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How Japan reduced one of the world's highest suicide rates

Takehiko KambayashiThe Christian Science Monitor
Stephen Nowers illustration

Japan has long been plagued by suicide. It has one of the world’s highest suicide rates and it’s one of the leading causes of death among men. But last year the number of suicides fell below 30,000 for the first time in 15 years, according to the government.

Though suicide is still a big problem in Japan, often linked with how the economy is doing, the decline provides the country a rare glimmer on the issue, following economic downturn a year after the devastating Fukushima Daiichi nuclear power meltdown, which had some observers bracing for a higher than average number of suicides.

Why the dip? Some say the community-based efforts of experts, activists, and citizens groups urging the government to address the social problem and draw up countermeasures is starting to work.

Such efforts have been bolstered by $113-million government subsidies, says Hisanaga Sasaki, an associate professor of health sciences at Akita University who researches suicide prevention and mental health. The people forced the government to confront the issue. The subsidies compelled government officials to take action, rework laws, and set up hotlines, and that has helped local communities, Mr. Sasaki says.

"The efforts made through cooperation with volunteers, civic groups, and local government officials have been effective in tackling the issue," Sasaki says.

On Jan. 17, Japan’s National Police Agency announced that the number of suicides declined to 27,766 in 2012, the first fall below 30,000 in 15 years.

Notorious

The large number of suicides in Japan is attributed mainly to the country’s protracted economic downturns. Many see bankruptcy as a personal failure, rather than a symptom of a temporary economic problem. In many cases, bankruptcy causes business owners to kill themselves just as samurai warriors used to practice hara-kiri, a ritual form of suicide, to show they accept responsibility for their deeds.

“As they keep blaming themselves for business failure, saying, ‘I’ve done wrong’ or ‘I’ve caused trouble to society,’ that totally impairs their judgment,” says Hisao Sato who started a suicide prevention program in 2002 in Akita city, some 720 miles north of Tokyo. The region is notorious for being home to the highest suicide rates.

Throughout the past decade of counseling mostly businessmen, Mr. Sato says he has gained some strong insight into how to change the tide.

If Japan is going to stem the tide of suicides, it has to begin with changing perceptions about suicide. “That is, suicide should be … dealt with as a social problem,” he says, not as a way to save face.

It's this change of perspective that could pave the way for a continued decline in the number of suicides in Japan, say analysts.

One perspective at a time

One former company president in Akita, who declined to be named because of his bankruptcy, recalls having suicidal thoughts as his business had deteriorated. By that time, five business managers whom he was acquainted with had already taken their own life, he says.

“I was also thinking about committing suicide to take responsibility. But Mr. Sato told me not to do so and reminded me of decades of my work,” he recalls. “Mr. Sato saved my life.”

Once a business goes under, Sato says, relatives and friends of the owners and managers start to distance themselves out of shame. This just exacerbates feelings of isolation, he says. When times get difficult that’s when people most need someone who will listen to them, he says.

“I take a lot of time for those who come here and try to give them the comfort of knowing we will connect with each other,” says the gray-haired man wearing wire-rimmed glasses. “I also promise to see them again the following week. And they come back.”

There’s a reason Sato can relate to these calls for help: Before he became a counselor and advocate, he ran several companies in Akita for more than 20 years. When one of them went under in Sept. 2000 he lost his house, personal assets, credibility, and status.

As Sato suffered depression he says he often had suicidal thoughts. But in May 2001, one of his close acquaintances committed suicide.

Seeing someone so close to him follow through with suicide made him determined to prevent more business managers – who have long contributed to the region’s economy – from killing themselves. The following year, he set up his nonprofit organization.

The numbers in Akita Prefecture seem to speak to its success. Although suicide rates there are still the highest in Japan, suicides among business owners in Akita fell nearly 70 percent from where it was 10 years ago, according to Akita prefectural police.

Japan still has a ways to go, say analysts. But as community groups continue to organize the government is trying to follow example.