Information Paper
Suicide by Students

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PURPOSE
BACKGROUND

Cases Analysis
Possible causes
Actions taken/to be taken to address and prevent the problem

Level I - dissemination of information and skills to students, teachers, parents and the community
Level II - creating a whole school prevention climate
Level III - establishing a supportive network among advisory committees, working groups and agencies
Level IV - formulation and coordination of policies
Conclusion

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PURPOSE

This paper presents an analysis of student suicide cases and sets out actions taken/to be taken to address and prevent the problem.

BACKGROUND

Cases Analysis

2. The recent occurences of student suicide cases have drawn public concerns on the cause of these cases and demand for measures to help those students in the verge of forfeiting their lives. For the past five years from September 1991 to December 1996, a total of 263 attempted and 97 fatal cases of student suicide have been reported to Education Department. The distribution by school year and age of those fatal cases is presented below:

Distribution by age of student committed suicide

according to school year

3. It is observed that student suicides peaked at the 1991/92 and 1992/93 school years, but dropped between 1993/94 and 1995/96. It has been found that "clusters" occurring from time to time in each school year when several suicide cases happened closely within a short period of time. Examples of these "clusters" included:

Nonetheless, after examining the occurring time of such "clusters", it is also noted that no obvious pattern can be observed.

4. From October to mid-November last year, there were 8 suspected fatal student suicide cases. Despite the apparent increased size of "cluster", according to past records, no correlation between the presence of "clusters" of suicide cases and a rise in the total figure in the same year can be established.

Possible causes

5. For each and every suspected fatal student suicide case, follow-up investigations would be conducted by the Working Group on Student Suicide under the Education Department, which consists of members from relevant divisions within the Department, to find out the underlying causes and the triggering factors which led to the death of the students concerned. A diagnostic classification summarising the salient features of the cases from the 1991/92 to 1995/96 school years and the initial analysis of the 11 cases recorded in the current school year are attached at Annexes 1(A) and 1(B) respectively. While the causes of most suicide cases are multifarious, these investigations showed that family circumstances, such as family discord, inadequate parent-child communication, inadequate or inconsistent child management, lack of parental support, etc. remain the major underlying causes.

6. On the other hand, the triggering factor in many cases, including those of the recent "cluster", is the students’ extreme emotional reaction to certain situations, such as scolding or accusation by their parents, teachers or peer. It seems to show that these students merely used self-destructive means to try to demostrate their grievances. In other words, they might have taken the suicidal acts as a means to "cope" with problems.

7. Excessive and sensational coverage by media is also believed to have induced imitation. The Commission on Youth conducted a seminar on teenage suicide in 1993 to explore the role of the media in countering the problem. Participants of the seminar generally agreed that the mass media could have a positive role to play in influencing the behaviour and values of young people. Some participants were of the view that the mass media had occasionally implanted, in their programmes or articles, an incorrect concept of matality, which could mislead students to resort to committing suicide to evade the pressures of life. Some felt that certain media reports on teenage suicide had misled young people to believe that they could resort to suicide as a means of revenge or to attract attention and publicity, and some media had deliberately depicted teenage suicide as a heroic act. While such views could be referred to as the possible causes for student suicide related to mass media, the seminar was unable to establish the fact that there was a direct causal relationship between the media and teenage suicide in the absence of specific research or studies in this area.

Actions taken/to be taken to address and prevent the problem

8. As explained above, the cause of student suicides are complicated and conceived as personal, family, community and social problems. To address such multidimensional problems, Branches/Departments involved in student/youth services have developed remedial and preventive measures. To tackle the problem systematically and comprehensively, a four-level comprehensive prevention programme which aims at working with the students, their parents, teachers and the community has been developed. A diagram showing all the four levels is at Annex 2.

Level I - dissemination of information and skills to students, teachers, parents and the community

9. This level focuses on the dissemination of critically important information about youth suicide to the students, their parents and teachers to counter any sensational, superficial information and rumours. It also aims at strengthening the coping skills of the students and the management ability of the teachers and parents.

