Elephant in the Room: The True Scale of Suicide in South East Asia

On July 5 this year, fans of Hong Kong-born Chinese-American singer Coco Lee woke up to the news that the songstress had died after a suicide attempt. Lee who, according to her older sisters, had been suffering from depression for several years, attempted suicide at home over the weekend and was rushed to hospital where she went into a coma before passing away. Considered by many Queer people in South East Asia and the US as a Gay Icon after she sang the title song “The Answer” for the 1998 Hong Kong indie Bishonen which tells the love story between a Gay sex worker and a police officer, her sudden death came as a shock to many who eulogized her and the impact her music had on their lives and formative years.

Though still a taboo subject in much of East Asia and especially South East Asia, suicide is increasingly and publicly being addressed. This is, in part, thanks to documentaries and exposes highlighting the prevalent culture of silence and shame affecting those living with suicidal ideations, and the families of those who have died from suicide. In Japan alone, a country famous for its high suicide rates and the Aokigahara suicide forest, suicide rates increased by 16 percent during the height of the second wave of the COVID-19 global pandemic.

South East Asian countries rank among some of the highest in suicide rates according to World Health Organization (WHO) statistics. Thailand ranked 32^nd worldwide with approximately 10,000 suicide deaths annually with a marked prevalence among the country’s youth and especially among gender and sexual minority teens, while South Korea has the highest suicide rates among all developed countries with an estimated 13,000 suicide deaths in 2021, increasing from 2020 rates. China saw suicide rates among 5- to 14-year-olds quadruple between 2010 and 2021 according to information published on June 23, in China CDC Weekly, the Chinese CDC’s official journal, and in neighboring India, a whopping 1.6 million suicide deaths were recorded in 2021, an increase of 7.2 percent compared to 2021 rates.

Dying Out Loud

More recently, the public struggles of some rising stars in the increasingly popular music genre of K-pop and the inherent culture of neglect of mental health therein, have also led to an outcry from legions of the genre’s fans globally and a call for the prioritization of mental health among the industry’s stars.

Recently, Chinese-American rapper, dancer, trainee, and former member of pre-debut K-Pop boy group M.O.N.T Arena, Beomhan, took to social media to reveal his mental health struggles which included self-harm and a suicide attempt on an Instagram Live broadcast which was deleted soon after. The rising star’s revelation resulted in an outpouring of concern for the 22-year-old’s wellbeing from fans. Far from reassuring fans that steps would be taken to safeguard Beomhan’s mental health, FM Entertainment not only terminated its exclusive contract with the trainee but dismissed his revelations as untrue.

In a statement announcing Boeham’s contract termination, the entertainment company claimed that “Tranee Beomhan has distorted the truth on numerous occasions and spread misleading information during live broadcasts. Consequently, other FM artists and fans have experienced significant mental health distress and stress as a result.” Beomhan’s fans have, in the past, expressed concern after increased instances of cyberbullying and an assault in which the assailant used homophobic and racist slurs against Beomhan.

Beomhan’s admission and subsequent dismissal by FM Entertainment come only months after K-pop star Moonbin and member of South Korean boyband Astro died of an apparent suicide at the age of 25. Billboard’s K-pop reporter Jeff Benjamin said, “Moonbin’s untimely passing was all the more shocking given how active the young star was, even the week of his death” and “No one around him saw this coming.” Moonbin’s death marks the third suicide-related death in the K-pop industry just this year alone, and one of a handful of suicide deaths in the industry over the last five to six years, most of which came as a shock to the stars’ fans and management.

To the West, Hollywood stars and major recording artists have increasingly become a part of the mental health and suicidal ideations discussion in recent years. After the death of actor Robin Williams, famous for his role in Mrs. Doubtfire and Queer cult classic The Birdcage, through an apparent suicide, much of Hollywood and fans around the world called for more attention to be paid to mental health. Williams had struggled with depression for much of his successful Hollywood career. The comedic actor’s happy disposition made his suicide all the more surprising even though he had spoken of the veneer of outward joy masking inner turmoil.

“I think the saddest people always try their hardest to make people happy because they know what it’s like to feel absolutely worthless and they don’t want anyone else to feel like that,” Williams is quoted as saying. Since then, many other public figures and media personalities including famous Dj Aviicii and Miss USA 2019 Cheslie Kryst among others have committed suicide with the former dying in 2018 while the latter jumped to her death in early 2022.

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Parallel Universes

Thanks to the ubiquitousness of social media and conspicuous consumption, users are at once presented with an opportunity to share their authentic selves with the world, gaining universal support from faceless, remote masses, while also being expected to keep up with trends and fads lest they suffer abuse from the exact same often nameless faceless mass. Cyberbullying which has been a source of concern since before the advent of mobile phones and social media apps as we know them now, has since graduated to online trolling and doxing, where targeted users are relentlessly attacked online by numerous accounts on social media platforms and have their personal contact information released to the public to further intensify the attack.

Individuals who come out as LGBTQIA+ including celebrities have fallen prey to trolling and doxing online, with some such instances leading to suicide attempts. Though similar in some ways, social media and its contribution to the deterioration of mental health and increase in suicidal ideations in Southeast Asia is slightly different. A toxic combination of conspicuous consumption, unattainable beauty standards, and a tendency toward conformity means that those who aren’t rich enough, pretty enough, or stand out from society are susceptible to real-life bullying or online criticism.

