling isn't restricted to the city-council level. This past week, the Cabinet released details of a plan that would create 75,000 new jobs under government departments. It unfortunately does not call for the expansion of emergency counseling services like Teacher Chang or Lifeline. Instead, the Department of Health would see an increase of 588 staff members charged with eliminating the source of dengue fever (mosquitos), which doesn't even register on the list of top killers in Taiwan.
There is a misconception in Taiwan that the increased suicide rate of recent years is directly related to the nation's poorly performing economy. This is not necessarily the case. The WTO reports that suicide levels rise during times of socioeconomic change, regardless of whether that change is for the better or worse.
Another misconception is that men are more likely to attempt suicide than women. While the Department of Health's yearly statistics show that men commit suicide at a rate two-times greater than women, research by Lifeline and Teacher Chang found that women are far more likely to attempt the act -- another deceit of the statistics. Some 70 percent of calls to Lifeline are from women. They fail at a greater rate because they employ milder methods.
By extension, analysts point to a correlation between a person's social status and the fatality rate of attempted suicides. More affluent people who attempt suicide often fail because, like Lisa, they overdose on pills then place calls to close friends to say goodbye. Less affluent people have a higher suicide mortality rate because they employ methods that are far more likely to be fatal. It's easier for a homeless man to leap off a building than to find a bottle of pills. An elderly person's body is more susceptible to a suicide attempt than is a young person's.
Too young to die
Liu was unnerved when she first became a counselor. "I thought every time I picked up the phone it was going to be a call from someone who had just swallowed a bottle of pills or was standing on top of their apartment building ready to jump. I quickly learned that most people who call just want to talk -- especially women. Men seem to get to a more severe stage of depression or anxiety before they admit to themselves that they need help -- older men especially."
Asked how she accounts for the increase in suicides among younger people, Liu cites a clash of eras. "The same is demanded of kids academically now that was demanded of their parents -- more so, even, if you consider that most kids today are forced to attend bushiban after school whereas their parents went home to study," she says.
"At the same time, they're confronted by popular culture in a way their parents never were. It's a much smaller world for kids today and it can feel cramped. Also, today's kids don't spend as much time with their parents as in previous generations. Sometimes none at all."
This has long been a fact of life for Lisa, whose father operates a business based in China. He spends several weeks at a time there keeping shop and, according to Lisa, keeping the company of another woman.
"I know he has a girlfriend over there because I can look at my mom and see it. Of course no one has ever spoken about it," Lisa said. "I thought it was my fault. My mom has only gone with him to Shanghai once or twice because she had to stay here with me. I'm sure it was one of the things that led me to do what I did." Now in college studying art, toting a backpack with a zoo of small stuffed animals hanging from it, Lisa seems light years from the depression she suffered just two years ago. Still, she admits, her emotions can get the better of her, particularly when she returns home from university.
"My parents always encouraged me in what I wanted to do, as long as it was business or law. I did poorly on the Joint College Entrance Exam and now I'm studying art. They're not happy about it, but I am." If her sentiment sounds selfish, it is, and that's the point. "The person I tried to kill that day was my parent's daughter. I want to live."
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