For Teachers

l The Resource Package on student suicide for teachers in 1992 has been revised and updated to help teachers become more proficient in crisis intervention skills and in conducting prevention as well as postvention programmes. This revised package has been completed and will be launched to all schools through a series of seminars during the week commencing 27 January 1997.

l A teaching kit in support of the Whole School Approach to Guidance is being developed to enhance teachers’ strength in guidance work such as communication skills so that they will become more alert to their students’ needs. The teaching kit will be distributed to all primary and secondary schools before the end of 1996/97 school year.

l A series of seminars and workshops were held in December 1996 to help teachers acquire understanding of the emotional states of people so that they could better manage the emotions of their students and themselves.

l Short courses on "Helping Students Cope with Stress", first organised in 1992/93 school year, were attended by 350 teachers. We will continue to conduct 10 short courses for about 270 participants on an annual basis. Moreover, another series of workshops on "Enhancement of Self Esteem", which was first introduced in 1994/95 school year, were attended by a total of 374 teachers.

l Support to teachers through telephone hot-line services (the "Helpline for Guidance Teachers" and the "Suicide Hotline" launched in February 1993 and September 1991 respectively) has proved to be effective and efficient. They will continue to be operated. We have stepped up promotion of these telephone lines by issuing pocket-sized information cards to all school teachers.

For Students

l Resource materials on problem solving skills were developed and issued to secondary school students in July 1996. A similar set of materials will be distributed to primary schools in early 1997. These resource materials aim to help students deal with life problems in a more confident way.

l A new school subject on ‘General Studies‘ is introduced into the primary school curriculum in 1996 with the objective to strengthen students’ inter-personal skills and their ability to cope with the demand of the changing society in a positive manner.

l The Education Department is well aware that teenage students have relatively little experience with life and may lack coping skills. Teenage students do not understand that the feelings of depression and the distress they experienced are usually time-limited and are not signs of inadequacy. In order to promote mutual understanding and a self-help culture among the teenage students, the Education Department commissioned the Department of Psychology, the University of Hong Kong to introduce a peer support programme to around 20 pilot schools. This programme helps students to recognize warning signs and know when, how and where to get professional assistance for a troubled peer. Students will be taught to recognize that it is essential and sometimes even life saving to take warning signs seriously and to break a confidence. The pilot project will be evaluated after a trial run of 3 months commencing October 1996. This life skill training and peer support programme will be promoted in schools in the 1997 school year.

l School-based talks for students by members of the Hong Kong Medical Association on mental health issues and stress management as well as substance abuse have been organised since 1992/93 school year. So far, more than 260 secondary schools had been given school-based talks by the doctors from the Association. The talks will be continued in the future.

For Parents

l A series of 4 leaflets on good parenting and parent-child communication will be reissued in February 1997 to parents of all primary and secondary school students.

l Schools were encouraged to set up Parent-Teacher Associations (PTAs) to strengthen home-school liaison. In the 1996/97 school year, another 101 schools will set up PTAs, making the total number of schools with PTAs exceeding 450 or about 60% of all secondary and 24% of all primary schools. To provide additional support for the PTAs, the Education Department is setting up a pilot Parents’ Centre in this school year to further promote parents’ education.

Reaching the public through the media and other community resources

l The Education Department produced jointly with the RTHK three series of TV programmes on . The third series was broadcast between October and November 1996. The aim is to educate parents on the effective ways of communicating with their children. A series of classes called "ABC for Mums and Dads" are organised for parents throughout the year as follow-up activities.

l Other activities involving the community to help young people develop a positive attitude towards life include the inter secondary school video production competition called "The Way Out" launched between June and October 1996. Participated by 13 secondary schools, this competition is the first of its kind in Hong Kong aiming to encourage young people to have a positive outlook of life through writing their own script and producing their own videos. Parents were also encouraged to participate in the production of the video jointly with their youngsters.

l Short public messages about appropriate parenting methods and positive attitude towards life are announced through radio and television via announcements of public interest (API) programmes.

l Six regional seminars with members of the Hong Kong Medical Association for both students and their parents were arranged on Sundays from March to May 1996 and participated by 900 attendents.

