Suicide in Rural Areas: The Case of Japan 1960–19801

Abstract Rural suicide rates are higher than urban suicide rates in industrialized Japan in contrast to the traditional pattern of higher urban suicide rates found in the West. The pattern is attributed to areal differences in social disintegration. This explanation is operationalized for Japan and tested empirically using data (1979–1981) on 47 prefectures. Higher suicide rates are observed in areas with a sparse population, a stagnant economy, and a population over-represented by elderly people. The explanatory power of the structural variables in the present study is also tested for each decade since 1960. These variables are found to be increasingly effective in predicting suicide rates as industrialization proceeds. Variation in social integration, rather than the degree of industrialization and urbanization, is the key to understanding the differentials in suicide rates.     

Multi-dimensional poverty in Australia and the barriers ill health imposes on the employment of the disadvantaged

A little over one million individuals in Australia between the ages of 24 and 64 years are in Freedom poverty – they have low family income, and have either poor health or an insufficient level of education. These individuals are some of the most disadvantaged in society due to their multiple capability restrictions. Current political rhetoric focused on reducing the number of individuals out of the labour force to improve their living standards may offer a means of improving the lives of these most disadvantaged individuals. Indeed, of those in Freedom poverty, 80% are not in employment. But these individuals also have poor health and/or a poor education and these capability limitations may act as barriers to their labour force participation. Indeed, 49% of individuals in freedom poverty who were out of the labour force cited ill health as the reason for this (39% cited their own ill health, and 10% cited another's ill health). Not only will these individual's ill health act as a barrier to their engaging in the labour force, but ill health will also contribute to reduced quality of life. Political promises to improve the lives of citizens should not focus narrowly upon increasing labour force participation rates, but should take a holistic view of the lives of individuals taking note in particular of how health may be restraining their quality of life.     

Suicide and unemployment in Japan: Evidence from municipal level suicide rates and age-specific suicide rates

Most previous studies on the relationship between unemployment and suicide use either individual level data or large unit aggregate level data. The former typically fail to distinguish the observed association from the causal link, and the latter often produce inconsistent findings on the unemployment-suicide relationship, making it difficult to draw policy implications. The present study contributes to this line of research by using two semi-aggregate level data in Japan. The results show that unemployment is significantly associated with male suicide rates, especially those of prime age working men, while the results are not straightforward for female suicide rates.     

Living with suicidal feelings: Japanese non-profit organizations for suicide prevention amid the COVID-19 pandemic

The number of suicides in Japan increased for the first time in 11 years during the COVID-19 pandemic. This trend is particularly high among employed women and students. The Japanese government expanded its budget for providing telephone and social network service (SNS) counseling by prefectures and non-profit organizations (NPOs). On the basis of interviews with the chairman as well as counselors of an NPO in Osaka (Japan) that has provided telephone counseling services on suicide for over 40 years, this study examines suicide and suicide prevention amid the COVID-19 pandemic with a particular focus on how suicidal feelings are accepted. The results clarify that people do not wish to die just because of financial troubles or health problems; rather, they have lost the meaning in their life in the conflicts between social conditions and their personal life histories. Additionally, as volunteer counselors often experience the suicide of close relatives, their empathy for a caller may be based on their experiences of being overwhelmed by the realization of the otherness of others. They do not regard the acceptance of suicidal feelings as a “job,” but act as “friends.” Although modern society conceals death and suicide cases, the key to achieving a society where no one is driven into committing suicide is to place human life and human rights first as well as to talk about suicide and suicidal feelings without making the subject taboo or an aberration.     

Mental health and firearms in community-based surveys: implications for suicide prevention

Suicide rates are higher among those who own a handgun and among those who [corrected] live in a household with a hand gun. This article examines the association between [corrected] gun ownership and mental health, another risk factor for suicide. Data from the General Social Survey, a series of surveys of U.S. adults, are analyzed to compare general emotional and mental health, sadness and depression, functional mental health, and mental health help seeking among gun owners, persons who do not own but live in a household with a gun, and those who do not own a gun. After taking into account a few basic demographic characteristics associated with both variables, there appears to be no association between mental health and gun ownership. Nor is there any association between mental health and living in a household with a firearm. Findings suggest that the high risk of suicide among those who own or live in a household with a gun is not related to poor mental health. Implications for prevention are discussed.     

