Driven to the edge

By Cathy Wong Source:Global Times Published: 2014-9-17 20:43:01

New app designed to diagnose depression aims to curb China’s suicide rate

Police officers attempt to persuade a woman out of jumping from a building in Beijing on June 23. Photo: CFP

Suicide remains an alarming social issue in China, which had suffered from one of highest suicide rates in the 1990s worldwide.

China reported 23.2 suicides for every 100,000 people annually from 1995 to 1999, equating to an estimated 250,000 deaths every year.

But the situation has improved in recent years. China's suicide rate has since decreased to among the lowest levels in the world. According to a recent study by the Centre for Suicide Research and Prevention at the University of Hong Kong, suicide rate have declined to an annual average of 9.8 out of 100, 000 people between 2009 and 2011, a near 60 percent reduction since the 1990s.

Still, suicide in China remains a critical issue, as an average 120,000 people die from suicide every year, according to the 2014 statistics released by the World Health Organization.

Depression is cited as one of the main culprits, as up to 20 percent of those diagnosed with depression commit suicide, revealed the report.

Depression-led suicides entered the spotlight in recent years partly due to cases involving notable celebrities.

In one recent example, accomplished translator Sun Zhongxu, whose works include 1984 and The Catcher in the Rye, committed suicide on August 28 in Guangzhou at the age of 41. Sun allegedly suffered from severe depression.

Mobile treatment

Modern technology is intervening to aid in early detection and diagnosis of depression.

A Beijing hospital is currently developing a smartphone app for those who display early symptoms aiming to prevent them from committing suicide.

"It is a comprehensive management platform that provides users with professional medical assistance throughout the entire diagnosis process," Han Biao, a doctor in Beijing Huilongguan Hospital and main developer of the mobile application, told the Global Times

The app, jointly developed with the Beijing Suicide Research and Prevention Center, is slated for release in two years.

"The series of standardized assessment questions was first adopted in China from America 10 years ago," Michael Phillips, director of Beijing Suicide Research and Prevention Center, told the Global Times.

Delayed detection has stopped patients from seeking help as nearly 80 percent of depression cases are not detected, and 90 percent are not treated, according to data issued by the World Health Organization this year. China's 21 percent detection rate is way below the global average of 56 percent.

"Due to a lack of awareness, most patients fail to recognize their problems and miss the window for early treatment. It is also too difficult to diagnose depression, which is easily confused with other mental illnesses," said Han. "Even after patients become aware of their situation, they may not know where to go for help."

To address these issues, the mobile application aims to provide comprehensive assistance, from early detection to follow-up consultations.

According to Han, users will first go through an online assessment to identify the level of their depression. The system will then refer users to services provided by relevant hospitals based on their specific needs.

Because depression is a mental illness with a high risk of relapse, the application will also provide post-recovery assessment and consultation, such as when patients are not sure if they should stop their medication.

But such apps are not without limitations. Han admitted it cannot replace face-to-face therapy sessions, and his team is still working to overcome the technical challenges.

As the mobile application is targeting urban youth, rural residents and older generations may not have access to the application due to their relatively lower exposure to technology. "But of course, some of the elderly are also active tech users," Han added.

Rising risk

The nation's suicide rate main caused widespread attention within and outside China when Canadian psychiatrist Michael Phillips and his Chinese colleagues Li Xianyun and Zhang Yanping published the article "Suicide rates in China, 1995—99" in respected medical journal The Lancet.

In addition to revealing China as having one of the world's highest suicide rates, the article also highlighted its unique trends. China was the only country at the time with suicide rates among women around 25-percent higher then men. Rates in rural regions were also three times higher than those in urban areas, accounting for 93 percent overall.

Suicide rates in rural China have since declined, falling to some 79 percent of the nation's total between 2009 and 2011.

Researchers have attributed the decline in numbers to higher incomes, better education and decreased familial pressures among migrant workers.

In particular, studies cite a lack of easy access to pesticides, which accounted for 62 percent of the suicides between 1996 and 2000.

However, experts warned that the trend could reverse.

"The declining rate of suicide in China could reverse in the next decade because of social stresses associated with the slowdown in economic growth, rapid ageing of the population, income inequality and social instability," wrote Paul Yip, director of the Centre for Suicide Research and Prevention at the University of Hong Kong.

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