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Following is a question by the Hon Frederick Fung and a written reply by the Secretary for Health, Welfare and Food, Dr Yeoh Eng-kiong, in the Legislative Council today (December 3):
Question:
Regarding the problem of Hong Kong students committing suicide, will the Government inform this Council:
(a) of the respective numbers of students who attempted suicide and who died of suicide in each of the past five years, broken down by grades in school; and
(b) whether measures and means are in place to identify suicide-prone students and to help them give up the thought of suicide; if so, of the details and effectiveness of such measures and means; if not, the reasons for that?
Reply:
(a) According to the information reported by schools to the Education and Manpower Bureau (EMB), the numbers of students involved in attempted suicide and fatal suicide (mutually exclusive) in the five school years from 1998/99 to 2002/03 are set out in the tables 1 & 2.
(b) Tackling the student suicide problem requires the concerted efforts of the Government and the community. Under a working group chaired by the Health, Welfare and Food Bureau, a multi-pronged strategy through a multi-disciplinary and cross-sectoral approach has been adopted, including -
(i) enhancing our understanding of the problem;
(ii) providing a range of preventive, supportive and remedial measures to facilitate early identification, timely intervention and effective support;
(iii) promoting public education and publicity; and
(iv) strengthening the training of frontline professionals and workers.
The various measures and means in place at the various settings are summarised below -
(1) School setting
(a) For early identification of suicide risks, the following tools are available to all local schools to raise teachers' alertness to students who may be at risk of emotional disturbance and suicidal ideation:
* Checklist for Youth Suicidal Risk Factors (2003) published by the Centre for Suicide Research and Prevention of the University of Hong Kong with web version;
* Assessment Programme for Affective and Social Outcomes (APASO 2002) to measure students' affective and social performance; and
* Resource package on "Student Suicide" (1997) developed by the then Education Department.
The Child Psychiatric Teams of the Hospital Authority (HA) also provide training for school teachers and social workers on detecting and assessing children with suicide risks. Support in various forms is given to students at risk. In addition to counselling and emotional support, support from families and schools will be mobilised. Multi-disciplinary support (involving education psychologists, clinical psychologists, etc.), emergency psychiatric consultation and hospitalisation will be arranged as appropriate.
(b) Other measures to mitigate the risk factors of student suicide and to strengthen the protective factors include:
* the provision of at least one student guidance professional for each school (school social workers for secondary schools and student guidance personnel for primary schools) to support students and assess their need for clinical intervention by psychologists and/or psychiatrists;
* the Understanding the Adolescent Project for early identification of the developmental needs of Secondary One students and addressing those needs through tailor-made primary preventive programmes;
* enhancement of the service of school-based education psychologists to cover 45 primary schools in 2003/04 (increased to 200 primary schools by 2007/08);
* the Comprehensive Student Guidance Services launched in primary schools and the new Integrated Humanities curriculum introduced in secondary schools to foster students' understanding of their personal growth and self-worth; and
* regular training programmes for teachers on enhancing students' self-esteem and helping them cope with stress, as well as parent education training packages and training programmes for parent educators.
(2) Health setting
(a) All students who attend the Student Health Service of the Department of Health (DH) will be interviewed by the medical and nursing staff to identify their health problems. The centres also use a locally validated health assessment questionnaire, which contains specific questions on suicide, with secondary students. Through the interviews and questionnaires, students at risk of suicide will be identified. According to the level of suicide risks, referrals to clinical psychologists, school social workers, the Social Welfare Department (SWD), the Suicide Crisis Intervention Centre or other non-governmental organisations, HA's Child Psychiatric Teams and/or Accident and Emergency Units will be made for further assessment and follow-up.
(b) The Central Health Education Unit of DH has published a fact sheet on suicide prevention on its website, the Health Zone. The 24-hour Health Education Hotline also has a recording on adolescent depression. As mental illness is a risk factor for suicide, the HA has been running the Early Assessment Service for Young People with Psychosis, which includes screening service and public education, to identify and treat adolescent psychosis at an early stage.
(3) Welfare setting
(a) SWD and non-governmental organisations offer a range of services to those in emotional distress or at risk of suicide. These include:
* the Suicide Crisis Intervention Centre run by the Samaritan Befrienders Hong Kong (SBHK) to provide round-the-clock crisis intervention to persons with high/moderate suicide risk;
* a Life Education Centre run by SBHK to enhance public education and promote positive life values, especially targeting at the youth and students;
* a Family Crisis Support Centre run by Caritas Hong Kong to provide time-out facilities and crisis support to vulnerable individuals/families in distress;
* a Youthline operated by the Hong Kong Federation of Youth Groups to provide hotline services for young people with emotional and other problems; and
* focused training to frontline social workers provided by SWD, and research by the Centre for Suicide Research and Prevention of the University of Hong Kong.
(b) Core welfare services for young people also play an important role in supporting the youth at risk. These include 131 Integrated Children and Youth Services Centres, 34 Children and Youth Centres, 16 District Youth Outreaching Social Work Teams, etc. These service units provide a full spectrum of preventive, supportive and remedial services for young people and their families, including identifying the developmental needs of young people and assisting them to overcome crises such as emotional distress or suicide risk.
In the past three school years, the number of suicidal cases referred by schools for EMB's education psychologist service was 78. Subsequently, there was no completed suicide among the cases given intervention. During the same period, the Student Health Service of DH identified a total of 507 students with suicidal ideation or attempts. The detection rate (i.e. proportion of students with suicidal risk identified) ranged from 0.3 per cent to 0.4 per cent. According to the information available, none of these students have completed suicide following referral and intervention. In addition, in-built evaluative studies for certain pilot projects, where appropriate (like the Suicide Crisis Intervention Centre), will be undertaken.
Also, literature reviews show that the media have an important role to play in the prevention of suicide, e.g. reducing imitated suicides (or called "copycat" suicide), in particular amongst young people. The Government has briefed the media and encouraged the media to adopt the World Health Organization's guidelines on reporting suicide cases. In 2002, members of the Board of Education, the Commission on Youth, the Committee on the Promotion of Civic Education and the Social Welfare Advisory Committee issued a public statement on the need for responsible reporting of suicide cases by the media.
Ends/Wednesday, December 3, 2003
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