Trust and the Dilemmas of Suicide Risk Assessment in Non-government Mental Health Services

Reducing suicide rates is a national mental health priority as over 2,200 people die from suicide each year in Australia. Increasingly, nongovernment organisations (NGOs) provide services to people experiencing severe and persistent mental illnesses—a significant cohort at risk of suicide. While clinical services are generally seen as the arbiters of risk, little is known of how suicide risk assessments are undertaken in NGOs. This article reports the findings of a survey-based pilot study of 44 frontline workers in mental health-focused NGOs in Tasmania, Australia, with the aim of sketching a preliminary picture of this under-studied terrain. We identified the assessment practices utilised by workers, and the challenges and dilemmas they experienced in navigating issues of trust in suicide risk assessment in contexts where they often felt vulnerable and under-prepared. We argue that these early findings demonstrate the need for organisations to foster cultures of trust to facilitate both the activities of relationship building between practitioners and clients, and those of monitoring risk.     

Small Arms Mortality: Access to Firearms and Lethal Violence

There is an intuitive appeal to the notion that the more lethal the weaponry the more lethal the violence. We explore one aspect of lethal weaponry, firearm accessibility. Using nation-level (N = 168) data from the Small Arms Survey and the World Health Organization's measures of mortality we examine whether rates of small arm ownership have a positive effect on rates of homicide and suicide. Contrary to the opportunity model, the accessibility of firearms does not produce more homicide or suicide when other known factors are controlled for. Consistent with past research, structural factors, like deprivation, explain a large portion of the cross-national variation in homicide and suicide, with some interesting differences between the two models. We discuss explanations for our findings and suggest that firearm accessibility may make some structural positions more lethal.     

“Good Manner of Dying” as a Normative Concept: “Autocide,”“Granny Dumping” and Discussions on Euthanasia/Death with Dignity in Japan

The purpose of this paper is to clarify the two characteristics of the way the issue of euthanasia/death with dignity has been discussed in Japan, compared with the situation in Europe and the USA. The two characteristics are: (i) that the concept of “euthanasia” is sharply distinguished from that of “death with dignity” in Japan in that the former only refers to the killing of a patient by administration of a lethal drug while the latter refers to letting a patient die by withholding or withdrawing life‐prolonging medical treatments; and (ii) that the view that it is sinful to commit suicide is not as common in Japan as it is in the West. In order to clarify these characteristics, I examine the nature of suicide and murder in relation to the issue of euthanasia and death with dignity while briefly reviewing the history of the debates in Japan in order to see how the characteristic understanding of “death with dignity” has generated. I also clarify, by giving examples, the structure of those narratives with regards to the “good manner of dying,” which excludes from society the elderly and people with incurable diseases and ones with motor and intellectual disabilities. In the end, I describe how biopolitics functions in the current Japanese situation.     

Suicide ideation,anxiety, and depression: Are children a protective factor for male Veterans?

ABSTRACT

Numerous mental health disorders plague our veterans when they return from deployment including anxiety and depressive disorders, which have been linked to elevated suicide risk when left untreated. Family factors, such as parenthood status, may serve as a protective factor against these mental health issues. This study examined the role of parenthood status of male veterans (N = 234) based on age of the child in order to determine whether a child’s age (minor children v. adult children) affects the likelihood of meeting diagnosis criteria for anxiety, depression, and suicide ideation after controlling for marital status. Three hierarchical binary logistic regression models were constructed to assess the predictive influence of children 18 years old and younger, children older than 18, and no children with the results indicating that parenthood status did meaningfully enhance the prediction of suicide ideation. Complete findings, clinical implications, and future considerations are discussed.     

On and Off the Reservation: A Discussion of the Social,Physical, and Mental Health Indicators of Suicide in the Native American Community

This article reviews explanations for the heightened rates of suicide among the US Native American population. Particular attention is afforded to the social, historical, physical, and mental health stressors that may contribute to such high rates. A great deal of scientific research has centered on determining and analyzing the many socio‐demographic indicators of suicide. Studies at the intersection of race/ethnicity and suicide have drawn attention to the fact that certain groups have higher suicide rates than others. At the pinnacle of groups most susceptible to suicide are Native Americans, followed closely by White non‐Hispanics, and then all other racial/ethnic groups ( Sederer 1994 ). As of 2008, Native Americans were more than twice as likely to commit suicide as Blacks, Hispanics, or Asian‐Americans. The analysis begins with an exploration of potential explanations behind the alarming rates of suicide within the Native American community, followed by critiques of the various theories.     

