In 2018, a total of 13,670 died from suicide in Korea. The suicide rate was 26.6 per 100,000. 37 people commit suicide a day. Three in two hours. Suicide is the number one cause of death from teens to thirties, and second place among deaths in their 40s and 50s. The age-standardized suicide rate of Korea is more than twice the OECD average suicide rate. Besides the highest suicide rate, we should concern that the suicide rate has not been decreasing.
From 2008 to 2018, suicide rates rose 2.4 percent while mortality rates from traffic accidents decreased by 38% (from 14.7 to 9.1 per 100,000). Among 28 OECD countries, between 1985 and 2013, suicide rates have decreased in 20 countries, and Korea is the only country where suicide rates have increased by more than 10 per 100,000. The government has already established the 5-year Strategy for National Suicide Prevention since 2004.
Then, why suicide prevention policy has not been able to reduce suicide in Korea?

A brief history of suicide prevention policy in Korea
After recording the highest suicide rate among 24 OECD countries (24 per 100,000) in 2003, the government established the 5-Year Framework for Suicide Prevention in 2004. According to this statement, the causes of suicide are comprised of both biopsychological and socioeconomic factors, but 80% of those commit suicide having depression. Thus, it stated that an “efficient way of preventing suicide is targeting depression which mediates suicide and can be treated by early detection, because it is difficult to change biopsychological or socioeconomic factors due to limitation of medical science or economic conditions.” Therefore, the goal in the framework was to increase counseling and treatment of depression, decrease suicide attempts rates, and lower suicide mortality rates to 18.2 by 2010.
Ignoring the basic background that the suicide rate has exploded in the IMF crisis and the introduction of neoliberalism in Korea, the policy has always focused on ‘depression’, a medical and mental health problem. Undoubtedly it did not work. The suicide rate, which was 24.0 in 2003, remained at 24.8 in 2007.
The Second Suicide Prevention Plan was announced in December 2008. It evaluated the previous policy was limited to mental health-oriented activity and failed to produce visible results because it did not consider various social factors of suicide. For the first time, the Second Suicide Prevention Plan diagnosed that the sudden increase in suicide rate in Korea was due to the 1997 economic crisis and the 2003 credit card crisis. In particular, it mentioned various socio-economic causes of suicide, such as unemployment, income polarization, household bankruptcy, and weakened social support network, which were not mentioned in the previous plans. Accordingly, suicide prevention policy has become pan-governmental responses led by the Prime Minister’s Office and the government announced that suicide prevention policy would be established through “individual mental health and socioenvironmental approaches.”
However, the socio-environmental approach that was declared in the 2nd Suicide Prevention Plan was not attempted properly. The subsequent 3rd Suicide Prevention Plan (2016 ~ 2020) and the National Action Plan for Suicide Prevention, announced in 2018 by the Moon Jae-In Administration as a complementary plan to the 3rd Suicide Prevention Plan, also showed similar limitations. This Plan still pointed out that the nature of Korean suicide is greatly influenced by the unemployment rate, and economic problems have accounted for 23.4% of the direct triggers of suicide, for example, “regional economic downturn” such as downsizing of the shipbuilding industry. However, the action plan reflecting this point was only establishing a support system for high-risk groups such as people receiving welfare aids.
Since 2003, national suicide prevention policy has focused on improving the awareness of suicide, promoting public health and mental health services for preventing suicide, and managing psychiatric high-risk groups such as depression, rather than resolving social causes. This is not a science-based policy, because it ignores the characteristics of suicide in Korea. Obviously, it is hard to expect the effectiveness of policies that neglect the specific nature of the problem and its cause.

Barometer showing limits of suicide prevention policy – Workers’ suicide
Workers’ suicide is a direct indication of the limitations of the suicide prevention policy in Korea. Everywhere in the world, a significant number of suicide deaths occurred in the economically active population, and many of those who commit suicide have jobs at the time of death. Therefore, finding a cause of suicide or preventing suicide at work is a concern of suicide prevention policy. Especially in occupational groups such as farmers, police officers and firefighters who are known to be at high risk of suicide, suicide prevention activities in the workplace are extensive. The high risk of suicide in specific occupations implies that there may be work- related causes of suicide, and preventive action should start from workplaces.
But so far, workers have been left out of the government’s suicide prevention policy. In the first and second Suicide Prevention Plans, ‘occupation’ was not cared at all. In the annual white papers on Suicide Prevention, the analysis of occupations is very simple, showing only the numbers of deaths by occupational groups. In the meantime, the number of workers’ suicide compensated as work- related death by the Industrial Compensation Insurance Act has continued to grow.
Now, the fact was revealed when the Korean government began conducting an in- depth approach to the cause of suicide, including conducting a psychological autopsy and securing police records. According to the ‘2018 Psychological Autopsy Interview Report’, those who commit suicide were having an average of 3.9 stressful events before death, complicated leading to death. Among the stressful events, mental health-related problems were the most common (84.5%), but occupational stressful events were followed by 68%.
In about 70% of suicide cases, at least one of the factors leading to death was an occupational stressful event. These included interpersonal relationships at work, retirement, lay- off, or changes in workload. Another important point is that the ‘workload’ was the most frequent of the first risk factors, the starting point for the suicide path. Even though the direct trigger for suicide is from mental health, the cause of the mental health problem might be work.
To build a science- based suicide prevention policy, interventions in occupational stress must be presented as a key task of the policy, considering occupational stress has been identified as one of the most important stressful events leading to suicide. However, the situation is hardly expected to be improved.

Take a fundamental approach to defeat causes
Look at the late Joong-won Moon, 40, who received a memorial service table at Sejong- ro on Lunar New Year’s Day. Moon is a jockey who killed himself in late November, accusing about injustice in the horse race industry. (Related article : KRA exploits jockeys, drives them to suicide) But the publicly owned company, Korea Racing Authority (KRA) has not reacted even a tiny bit. The Ministry of Employment and Labor announced that in relation to workplace harassment, they will supervise even contract laborers, but they have ignored this issue. There is no response from the Ministry of Agriculture, Food and Rural Affairs, which is a supervisory department of KRA, either.
If there is something that the government has learned from the past, it would not be possible to ignore the problem of Gyeongnam Park, one of horse race tracks of KRA, where seven workers including Moon had already committed suicide. Their deaths are not because they had poor horse racing record, they had a lot of debt, or they had impulsive personalities like the government saying. This government’s suicide prevention policy is not an effort to provide a human life to those who give up their lives in order to live properly. It only provides a pill to endure an inhuman life. The current approach cannot reduce suicide.
Suicide prevention policy should be much broader in order to have a real effect. In particular, the promotion of workers’ rights and health must be included. Otherwise, a “healthy society that is safe from suicide”(the goal declared in the National Suicide Prevention Plan) will not come.

(After this article was written, Joong-won Moon’s funeral was held 102 days after his death.)