Attitudes Toward Suicide Among Chinese People in Hong Kong

572 Attitudes Toward Suicide in Hong Kong
TABLE 4
Endorsement of Suicide Under Difficult Life Scenarios
Life Scenarios Mean Score SD
Being terminally ill 2.61* 1.10
Having a chronic psychiatric illness 2.53* 1.12
Being severely depressed 2.50* 1.14
Being a burden to others and feeling hopeless about the future 2.36* 1.11
Being heavily indebted because of gambling 2.22* 1.11
Not having anyone to provide financial or emotional support in old age 2.22* 1.08
Having been raped 2.10 1.09
Being addicted to drugs 1.96 1.02
Being sentenced to imprisonment 1.88 0.94
Having a business failure 1.86 0.95
Being criminally charged 1.81 0.95
Frequently abused or beaten up by spouse 1.75 0.94
Note. Each of the 12 items was measured on a 5-point Likert scale as follows: 5 = definitely
consider, 4 = very likely to consider, 3 = probably consider, 2 = probably not consider, and 1 = definitely not
consider.
*refers to mean score significantly higher than 2 (probably not consider) (p < 0.05)
suicide. Filial piety in the Confucian tradi- more sympathetic toward suicidal people
tion has often been cited as a Chinese virtue when compared to male respondents. They
that protects the elderly from adversities, yet were also more likely to make a distinction
the rates of suicide among the elderly are between suicide and attempted suicide. This
consistently very high among Chinese com- combination of attitudes appears to protect
munities in Hong Kong, China, Taiwan, and them against suicide but, in the presence of
Singapore (Lee & Kleinman, 2005). Such a impulsivity, may also make them more likely
paradox indicates the need to take a multi- to attempt suicide under circumstances of
attitudinal approach to understanding the el- perceived hopelessness (Goldsmith, Pellmar,
derly vulnerability to suicide. The present Kleinman, & Bunney, 2002). Conversely, by
study provides at least two clues to this vul- making a smaller distinction between suicide
nerability. First, terminal and chronic dis- and attempted suicide and demonstrating less
eases were the most commonly endorsed ra- sympathy toward suicidal people, male retionales
for suicide out of the twelve difficult spondents might be less likely to expect res-
scenarios presented to our respondents (Ta- cue or seek help, and more likely to make a
ble 4). Second, older respondents were more lethal attempt. This may help explain the
fatalistic toward suicide and more likely to higher ratio of suicide/attempted suicide
consider suicide under the hypothesized sce- among male than female individuals in both
narios. This indicates a clinical need for help- Chinese and Western communities (Lee &
ing professionals to be especially sensitive to Kleinman, 2005). The clinical implication of
the vulnerability to suicide of Chinese elderly this finding may be that proactive approaches
with chronic diseases.
are required for helping suicidal males. Pop-
Attitudinal variability may stem from ular measures such as hotline counseling may
the fact that a given person holds a contradic- not be effective.
tory mixture of attitudes that interact among
themselves under particular scenarios. In the
Cross-Cultural Comparison
present study, female respondents exhibited a Different methodologies employed premore
negative appraisal of suicide and were clude a valid comparison between the find-
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