Contemporary Social Problems in Japan: A Study of the Suicide and Depopulation Problems

Abstract  Two complementary investigations were undertaken:
1. Research into the relationship between suicide and depopulation in Shimane Prefecture.
2. Research into the relationship between the perception of social problems and unwanted objective conditions, employing suicide as the example of unwanted conditions.
To summarize the most important findings:
1. The suicide rates have been notably higher in depopulated areas.
2. The partial correlation of suicide to depopulation was high, when the effect of aging of population was removed.
3. This partial correlation has increased since 1975. There has been an aggravation of the problem of suicide as a depopulation problem.
4. The correlation of suicide to aging of the population vanished, when the effect of depopulation was removed.
5. At 70 and over, the suicide rates have been notably higher in depopulated areas.
6. The correlation of the age-specific suicide rate with the depopulation rate, increases with age and the correlation of the suicide rate among old people to the depopulation rate, was notably higher.
7. These suicidal tendencies express the mores of society. Morality underlies the perception of social problems, while morality could not exist without generating suicide at a certain point. Both suicide and the perception of suicide as social problems are largely determined by morality. This is our paradoxical hypothesis.
8. Lastly, we emphasize that there are serious depopulation problems in Japan. This is particularly obvious, if suicide is employed as the indicator of depopulation severity.     

The Effect of Unemployment Duration on National Suicide Rates: A Time Series Analysis, 1948–1982

Abstract

Periods of increasing unemployment are associated with increases in suicide rates. Unemployment increases suicide among laid off persons, new entrants, reentrants to the labor market, and groups indirectly affected—the underemployed, those fearing unemployment, the families of the unemployed, and even those suffering from falling real wages, a condition endemic in major recessions. The present investigation deals with a neglected unemployment measure: the duration of unemployment, a condition known to be critical to the generation of extreme behavior such as suicide. Controls are introduced from alternative perspectives on the problem including the incidence of divorce. The data analyzed refer to yearly measures of the variables over a 31 year period. The results of a Cochrane-Orcutt iterative regression analysis indicate that the greater the duration of unemployment the greater the suicide rate. Using ex post forecasting techniques it is estimated that increases in unemployment during the Reagan administration have been associated with at least 929 additional deaths from suicide. The duration of unemployment increases suicide rates for both males and females. The model explains between 59 and 88 percent of the variance in suicide.     

Sleep disturbances and suicide—New battles for veterans of U.S. wars in Afghanistan and Iraq: A retrospective review

In this article, we systematically reviewed 116 veterans’ medical records to explore the mitigating factors in sleep disturbance, polytrauma clinical triad (PCT), and suicide. We discovered that a particular nonaction (i.e., no standardized completion of sleep-disturbance screenings) had strong implications for resulting suicides among veterans with reported sleep disturbances, PCT, and suicidal ideations. This study provides strong propositions for the further study of this veteran cohort—Operations Enduring Freedom (OEF), Iraqi Freedom (OIF), and New Dawn (OND)—with regard to the impact of sleep disturbance on PCT and its relationship with suicide symptoms, ideation, and completion. The purpose of this study was to examine the outcomes of sleep disturbances on complex relationships among the three primary diagnoses—posttraumatic stress disorder (PTSD), traumatic brain injury (TBI), and chronic pain—that establish the PCT cluster. We identified that those diagnosed with sleep disturbances had increased suicidal ideations and rates of completed suicides. We analyzed these factors in veterans returning from the current wars in Afghanistan and Iraq. We hypothesized that (a) clinicians were not completing sleep-disturbance screenings as a standard practice for the OEF/OIF/OND veterans diagnosed with PCT who reported sleep disturbance concerns within the U.S. Department of Veterans Affairs; (b) if no sleep-disturbance screening instruments were used by clinicians, veterans would be at a greater risk of suicide completion.     

How does discharge status impact suicide risk in military veterans?

Little is known about over 125,000 veterans who received non-honorable military discharges since 2001, even though these veterans face substantial barriers to obtaining services and are likely to be at high risk for negative mental and behavioral health outcomes including suicide. Seven-hundred twenty-two veterans living the in the San Francisco Bay Area participated in the study. The sample comprised honorably discharged (n = 508) and non-honorably discharged veterans (n = 214). T-tests were used to compare means on predictors of suicide risk including Posttraumatic Stress Disorder (PTSD), depression, alcohol use, somatic symptoms, and physical disability. A series of regression models tested relationships between predictors, discharge status, and suicide risk. Non-honorably discharged veterans demonstrated higher mean scores than honorably discharged veterans on all predictors. In regression models, somatic symptoms (β = 0.22, p < 0.001), physical disability (β = 0.16, p < 0.05), and discharge status (β = 0.33, p < 0.001) were associated with suicide risk. The final model showed an interaction effect for discharge status on the relationship between somatic symptoms and suicide risk (β = 0.16, p < 0.05). Non-honorably discharged veterans showed higher rates of mental and physical health problems and suicide risk compared to honorably discharged veterans. The magnitude of the relationship between somatic symptoms and suicide risk was significantly greater in non-honorably discharged veterans.     

