On the frontlines of Korea's suicide epidemic

Joo Sang-hyun, left, and Lee Kyoung-young from Seoul Suicide Prevention Center / Korea Times photo by Ko Dong-hwan

By Ko Dong-hwan

Despite being a major international player in areas such as high technology and popular culture, South Korea continues to be haunted by having the highest suicide rate among OECD countries.

Last year, data showed that 29.1 people per 100,000 took their own lives ― more than triple the OECD average.

Less is known about front-line efforts to prevent suicide in Korea, in particular, the counselors who provide crisis intervention and counseling to people at risk of killing themselves.

To better understand these efforts, The Korea Times visited the headquarters of the Seoul Suicide Prevention Center (SSPC) and sat down with two of its counselors, Lee Kyoung-young and Joo Sang-hyun.

Lee and Joo are part of the crisis intervention team of the SSPC, a program launched in 2005 under the supervision of the Seoul Metropolitan Government.

The counselors accompany police and firemen to hundreds of locations each year where people are at risk of harming themselves. Each counselor monitors some 50 to 60 high-risk cases each year.

During the interview at SSPC headquarters in Nonhyeon-dong, southern Seoul, the counselors said that as much as they feel they are doing important work, the stress and trauma involved makes it a very difficult job.

Q. What are some of the more common “triggers” you’ve observed in suicide intervention cases?

Lee: What pushes people past the threshold ― the triggers ― vary case-by-case. But most of them are social issues, including economic hardship.

Joo: Recently, I’ve seen an increasing number of cases deriving from family troubles, including teenagers who are primarily affected by their school report cards. There is also a hike among those in their early 20s and baby boomers in their 50s who were laid off.

Q. What’s your first task when you encounter people at high risk of committing suicide?

Joo: There are two types of people at risk. One is when police bring suicidal subjects into safety and request us to attend the scene.

When we get there, we must build a rapport by talking to them and understand their situation. We then conduct a suicide risk evaluation and, depending on the results of this, send such people to a hospital or hand them over to their guardians.

There are cases when people are hurt during their attempts at suicide. The first step then is for police to take them to a hospital for treatment. After that, with an agreement by the subjects’ family members, we are dispatched to the hospitals to conduct an evaluation.

Lee: The second type is those who contact us by calling us directly after having prepared a plan to kill themselves. It’s our job to persuade them to give up the plan.

Q. How do you first approach such people when engaging with them?

Lee: It varies, depending on their age and situation.

Joo: We have manuals that we go by, a set of detailed questions designed to assess why a person considered suicide in the first place. But that in itself solves nothing. We must build a personal rapport with them to understand their psychological state.

Lee: These subjects are really desperate people in dire situations with no one else to reach out to. They say their lives are hard and that they wish to kill themselves, and I must try to identify what caused them such hardship.

Q. One would imagine that unexpected challenges occur during the process.

Joo: From time to time, we see triggers appear out of nowhere (and a person commits suicide). This occurs even when the evaluation appears promising and the suicidal intentions seem to be abating. Of course, we feel despondent whenever such incidents happen. Any social worker would feel the same way.

Q8. Have you experienced post traumatic stress disorder (PTSD) because of your line of work?

Joo: I once received a call from a person during an overnight shift who said he would kill himself at any minute and asked me to take care of his body. The horror of such calls is much more intense than encountering a person at risk at the scene. We try to locate such people but don’t always succeed. That’s when we ask ourselves questions such as, “What if I did something wrong?”

Lee: Constant “what if” doubts linger in my head, despite my utmost efforts, from cases when interventions fail. I think that can certainly raise the risks of PTSD for workers. PTSD also depends on how deeply workers empathize with subjects. Once empathy kicks in, some workers can’t let go of people they are trying to help psychologically.

Q. What more can Korea do to lower the suicide rate? Is it a matter of providing more preventative mental health services?

Lee: It’s hard to pinpoint. But it’s true that our office, with only eleven experts, cannot manage all people at risk. If they only had someone to speak to about their suicidal thoughts, the triggers may decline. There aren’t enough services where experts can talk to people in need. We definitely need more manpower.