Level II - creating a whole school prevention climate

10. This level focuses on the school as a system whereby the staff of the entire school take the lead to work with students and their parents to demonstrate that the school personnel are caring, knowledgeable and approachable professionals to whom teenage students with emotional problems can turn for help. The school also coordinates the work and activities mentioned at Level I.

l In January 1996, the Education Department invited an expert from the United States of America to deliver training activities on the Growth with Guidance System to 8 primary and 5 secondary schools for pilot running. During the programme, intensive training for the "core group" teachers (about 60) as well as school-based training for all the teaching staff were given.

l To assist schools in assessing the effectiveness of the development and progress on their Whole School Approach to Guidance, an evaluation tool was distributed to schools in this school year. This evaluation tool will constitute a common platform for discussions with officers of the Education Department with a view to further enhancing the system.

l A video tape on the positive and good practices from schools using the Whole School Approach to Guidance was produced and distributed to all secondary schools as reference materials in 1996.

Level III - establishing a supportive network among advisory committees, working groups and agencies

11. A comprehensive programme on prevention requires coordination and networking components. This level focuses on the supportive network formed by the Government and NGOs to undertake both prevention and remedial actions. The core part of this network include:

l Relevant advisory bodies such as the Advisory Committee on School Guidance, Discipline and Support Services (ACSGDSS) and professional associations to share their views and exchange opinions on school guidance and supportive services. These bodies comprise official representatives and those from the school sector. Student suicide was discussed in the ACSGDSS, which then produced "A Review of The Adolescent Suicides in 1991/92". The recommendations, including to promote Whole School Approach to Guidance, strengthen parent education, encourage setting up of Parent-Teacher Associations, etc., remain our guiding principles, which called for the concerted efforts of every relevant sector of the community to tackle the problem of student suicide.

l Departmental task force such as the Task Group on Student Suicide with representatives from different divisions to coordinate the work and to follow up with the progress of the recommendations made by the ACSGDSS and other relevant parties, for example, the coroner; and the Student Discipline Section to strengthen support for the school discipline work and to promote the adoption of positive discipline.

l The Curriculum Development Institute (CDI) to help students, through developing and making changes to the formal or informal curriculum. New elements requesting students to adopt a positive attitude towards life and to act decisively and responsibly in respect of their own life were introduced. Example of these curriculum development is at Annex 3.

l The Education Department also maintains close liaison with the relevant teacher bodies such as the Hong Kong Association of Careers Masters and Guidance Masters and the Hong Kong Association for School Discipline and Counselling Teachers so that concerted efforts could be made for the well-being of the students. In addition, the Department maintains close working relationship with the school social workers, mainly through the Hong Kong Council of Social Services and the Social Welfare Department. In schools, the school social workers/student Guidance Teachers works in close collaboration with the guidance team in helping students whose academic, social and emotional development is at risk.

l The Commission on Youth has since 1991 made recommendations on the measures to be taken to youth suicide and some of them have been taken into account by various Government departments. Moreover, to further examine the supportive network for secondary school students, the Commission on Youth had conducted a study on the supportive system for these students, which was completed in 1995. The report, with recommendations on how best to enhance the supportive network, has been sent to various Government departments and youth organisations concerned.

l The Social Welfare Department (SWD) and non-governmental organisations (NGOs) also help young people both in terms of prevention and remedial action. Remedial counselling and support are provided by caseworkers in Family Services Centres, school social workers in secondary schools, outreaching social workers, professional youth workers in Children and Youth Centres, medical social workers and clinical psychologists. There are also a variety of hotlines, for example, that run by the Hong Kong Federation of Youth Groups called "Youthline", which give young people the chance to seek help from a trained, sympathetic and anonymous ear. Government started subventing "Youthline" in August 1995.

l "Family Life Education Programmes" are organised by life education officers and family activity and resource centres to help parents to create a supportive home environment for their children and to improve communications between them so that young people who are facing problems can talk them through and resolve them rather than trying to escape through suicide. Since very often those who understand young people’s problems best are their peers, mutual help and peer support groups were also set up, for example, in children and youth centres and group work units.

l SWD are also providing social work support in schools through the school social work service. At present, 272 secondary schools are provided with school social work units. More school social workers are provided in schools with more student problems. The service is now under review having regard to other school based and non-school based services to consider how social work support should best be provided in schools.

l To maintain the supportive efforts to all those involved : the parents, the social workers and, most importantly, the young people themselves, the SWD has produced a cartoon booklet entitled "To live" which is aimed at young people to put across the message that suicide is not the way out. SWD has organised over 260 activities in the first six months of this year, including workshops, camping trips, film shows and drama competitions, for young people and their families. In addition, special in-service training programmes are offered for staff in SWD and NGOs on topics such as "Working with Adolescent Self-Destructive Tendencies" and "Handling Suicidal Clients".