Anomic suicide: A Durkheimian analysis of European normlessness

ABSTRACT

According to Durkheim (1897), periods of economic, social, or political change result in a state of anomie or normlessness. Anomic periods lead to deregulation of desires and suffering. Durkheim hypothesized that, as an expression of suffering, societies and groups experience an increase in suicide rates. This paper provides two formal tests of Durkheim’s (1897) theory of anomie - a behavioral aggregate analysis and an attitudinal individual-level analysis - on the backdrop of the 2008 economic crash. The first analysis assesses the relationship between unemployment and suicide in the European Union between 2000 and 2010. Results provide conditional support for Durkheim's theory: suicide rates increased following the crash and decreased once economic stability resumed in 2010 for males only. A second attitudinal analysis identified factors contributing to the gendered relationship between anomie and suicide. Results indicated that traditional Durkheimian regulatory mechanisms, such as marriage and divorce, contributed to the gender-specific results.     

Right-to-Die Legislation: A Note on Factors Associated with Its Adoption

Legislation allowing for some form of death prior to it naturally occurring presently exists in very few industrial democracies. This article explores what large-scale economic and social factors may be associated with the legality of right-do-die measures, namely, a nation's health care expenditures, the old-age dependency ratio, religious pluralism, and homicide and suicide rates. Using data from several sources, we find an association among these factors and right-to-die legislation. Four of the six countries with recent experience of legalized physician-aided death ranked in the top 50% of countries on our combined measure of the five factors under examination. Implications of this study and suggestions for future research of this timely issue are discussed.     

Demographic change, macroeconomic conditions, and the murder rate: The case of the United States, 1934–2006

Fluctuations in aggregate crime rates contrary to recent shifts in the age distribution of the U.S. population have cast doubt on the predictive power of the age–crime hypothesis. By examining a longer time horizon, back to the early 1930s, we show that the percentage of the young population is a robust predictor of the observed large swings in the U.S. murder rate over time. However, changes in the misery index—the sum of the inflation and unemployment rates—significantly contribute to explaining changes in the murder rate. This applies, in particular, to those changes that are at odds with the long-run trend of the U.S. age distribution, such as the decline in the murder rate in the latter part of the 1970s or its increase starting around the middle of the 1980s.     

Sexual Orientation–Based Depression and Suicidality Health Disparities: The Protective Role of School‐Based Health Centers

This study's purpose was to examine whether school‐based health centers (SBHCs) support mental health indicators among sexual minority youth (SMY). Data came from the 2015 Oregon Healthy Teens Survey with 13,608 11th graders in 137 public high schools in Oregon. Regression results revealed significant SBHC by SMY status interactions indicating relative reductions in likelihood of depressive episodes (30%), suicidal ideation (34%), and suicide attempts (43%) among SMY in schools with SBHCs. SMY students in SBHC schools reported lower likelihood of a past‐year depressive episode, suicidal ideation, and suicide attempt versus those attending non‐SBHC schools. Conversely, no differences in these outcomes were observed for non‐SMY by SBHC status. SBHCs may help reduce mental health disparities among SMY, a marginalized, underserved population.     

Does state spending on mental health lower suicide rates?

Using recently released data on public mental health expenditures by U.S. states from 1997 to 2005, this study is the first to examine the effect of state mental health spending on suicide rates. We find the effect of per capita public mental health expenditures on the suicide rate to be qualitatively small and lacking statistical significance. This finding holds across different estimation techniques, gender, and age groups. The estimates suggest that policies aimed at income growth, divorce prevention or support, and assistance to low income individuals could be more effective at suicide prevention than state mental health expenditures.     

Young people's explanations for youth suicide in New Zealand: a thematic analysis

New Zealand has one of the highest youth suicide rates in the developed world and dominant approaches to prevention do not always take into account the views of young people. The purpose of this research was to update our understanding of young people's explanations of suicide in order to inform suicide prevention efforts. Focus groups were conducted with 38 young people, including 30 young women and 8 young men aged 15–22. The data was analysed thematically to identify the range of explanations young people ascribe to youth suicide. Five themes were identified by the analysis including that suicide could be explained by inescapable difficulties, constant pressure, emotional distress and could also be seen as a cry for help. In contrast to these normalised experiences, participants also expressed the view that mental illness might also account for suicide. The findings suggest that young people recognise suicide as a complex problem with multiple causes. While they recognised mental health problems as contributing, youth suicide was primarily understood by young people as a normal response to emotional distress and pressure. Prevention programmes should address the full range of explanations that young people give for suicide in order to promote their engagement in prevention programmes.