August 16, 2007 2:46 PM | Posted by Benita: | Reply

I think the adventage of a cultural specific group is that people will feel the fellow members will understand more. There are lots of political and social issues surrounding mental health that is specific to each country. I am not sure if such cultural research in mental health have been done in support group. Any insights?

August 16, 2007 3:00 PM | Posted by Rose: | Reply

I don't think it's likely that these people suddenly wanted to die where they didn't want to die before.

Perhaps they wanted to die, but the charcoal thing was easier and less painful than other methods they may have considered. So, having this new method available lowered the, er, barrier to entry?

August 17, 2007 5:09 AM | Posted by robotslave: | Reply

OK, when you go looking for charcoal suicides in Western nations, you're looking at the wrong data.

What you want to look at is suicide by carbon monoxide poisoning, which, in the West, means vehicle exhaust.

So go re-run your numbers with sealed-garage or hose-from-the-tailpipe-to-the- window type suicides, or copycats, or what have you.

The East/West difference is that the West has cars, while the East has, well, fire. Charcoal, in this case.

The similarity is the carbon monoxide poisoning. Which is supposedly painless and tranquil, according to the people who pretend to know what it's like to die in various ways.

Carbon monoxide poisoning is different from jumping from a building (or bridge, in your Western context) in that it doesn't require that great gathering of nerve up front, and in its supposedly gradual nature-- news articles often describe death by carbon monoxide poisoning as a "gradual loss of consciousness," or similar (do yourself a favor, and check to see if that initial Hong Kong report went into any detail regarding what dying by charcoal might feel like).

So carbon monoxide poisoning appeals to people who are less suicidal than bridge/building jumpers. Not just more cowardly-- while it does promise a more peaceful death, it also presents a much greater possibility of rescue than, well, jumping off of a tall thing.

So there's a certain subset of the suicidal population that shies away from the no-looking-back total suicide, and instead wants a sorta-kinda-maybe suicide that probably won't hurt much and might well be aborted by rescuers. This subset does not generally have uniform access to the preferred method for such cases, i.e., pills. We're not all children of pharmacists, right?

These not-completely-suicidal people do, however, have access to excess carbon monoxide, provided they live in at least somewhat urban societies (the smallish sealed-enough space is just as important as the CO source). You shouldn't think of this in terms of "news reports cause suicide," but rather in terms of "news reports make people aware of ready access to a a drug they hadn't previously known about."

Which puts us back into the realm of psychiatry, albeit in a rather sick and twisted way.

Alone's response: actually, the charcoal is a very specific method, and I think not equivalent to the car exhaust. That's my point about the demography; ask it another way, did the charcoal suicides do it because they didn't have convenient access to a car?

August 17, 2007 8:31 AM | Posted by Jayme: | Reply

Mental health support groups have been the primary factor in my TOTAL recovery from serious mental illness. I have spent years in institutions and day programs. Peer support is so underrated, though, thus the lack of measurable outcomes. Nobody is going to fund a study that serves poverty-stricken consumers at the expense of existing programs that serve drug companies and the status quo.

August 18, 2007 5:02 AM | Posted by robotslave: | Reply

I of course agree that charcoal is a very specific means to The End, and, in response to your question, I rather doubt that the Chinese outbreak was due primarily to a lack of automobiles.

Demography is swell, sure, but how aware do you think the average suicidal Chinese person is of that scenario all too familiar to us, "Found dead sitting in the car with the garage door closed and the engine running"?

It's not the mechanics that are relevant here, it's the type of death supposedly delivered by a particular drug, Carbon Monoxide, as supplied by smoldering charcoal (or, in our Western context, vehicle exhaust).

Did you even bother to look up vehicle-exhaust suicides, and copycats, in the US?

I'm pretty sure that the vehicle-exhaust method of CO delivery didn't start lighting up the suicide stats until rather well after the invention of the internal combustion engine.

Once upon a time, plain old Natural Gas used to do the trick (the trick being anoxia). Which led to those "head in the oven" jokes, though of course that wasn't how the actual mechanics of the thing worked.

These days, I'm guessing, your USian demographic with the higher suicide rate tends not to cook with gas.

But your suicidal Chinese demographic, well, I don't know for sure, but perhaps they tend to cook with charcoal.

Something else to consider, here: in initial news reports on deaths due to both vehicle exhaust and insufficiently ventilated charcoal fires, the media might assume the deaths were accidental, and then go on to describe how very easy it might be to die from such an accident, given the supposed trajectory of "slow descent into unconsciousness, and then death."

So, you asked three questions. For the sake of clarity, I'll state my answers to those questions:

• Because copycatting, be it of suicide or criminal behavior, happens almost exclusively within cultures, as opposed to across cultures.
• The people using CO for suicide are less determined, and/or harboring stronger rescue fantasies, than jumpers.
• The charcoal didn't make anyone want to die any more than they already did, what it did provide was a practical method to achieve the sort of painless-death or near-death they had been fantasizing about, where means previously considered had been too painful or final.

August 19, 2007 5:54 AM | Posted by Velvet Elvis: | Reply

Wouldn't the kind of wood from which the charcoal is made have an effect on the amount of CO produced when it's burned? Perhaps there was a change in the composition of the charcoal available in the area which made it much more lethal. The statistic you're missing is the ratio of failed to successful attempts.

Do these statistics rule out instances of ritual suicide if such a phenomena exists in Hong Kong as it does in Japan?

If the individuals were somehow connected it could explain it, ie they could have been in a cult or part of some kind of online suicide pact or something. It doesn't have to have been a copycat phenomena. It might have been group planning.

August 20, 2007 9:09 PM | Posted by whatever: | Reply

Maybe its something about Chinese culture that makes them more susceptible to the copycat phenomenon in relation to suicidality. You know, those generalizations about the culture internalizing their feelings more, going to a shrink being a VERY taboo thing and sign of weakness etc. Somehow this may lead them to walk around suicidal with a lid on their id until a media driven phenomenon gets them to burst and step up to the plate in an all or none phenomenon (because if they fail, then they deal with the profound shame of being mentally ill and out in the open)...and perhaps the less painful method as a previous poster suggests, is the enticing aspect of it.

Did the same phenomenon happen with a tylenol OD in China?

Or maybe there is something spiritual about breathing the gas and dying in the Chinese culture?

August 27, 2007 6:54 PM | Posted by none: | Reply

there was an article about this in the atlantic several months ago.

an interesting thing that it emphasized was that the japanese suicides by charcoal are group suicides... where the groups are composed of strangers who meet only to die together (there are apparently large internet chat rooms where people arrange this). That seems pretty peculiar, at least compared to suicide methods in the West. I can't think of a practical reason for it, like a lack of the needed resource (charcoal) or large expense associated with it (i assume it is relatively cheap).