Monday, 1 September 2008

South Korea tackles record suicide rate

South Korea has the highest suicide rate in the 30 OECD countries (24.7/100,000) followed by Hungary (21/100,000) and Japan (19.5) – this compares with New Zealand on 11.9/100,000 (OECD Health report 2008; figures from 2005). Now it seems the South Korean government is doing something about it. According to The Korea Times the government is coming up with a strategy that involves “that focuses on strengthening the social and economic safety net for those in the low-income bracket and the aged…. seeking to establish more screen doors at subway stations to prevent people from committing suicide by jumping in front of trains…regulating purchases of poison pesticides … and Web sites encouraging suicide are also considered a major target.” Curiously no mention at all of the role of mental health services or primary care in suicide prevention. The strategy will be announced on world suicide day on September 10th – hope they’ve looked at the ways other countries are doing it.

Drugs and suicide?

A sign of things to come. The FDA in the USA is now considering the case of various drugs prescribed for “physical illness” in causing an increase in suicides. The two drugs reported to be in the spotlight are Singulair (Montelukast sodium) an asthma medication and Neurontin Gabapentin). The report describes two people who committed suicide whilst on these drugs – and that really is the difficulty. Providing any evidence for a connection between the prescription of these drugs and suicide is going to be hard to do as suicide is such a relatively rare outcome – even in people taking antidepressants it is a rare outcome and hard to prove a connection. One solution proposed is to set up a monitoring system for all new drugs to look at suicidal thoughts – however thinking about suicide is a wobbly old construct which is quite complex and doesn’t usually lead to any actions. It certainly is not the same as thinking about death (something it is often confused with in teenagers). However at least this shows that yet again thinking about physical and mental problems as separate is not a particularly helpful thing to do.