12. The objective of all these efforts is to increase understanding of how young people think, what they need and how they can be helped to better cope with the stress in their lives.

Level IV - formulation and coordination of policies

13. This level focuses on the formulation of policies. Youth suicide is a multifaceted societal problem involving personal, social, psychological and biological factors. It is not just a "school problem". However, the school represents the first major contact with students beyond the family. Schools provide students with daily professional contact. Consisting of educational expertise, they are in an ideal position to assist students in learning about and effectively dealing with life problems. Effective school and education policies encompass the various levels of work mentioned above.

14. One of our fundamental education aims is to equip our student with the knowledge, skills and attitudes which help them to lead a full life as individuals and play a positive role in the life of the community. In keeping with this education aim, our overall policy gives a formal recognition that every school has an important role in and commitment to help students play a positive role in the life of the community. Suicide prevention is part of it. This system-wide policy provides for the input, commitment and participation of all the elements mentioned at the other levels and increases the chance for students to receive the required support and assistance for dealing with suicide issues in themselves and others.

15. The Co-ordinating Committee for the Welfare of Children and Youth at Risk chaired by the Secretary for Health & Welfare was set up in 1993. This Committee has established a Working Group on Services for Youth at Risk with the Director of Social Welfare as its chairman. This Group, which comprises representatives from NGOs and relevant Government departments, is tasked with examining current youth problems and recommending measures to tackle them. It has looked at the issue of youth suicide and proposed several initiatives. Highlights include :

· modernisation of children and youth centre service

This involves the formation of a task group to take a fresh look at children and youth centre facilities. The idea being that if we are to attract young people off the streets and away from places where they could be vulnerable to bad influences, we need to make these centres more appealing. So the group is reviewing their accommodation and equipment and suggesting ways to up-date and improve them.

· promotion of peer group support

SWD is promoting peer group support in the districts through increased efforts by District Social Welfare Officers and NGOs.

Formal reviews are conducted from time to time. Insofar as youth services are concerned, for example, two reviews have been conducted of the outreaching social work service, one in 1987 and one in 1994. As a result of these reviews, six more outreaching teams were created since the first review and two more outreaching teams were created in 1996/97. These teams are being established in recognition of the more complex problems being faced by today’s youth and the effectiveness of the outreaching service in identifying young people in need and preventing their problems from getting worse.

16. Between 1992 and 1994, Children and Youth Centre Services were reviewed to ensure that the policy objectives were appropriate, and the organisation structure and services were meeting young people’s needs. The conclusion was that these centres should adopt a "holistic" approach in addressing the problems of young people. That is to say, all aspects of a young person’s life should be looked at. To achieve this, it was recommended that an integrated approach in terms of the professionals involved should be adopted so that youth workers of children and youth centres, school social workers, outreaching social workers, family life education workers co-operate in providing support and organizing programmes in the centres. SWD has already set up 13 Integrated Teams and are conducting an independent evaluation of their effectiveness.

17. The Working Group on Services for Youth at Risk has also commissioned the "Breakthrough" to develop a screening tool to identify early those young people who might be at risk so that we can meet their needs before their problems develop or become too serious. The Breakthrough has submitted a draft report on the study and we are considering whether and how to conduct a pilot in certain school.

Conclusion

18. The Government has been adopting and will continue to adopt preventive, educational and remedial measures to tackle student/youth suicide. Government departments and NGOs concerned will continue to make concerted efforts to provide more comprehensive supportive networks to youth/students. The Co-ordinating Committee for the Welfare of Children and Youth at Risk and the Commission on Youth will be invited to consider to re-visit the issues of youth/student suicide to discuss preventive and remedial measures at their coming meetings while the Education Department will continue to step up the educational measures.

Education and Manpower Branch
January 1997

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