Health Features

Hong Kong seeks solution to suicide trend it started (News Feature)

By Simon Parry and Hazel Parry Apr 27, 2010, 4:16 GMT

Hong Kong - A middle-aged Hong Kong woman started a macabre trend in November 1998 when she sealed the door and windows of her bedroom, lit a pile of barbecue charcoal and lay down to die.

Within two months of that lonely act - recorded in lurid detail by Hong Kong's mass market newspapers - charcoal burning emerged from nowhere to become the city's third most common method of suicide.

Twelve years and thousands of deaths later, it is a truly global phenomenon. It has become the leading method of suicide in Taipei and in 2007, the lead singer of US rock band Boston killed himself at his home in New Hampshire by burning charcoal.

Now the city that started the trend may have found a partial solution. A year-long experiment conducted in supermarkets across two districts in Hong Kong indicates that restricting access to barbecue charcoal significantly cuts the suicide toll.

In the experiment, supermarkets in one district kept bags of charcoal on sale as usual. In another area, they were kept in locked storerooms in dozens of supermarkets and brought out only at the request of shoppers.

Over the course of the year, deaths by charcoal burning fell by 53 per cent - the equivalent of 11 lives - in the district where sales were restricted.

In the other district, where charcoal remained on sale as usual, suicides by charcoal burning increased by 43 per cent, according to the study by the University of Hong Kong Centre for Suicide Research and Prevention.

Dr Paul Yip, who headed the project, said the approach has been effective because people who commit suicide by charcoal burning are different from those who do so by other methods.

'With charcoal burning, people are middle aged, they are less likely to be suffering from any mental illnesses, they are employed, and they have financial problems to a greater extent that those who die from other forms of suicide,' he explained.

'These are people who don't find the idea of jumping or hanging appealing as a method of suicide. But charcoal burning is portrayed wrongly as a painless way to commit suicide - and so some people think they've identified a way to solve their problems.'

The difference means that those who commit suicide by charcoal burning will not necessarily kill themselves by other methods if their access to charcoal is restricted, Yip said.

Yip compared the finding to the banning of large jars of paracetamol tablets in the Britain, which is credited with reducing the overall suicide rate by partly eliminating the 'easy' method.

Supported by overseas experts, Yip is now appealing to the two Hong Kong supermarket chains that helped in the research project - Wellcome and Park n Shop - to introduce a permanent restriction on charcoal sales to prevent more deaths.

Although suicide by charcoal burning has fallen from its peak of more than 250 cases a year, it still accounts for 130 to 140 of the roughly 1,000 suicides a year in Hong Kong.

'Many lives could be saved,' said psychiatrist Yin Yen-chen, head of a suicide prevention centre in Taipei. 'The results are inspiring for suicide researchers and policy makers in Taiwan.'

Neither Hong Kong chain has agreed, however, saying there would be practical difficulties in extending the scheme to the whole city, including space restrictions in inner-city stores.

'Packs of charcoal are quite big and occupy quite a lot of space,' Park n Shop spokeswoman Teresa Pang said. 'We have to take logistics into account. Space is very limited in urban stores.'

Wellcome spokeswoman Annie Sin said she was unconvinced by the study. 'The economic situation is different now. There are not so many people committing suicide by charcoal burning. It has decreased a lot from the peak.'

The supermarkets' response has left Yip and his colleagues frustrated.

'I can understand that it will create some inconvenience,' he said. 'But if that inconvenience can help desperate people and stop them from killing themselves, that is a price we ought to be prepared to pay.'