The number of suicides rose in Japan in August due to more women and school-aged children taking their own lives, offering a first glimpse into the consequences of the mental health strain brought about by COVID-19 around the globe.
The nation is among a few major economies that release timely data on suicides, as it is a persistent societal issue.
The numbers hint at what might be going on around the world, as countries grapple with the fallout from mass unemployment and social isolation that is affecting certain groups of more vulnerable people.
Illustration: Mountain People
Sociologists have long warned that the economic and social disruption wrought by measures to contain COVID-19 could cause more deaths than the pathogen itself.
In Japan, the suicide rate has been falling, but it remains a top cause of premature deaths.
Japanese government statistics showed that the number of suicides in August increased by 15.4 percent to 1,854.
Although a smaller proportion of suicides, the number of women taking their own lives jumped by about 40 percent.
The number of suicides of students in elementary to high school more than doubled to 59 from the same period last year.
The mental health toll looks set to be one of the pandemic’s most insidious legacies, given the difficulty of grasping or measuring the magnitude of self-inflicted harm until it is too late.
Major economies, such as the US and China, do not report official data on suicides until years later, although experts have predicted a wave of such deaths this year and anecdotal evidence abounds on social media platforms.
“Up-to-date suicide numbers can help quickly determine which groups are at high risk,” said Yasuyuki Sawada, chief economist at the Asian Development Bank and a University of Tokyo professor who has written books on suicide prevention and the phenomenon’s economic effects.
“If local governments can determine which age group or what occupations are showing higher risks for suicides, suicide prevention measures can be implemented swiftly,” Sawada said.
A US study released in May predicted that the COVID-19 pandemic could result in as many as 75,000 additional people dying over the next decade from “deaths of despair,” a term that refers to suicides and substance-abuse-related deaths.
In India, 65 percent of therapists reported an increase in self-harm and suicide ideation among patients since the pandemic began, a study released last month by the Suicide Prevention India Foundation showed.
Not only has the coronavirus caused unemployment to rise around the globe, it has upended social norms and halted community interaction, key factors known to worsen mental health strain.
More than 60 percent of 130 countries surveyed by the WHO said that mental health services for vulnerable populations were disrupted as a result of the pandemic, a report released last week showed.
The trend in Japan reveals that the pandemic’s adding new, potentially deadly stressors: Calls to domestic violence helplines have risen as families remain trapped at home together.
Economically, the coronavirus has disproportionately affected women, who are more likely to be in irregular employment in retail or service industries — they made up nearly 66 percent of recent job losses in Japan.
In neighboring South Korea, which has the highest suicide rate in the Organisation for Economic Co-operation and Development, a spike in women taking their own lives also occurred in April, March and June, although the overall number of suicides from January to July declined from a year earlier.
Generally, depression is more common in women and addiction is more common in men, so the prolonged pandemic might have affected the rise in women’s suicide rate, said Paik Jong-woo, a psychiatrist and the director of the Korea Suicide Prevention Center.
“Public health and infectious disease prevention measures aren’t enough to save lives on their own,” said Toshihiko Matsumoto, director of the drug dependence research department of Japan’s National Institute of Mental Health.
He emphasized the need for spaces where people can be away from family pressure, while also avoiding crowded conditions with infection risk.
Children present an even more complex picture.
Pressured by the pandemic, stressed-out parents “may be missing signs from their children and not being compassionate enough about their problems,” said Mayumi Hangai, a pediatrician and researcher at the National Center for Child Health and Development in Japan who has surveyed children’s stress levels during the coronavirus.
Any stress or unhappiness displayed by parents can transfer to their children, who lack social outlets when schools are closed and extracurricular activities are unavailable.
Japan has seen suicides drop overall over the past decade, except for among those aged 20 or younger.
In Asia, the toll could be compounded by a greater stigma surrounding mental health issues than in Western societies.
For example, in Japan, people are under social pressure not to show their feelings or true self.
Suicides at first dropped in the spring during a state of emergency ordered by the Japanese government to curb the spread of the virus, which experts chalked up to people being away from the stress of the workplace and school.
A collective solidarity like that inspired by wars and natural disasters also emerged.
However, when the economy started reopening, portions of the population were left behind — such as laid-off workers or those who continued to be stuck at home.
In Japan, schools restarted in June after a three-month closure, which saw an increase in reports of bullying and added stress about catching up on schoolwork.
“Children feel even more pressured to catch up with the delay,” said Hiroyuki Nishino, head of Tamariba, a non-profit organization that helps struggling children.
The disruption caused by COVID-19 is exacerbating the deeply rooted phenomenon of futoko — children refusing to go to school. Such children are at high risk for suicide.
“We’ve heard kids as young as five years old talking about dying or wanting to disappear,” Nishino said.
Lifelink, a Tokyo-based non-profit that operates a suicide hotline, said that about 20 percent of calls received from May to August were from children in elementary, middle and high schools.
Messaging apps have been effective for children to reach out for help, as some can use these without parental knowledge, Lifelink head Yasuyuki Shimizu said, adding that this is especially crucial when the issue is domestic violence.
In July, the Japanese government allocated a supplementary budget of ￥1.1 billion (US$10.44 million) for suicide prevention on top of the ￥2.6 billion approved in April.
The governments of Japan and South Korea, despite bitter disputes over trade and territorial rights, also regularly exchange ideas on suicide prevention strategies, a Korea Suicide Prevention Center official said.
Funding and investment in mental health infrastructure to serve vulnerable populations is urgently needed in the wake of COVID-19, experts have said.
Mental health services are chronically underfunded everywhere, even though studies have shown that investing US$1 into care for depression and anxiety can return US$5 in economic productivity, the WHO said.
“Financial support from the government is important, but so is recognizing that mental health is an issue,” Sawada said. “Measures to address mental health should be a pillar of public health policy as well.”
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