Research on suicide rates among LGBTQIA+ youth in Taiwan especially after the legalization of same-sex unions found that those who self-reported as having attempted suicide did so because of depression, internalized stigma, lack of self-esteem, and a lack of social support, factors exacerbated by social media use.  

Fat shaming is rife on Chinese social media platforms such as Sino Weibo and XiaoHongShu (Little Red Book) especially aimed at women who don’t fit into an ever narrow standard of beauty. The legacy of an anti-sissy campaign launched in 2021 in China means that men who don’t present as traditionally masculine, though praised before for their androgynous looks and likeness to K-pop and Japanese popstars, are now open to ridicule for being too effeminate. 

A Global View

According to statistics in the Trevor Project’s 2022 National Survey on LGBTQ Youth Mental Health released earlier this year, 45 percent of LGBTQ youth seriously considered attempting suicide in the past year while nearly one in five Trans and Nonbinary youth attempted suicide. Additionally, LGBTQ youth of color reported higher instances of suicidal ideations than their White counterparts.

It is important to note that this report is a reflection of the situation in the US for LGBTQIA+ individuals, with mental outcomes for gender and sexual minorities in the North American country being affected by factors such as COVID-19 and the resultant effect of isolation and lack of access to healthcare, the politicization of gender and sexual minorities and the rolling back of rights and access such as gender-affirming care for Trans youth, and a worsening economic situation leaving LGBTQIA+ individuals far more susceptible to financial hardship and exploitation.

Similarly, a published research article titled Serious and Persistent Suvalidality Among European sexual minority youth found that Sexual Minority Youth (SYM) in the six European countries sampled were “a high-risk group for suicidality, independently from objective factors such as victimization or substance abuse.” Even when controlling for factors such as respondents’ countries of origin, substance abuse, bullying, school-related stress, and lower economic status, while using the Paykel Suicide Scale (PSS), “Stratified analyses showed significant associations between SMY status and persistent serious suicidal ideation for both sexes, with a notably strong association among male pupils.”

Such ideations continue well into young adulthood as an article published by the Journal for Psychiatric Research titled “Suicidality and sexual orientation among men in Switzerland: Findings from probability surveys” suggests. The survey focused on rates of suicidal ideations and attempts among Swiss men, a country that, at the time of the article’s publishing, had one of the higher rates of suicide completions in Europe. Data collected by various men’s mental health surveys in Switzerland showed that there was a higher instance of suicidal ideations among Gay and Bisexual men as compared to Heterosexual men. It also pointed out a significant difference between Heterosexual and Gay/Bi young adults with suicidal ideations. “Although increased risk of suicidality is especially pronounced among young homo/bisexual men, it remains elevated among gay men through middle age.”

Similar patterns are seen in Africa where the prevalence of self-harm and suicidal ideations among LGBTQIA+ youth is higher than among Heterosexual youth. Faced with the criminalization of homosexuality, possible arrest, being ostracized, being denied access to education and healthcare, and running the risk of falling prey to extortion or vigilantism, LGBTQIA+ youth in Sub-Saharan Africa grapple with social hostility and stigma leading to a “rise to increased vulnerability of persons identifying as sexual and  gender  minorities  to  negative health outcomes and risky health behaviors including alcohol and substance use and abuse, self-harm, and suicide.”

Are There Solutions?

The WHO has identified suicide as “a serious public health problem” responsible for the death of 703,000 people each year. In some of the measures proposed to prevent suicide, the WHO identified limiting access to means of suicide including pesticides and firearms, responsible interaction with the media to responsibly report on suicide, the fostering of socio-economic life skills among adolescents, and the early identification, assessment, management, and follow up with anyone affected with suicidal ideations as practices that should be implemented.

On September 10, 2019, the WHO launched a “40 seconds of action” campaign in collaboration with global partners with the theme suicide prevention. Members of the South Korean K-pop group BTS have also gotten involved in suicide prevention, using their platform to support the “Love Myself” campaign, a UN-sponsored anti-violence and anti-suicide campaign promoted under the hashtag #BTSLoveMyself. The campaign encouraged the band’s fans to post self-loving pictures under the hashtag on social media.

Platforms such as Lifeline, a non-profit organization in China, offers support to those grappling with declining mental health or suicidal ideations, offering assistance on WeChat, an instant messaging App widely used in the country. The Chinese CDC article on suicide rates in China also lauded the WHO’s recommendations as “a valuable reference for China” while noting that “Adequate resources must be invested to ensure the high-quality implementation of these recommended actions.”

Similar organizations like AASRA in India offer reach-out services to those with suicidal ideations. The organization’s website states “Aasra recognizes that loneliness and distress often lead to the act of self-destruction, the potential suicide can be averted by active listening. We at Aasra believe that an attempt or act of suicide is a message indicating despair.” The Seoul Counseling Center is leading the charge in South Korea by offering suicide prevention services and resources including a suicide hotline and even offers English-speaking crisis resources to accommodate the country’s international population grappling with suicidal ideations.

As the world marks yet another Suicide Prevention and Awareness Day, the world is once again reminded of the importance of mental health awareness, and the indiscriminate nature of suicidal ideations, affecting everyone from the most famous and influential to the weakest in society. Suicide has no face, and is, as Robin Williams put it, a permanent solution to a temporary problem.  

^{Photos: Unsplash}