Attitudes Toward Suicide Among Chinese People in Hong Kong

574 Attitudes Toward Suicide in Hong Kong
behavior. This tallied with our finding that tudinal complexity of suicide may navigate
respondents who were classified under hypo- different forms of prevention efforts to more
thetical scenarios as being high risk had more
suicidal ideation, made previous suicide at-
realistic goals.
tempts, and demonstrated a more positive
appraisal of suicide than their respective
Limitations and Future Research
comparison groups. The present study has several limitations
that suggest the need for further re-
Implications for Suicide Prevention search. First, the findings from a convenience
sample clearly cannot be generalized to the
Phillips, Liu, and Zhang (1999) sug- general population in Hong Kong or other
gested five interacting factors that collec- Chinese communities. The low variance extively
determined suicide rates in a commuplained by the identified factors could, for exnity.
These included cultural attitudes toward ample, be due to sampling bias toward pro-
suicide in addition to the prevalence of social ductive members of society (namely, employees
and mental health problems, convenience of and students). Future studies should encommethods
of suicide, and comprehensiveness pass a general population sample that in-
of suicide prevention services. While intu- cludes socially disadvantaged people who
itively plausible, these five factors are not eas- may be more prone to endorse suicide. Secily
modifiable, especially by clinicians. In the ond, attitudes do not necessarily translate
case of Hong Kong, there is little popula- into behavior in accordance with the multition-based
public health policy that addresses factor model of suicide (Manstead, 1996). At-
the treatment gap of mental disorders, not to titudes must interact among themselves and
speak of their prevention. Widely believed to with non-attitudinal factors in their ultimate
be gatekeepers, primary care practitioners are impact on behavior. As such, our findings
inadequately trained to manage common should be interpreted cautiously. Third, the
mental disorders (Lee, Tsang, & Kwok, CASQ-HK was lengthy and, because of our
2007). The most common methods of suicide failure to secure consent from the partici-
in Hong Kong—jumping from height and pants for a second round of distribution, its
charcoal burning (Centre for Suicide test-retest reliability was not established.
Research and Prevention, 2005)—are hardly Shortening it will allow larger samples of
controllable. Moreover, suicide prevention people to be examined and a more stringent
efforts are not only limited in quantity but assessment of its psychometric properties. Fi-
also have adopted methods (e.g., hotline nally, we believe that attitudinal surveys fail
counseling by volunteers and advice to jour- to uncover the layers of privacy and equivonalists
on appropriate ways of reporting sui- cality that typically envelop suicide. They
cide) that are of questionable usefulness. In should be complemented by ethnographic
regards to the findings of the present study, research that elucidates the complex interac-
we are still uncertain about how attitudes and tions of attitudes and behaviors in specific
contextual factors act in concert to evoke sui- contexts and how large-scale socioeconomic
cide, and how attitudinal data can be inte- transformations in Chinese society shape the
grated into health interventions to reduce inter-subjective meanings of suicide (Lee &
suicide. Nonetheless, acknowledging the atti- Kleinman, 2005).
REFERENCES
Census and Statistics Department of
HKSAR. (2004). Women and men in Hong Kong—
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its prevention. Hong Kong: University of Hong
Key statistics. Hong Kong: Author. Kong.
Centre for Suicide Research and Pre-
Goldsmith, S. K., Pellmar, T. C., Klein-
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