The Opening Ceremony of the 2nd Asia Pacific Suicide Prevention Conference 2006

10 Mar 2006

By Ms Yong Ying-I, Permanent Secretary

Good morning ladies and gentlemen,

1. On behalf of the Ministry of Health and the Institute of Mental Health, I would like to welcome Prof Brian Mishara, President of the International Association for Suicide Prevention and all our other visitors to Singapore.  I wish you a very happy stay here.  I would also like to take this opportunity to thank the Association for choosing Singapore to host your 2nd Asia Pacific Suicide Prevention Conference 2006.

Suicide

2. Suicide is recognised as a significant public health concern. According to the World Health Organisation (WHO), there are almost one million deaths per year due to suicide. In the year 2001, the global toll of suicide exceeded that of homicides and war combined and this figure is estimated to increase to 1.5 million people by the year 2020.  It is a tragedy that leaves families and friends devastated emotionally, socially and economically.  The tragedy is all the greater because suicides are largely preventable. 

3. In Singapore, suicide accounts for approximately 2% of all deaths locally. This translates to an average of one Singaporean dying from suicide each day.  It is a significant public health concern in Singapore too - after all, this figure is even higher than deaths caused by road traffic accidents.  The psychological, social and financial impact of suicide on the person's family and the community is tremendous, as families and friends are left to struggle with the aftermath of a suicide. 

4. Worldwide, the rates of suicide are highest in the elderly.  Singapore is no different. However, we are also concerned about suicides in the young.  Currently, suicide ranks as one of the top three causes of death among people aged 15 to 35 years. This is of great concern as the young are supposed to be society's hope for the future, and at the personal level, the hope of their families.  This is potential lost - the potential to contribute to their societies and economies, the potential to live full and fulfilling lives.

5. Suicide is the result of a complex interaction of factors. These include mental illness, poverty, unemployment, substance abuse, social isolation, loss, relational difficulties and workplace problems.  Physical illnesses and disabling conditions are also important factors particularly in the elderly.  For the young, we are only beginning to study it, but most analysts would agree that the major factors are these: pressure to perform to society's and family's expectations; relationship difficulties, and disorientation from the sheer pace of change in the world around us today.  Today's teenagers get far more information, ideas and get to experiment with so much more than the teenagers of a generation ago - blogs, chat-sites, digital gaming, google.  But they are psychologically no better prepared for it. 

6. At the risk of sounding totally off-side, I wanted to repeat to you a story that I was told by a quite well-known leadership guru called Margaret Wheatley.  I heard her tell this at an organisational leadership conference here last week.  Margaret Wheatley was fascinated by the fact that Senegal had no suicides.  She thought this was most strange, considering the extremes of poverty, unemployment and health challenges that they suffer.  In exploring this phenomena, she discovered that this is part of the deeply held beliefs in their culture that "you are only a person, through other people".  You live with others and through others.  In other words, their sense of community and caring for each other is very strong, and they share what little they have openly and easily.  So there is no hunger or homelessness at the individual level.   I was not able to double check the factual accuracy of this statistic, but if right, it is most thought-provoking.  I am reminded that in the Singapore of the past, we ourselves had a strong culture of "gotong royong", which is a Malay village-community philosophy of help-and-be-helped.  Somewhere in the rush towards modernization, urbanization, globalization and high-pressure competition, we have become a more transactional society.  There is less room within our official interactions for deeper people-oriented approaches.  I am quite sure that the vast majority of our visitors would also say this about their own societies.  This Senegalese statistic is a reminder to all of you who are surreptitiously clearing your emails and SMSs during the conference that we need to find time to slow down, to nurture people-to-people relationships and to rebuild societies where people naturally care for each other.

Interventions

7. We know that suicide is preventable. And if it's the result of many factors interacting together, we need more comprehensive intervention programme to tackle it well.  The trouble is that working on solutions is far harder than understanding the factors contributing to suicides because they require solutions to some of society's deeper problems and they need people from a wide variety of disciplines and backgrounds to work together on integrated solutions.

• Take unemployment, poverty and workplace problems.  With an aging workforce and economic restructuring, many of you would have seen older workers in your countries displaced from their jobs and they face difficulty getting new jobs.  This impacts their self-confidence, their family relationships, their lifestyles.  But the solution - that of getting new skills in order to get into new jobs, and a more supportive overall environment - requires many, many parties to work together.  Training providers; unionists; employers; social workers, psychologists.  

• As for tackling youth problems, this is a special challenge because typically the people who work on this are adults i.e. they are older.  I honestly think that to be very effective at designing stronger societal support systems, you must understand youth culture and youth communications - what moves them, what is important to them, who are their idols, how do they communicate, what different pressures are they facing; what support structures they have.   Parties that are major influencers are their teachers, their relatives or their religious leaders if they are religious, advertisers and journalists, music deejay and football stars.  How do we make these our partners in a broader, more encompassing effort?

8. On the part of health workers and people in the social services sector, we ourselves can and should identify early high risk groups such as bereaved elderly or youth in crisis.   Support infrastructure for intervention such as crisis counselling and hotlines must also be available and accessible.  And we should treat early rather than let the downstream problems happen.  So mental disorders such as depression must be diagnosed and treated effectively.  For that, it is imperative that frontline healthcare professionals like Family Practitioners are trained in identifying and managing suicidal behaviours.  But we will need the help of the sorts of people I mentioned above, who influence and have direct front-line contact in normal day to day living with the at-risk groups.  They can only be effective if we do more to make them aware of suicidal behaviours, help more such people identify the warning signs of suicide and know where to get help.  In other words, a multi-pronged, integrated and comprehensive approach to suicide prevention is needed.

9. In Singapore, our health institutions have been training family physicians in managing mental and suicidal conditions. Our Institute of Mental Health and the Health Promotion Board have a joint programme called "Mind Your Mind" to increase awareness of mental disorders.  IMH has also been working closely with SOS, counselling centres and family service centres to manage suicidal patients. However, the network needs to be expanded greatly if we are to have what I earlier called "a multi-pronged, integrated and comprehensive approach" to suicide prevention.    

10. That is why we are launching DepNet today. This is the first Singapore website dedicated to offering extensive information, local resources and interactive support from qualified professionals for people affected by depression.  DepNet provides depressed people a discreet way of seeking help and advice and it is hoped that they will be then be encouraged to seek definitive help from trained professionals.

11. This conference offers a unique opportunity for participants from different ministries, voluntary welfare organisations and hospitals to learn more about the suicide trends in the Asia Pacific region, explore effective preventive strategies for the high risk groups, and benefit from the experiences of overseas suicide prevention programmes.  I believe that the knowledge and skills acquired from this conference and the networks formed will lay the foundation for more effective suicide prevention programmes.

12. In closing, let me wish all of you a very successful conference.

Thank you.