Assignment: Seoul: In prosperous South Korea, a troubling increase in suicide rate

By Blaine Harden
Sunday, April 18, 2010

Choi Jin-young hanged himself last month with an electrical cord. The 39-year-old actor wasn't getting any work in local TV, police said, and he had been depressed since the suicide of his famous older sister.

The sister, Choi Jin-sil, was known as the "nation's actress." When she hanged herself in her bathroom in October 2008, a wave of sympathetic suicides swept South Korea and 1,700 people took their lives the following month.

Seven months later, former president Roh Moo-hyun jumped off a cliff to his death. "I can't begin to fathom the countless agonies down the road," he wrote in a note. Then a 20-year-old Chanel model, Daul Kim, killed herself, posting a blog entry that said: "Mad depressed and overworked." Another said: "The more I gain, the more lonely it is."

And so it ends for 35 South Koreans a day. The suicide rate in this prosperous nation of about 50 million people has doubled in the past decade and is now the highest in the industrialized world.

The rate of suicide in most other wealthy countries peaked in the early 1980s, but the toll in South Korea continues to climb. Twenty-six people per 100,000 committed suicide in 2008 (the most recent year for which data are available). That's 2 1/2 times the rate in the United States and significantly higher than in nearby Japan, where suicide is deeply embedded in the culture.

Before South Korea got rich, wired and worried, its suicide rate was among the lowest in the industrialized world. But modernity has spawned inordinate levels of stress. People here work more, sleep less and spend more money per capita on cram schools than residents of the 29 other industrialized countries that belong to the Organization for Economic Cooperation and Development.

Still, it remains a taboo here to admit to feeling overwhelmed by stress. The word "psychiatry" has such a negative connotation that many leading hospitals have created departments of "neuro-psychiatry," in the hope that people perceive care as medical treatment and not as a public admission of character failure.

Before he hanged himself last month, Choi Jin-young had been struggling with serious depression, his friends told reporters. But they said he refused to consider psychiatric treatment.

"This is the dark aspect of our rapid development," said Ha Kyooseob, a psychiatrist at Seoul National University College of Medicine and head of the Korean Association for Suicide Prevention. "We are unwilling to seek help for depression. We are very afraid of being seen as crazy."

Denial extends to relatives of suicide victims. Recent attempts by the Ministry of Health and Welfare and suicide prevention groups to interview the families of those who kill themselves have produced little cooperation.

"When we go to the families and ask questions about why it happened, they say to us, 'Do not kill him twice,' " Ha said. "We have tried to interview hundreds of families, but we have only been allowed to talk to a few of them. If one is dead from suicide, everything is a secret."

Incidents of suicide are increasing most rapidly among the rural elderly, government figures show, driven among other things by isolation, illness and poverty. Suicide among the young has been abetted by the long hours South Koreans spend online. Police investigators say the Internet enables young people to meet and plan group suicides, even when they are strangers to one another and live in different cities.

Suicide is the leading cause of death among South Koreans in their 20s and 30s, and it is the fourth leading cause of death overall, after cancer, stroke and heart disease.

Yet what has particularly caught the eye of the public and the news media is a flurry of change-reaction suicides among the rich and famous.

Choi Jin-young's suicide generated front-page headlines, reminding the public of the suicide of his beloved sister, who killed herself after becoming distressed over Internet rumors that linked her to the suicide of another celebrity, comedian Ahn Jae-hwan.

No studies have found a statistically significant increase in suicide among the nation's elite. Still, noisy news coverage of these deaths has caught the public's imagination, and that worries Ha, the psychiatrist.

Government data show that suicides can trigger copycat behavior. Choi Jin-sil's death triggered a 70 percent increase in the suicide rate. It lasted for about a month, resulting in 700 more deaths during that time than would normally be expected.