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The Grave Problem of University Student Suicides
How to Deal with Young People Who Want to Die

Masashi Hori, Associate Professor
Faculty of Education and Integrated Arts and Sciences
Waseda University

For eleven years straight, from 1998 on, the suicide rate in Japan has exceeded 30,000 per year, and this year shows no signs of letting up. Young people do not make up a large number of these suicides by any means, but as youth is a period with a low mortality rate in general, suicide is becoming a leading cause of death among them. And as these suicides are occurring in a generation filled with the promise of being at the center of society going forward, the problem is far graver than their number might indicate.

1. Suicide prevention measures that should be implemented daily
(1) Analyses of the suicidal behavior of university students

Regarding youth suicide, it is important that we consider the groups that young people join and encounter every day-that is to say, it is vital that we implement suicide countermeasures within school organizations. In order to create efficient and effective suicide countermeasures, we must analyze the characteristics of the suicidal behavior that occurs in these groups. Taking the example of the university, the actual conditions vary depending on factors including location, the structure of departments, the ratio of males to females, and the ages comprised. By conducting suicidal behavior analyses to this degree, we can clearly determine countermeasures with practical application.

(2) Genuine bond(Kokoro-no-Kizuna)

Recently it has become increasingly difficult to recognize the circumstances when someone is having suicidal thoughts. Their opportunities to talk about their troubles with friends or family have decreased and instead they meet perfect strangers on the internet who want to commit suicide, collaborate with them, then take the next step and cross over the line with no hesitation. But those who appear determined in this way still have a fear of death, and that is precisely why they invite people to join them in a suicide pact. In dealing with this kind of people, the only way to dissuade them is to make them realize that a great many people always care about them. In many cases, support for those who are contemplating suicide comes from horizontal relationships with their fellow students. The challenge going forward is how best to cultivate ways within the school of increasing solidarity among students to unprecedented levels.

(3) Ways to identify students who are susceptible to suicide

Seniors are most susceptible to suicide at university. They are at once facing the crossroads of choosing a career path-whether to enter the workforce or to earn an advanced degree-as well as the extremely harsh job hunting conditions during the recent economic downturn. Even though they are under such great stress, seniors are preoccupied with their individual career activities and, unlike previous school years, have little time to get together with their friends in one place, and as a result they tend to feel isolated. Identifying the most susceptible students under these conditions is no easy task, but checking on their individual academic progress is one valid means of doing so. Because there are issues of respect for the independence and privacy of students themselves, there is still deeply rooted resistance among some of the faculty over implementing this means of checking. It goes without saying, however, that the urgency of suicide prevention is a grave matter that exceeds these other issues.

(4) Preventing suicide chains

One characteristic of university student suicides is that those close to a student who commits suicide are shocked and then follow the example to commit suicide themselves-a so-called suicide chain. The first priority in preventing such a chain is to proactively support students who were close to the deceased. Out of feelings of guilt that the system failed to prevent the suicide from occurring, there are often attempts to conceal the facts. But over time, rumors spread. On the contrary, through proactive support such as launching a counseling system for affected students, we can prevent more students from falling victim. Another characteristic of suicide chains is the imitation of the location and means of suicide by those who follow the previous victim in the chain. This characteristic can be used conversely for prevention: after a suicide jump from a high altitude, for example, equipment could be installed to restrict opening and closing of the windows. Implementing such physical barriers has frequently been effective. Haphazard mood swings from wanting to go through with committing suicide to feeling hesitant about it occur out of impulse. I have heard many students who had attempted suicide report stories like: I thought that I wanted to jump, but the window was broken and wouldn't open, so I gave up.

2. Dealing with those who have a strong desire to commit suicide

How should one respond if a fellow student reveals that they want to die? Certainly people outside of our profession-involving psychological counseling and administering treatment-are very rarely asked for such advice. Perhaps not once in a lifetime. In the event that they are asked for such advice, many fellow students or faculty would likely feel bewildered and hope that they can entrust the issue to someone else. These are dire words, after all. But the person has decided to open up and talk about their problems with this person, and I would therefore like this person to handle the situation with a level head. There is no need for complex theory here, and a rousing pep talk would be counterproductive. The best thing to do is find a quiet place where we can talk with the suceptible person directly. As they have confided in us, it is vital that we convey to them that we are genuinely concerned about their welfare, and that we set aside our personal feelings and listen intently to their concerns. This forms the very genuine bond(Kokoro-no-Kizuna) that I mentioned above. We must simultaneously take steps to ensure their safety by removing the means to commit suicide from the vicinity and by watching over them vigilantly until the dangerous condition subsides.

3. Supporting students who have attempted suicide

We cannot let our guard down in dealing with those who have attempted suicide-even if, for example, they claim to regret it. There is a high probability that those who have attempted suicide will make subsequent attempts. The reason for this is that the issues that caused the initial attempt have not been resolved. Those offering support should feel genuinely happy in helping save a life, and listen carefully to the person they are helping. It is especially important that we fully deal with the complex feelings that people have after attempting suicide, such as shame and guilt. And we must not forget to approach other people in the victim's life, as they have also been affected and have a variety of feelings toward the victim.

Masashi Hori
Associate Professor, Faculty of Education and Integrated Arts and Sciences, Waseda University

Education and Professional Experience
1958 Born in Amagasaki City, Hyogo Prefecture
1984 Graduated from the Medical Specialized Cluster of Colleges at the University of Tsukuba
1988 Chief of Staff at the Kurita Hospital Yuho-kai Healthcare Corporation
1991 Assistant at the University of Tsukuba Institute of Clinical Medicine (Tsukuba University Health Center)
1993 Lecturer at the University of Tsukuba Institute of Clinical Medicine (Tsukuba University Health Center)
2004 Associate Professor in the Comprehensive Human Sciences Department at the University of Tsukuba Graduate School
2009 Associate Professor on the Faculty of Education and Integrated Arts and Sciences at Waseda University

Other Appointments
From April of 2000 Attending Staff at the Ibaraki Labor Department Regional Workers' Compensation
From December of 2005 Board Member of the Japanese Association of Sports Psychiatry

Academic and other Certifications
Acquired Medical License (1984), Mental Health Counseling Designation (1991), University of Tsukuba PhD (Medicine) Psychiatric Research on Delusional and Non-Delusional Depression (1993) Clinical Psychologist Certification (2000) Japan Medical Association Certified Industrial Physician (2001) Japan Sports Association Certified Sports Doctor (2005)

Areas of Specialization
Clinical Psychiatry (Adolescent psychiatry, mood disorders, sleep disorders?
Student mental health, mental health in the workplace, athlete mental health, faculty mental health, collaboration with fellow faculty members