Specific measures to enhance suicide prevention in Japan

The General Principles of Suicide Prevention, which are Japanese guidelines on measures to prevent suicide, were devised in 2007 and then revised in 2012 and 2017. In addition, the Cabinet approved new general principles of suicide prevention on 14 October 2022. ¹ The new general principles of suicide prevention include Enhanced Support for Women, Enhanced Measures to Prevent Suicide by Children and Young People, Enhanced Community Efforts to Prevent Suicide, and Enhanced General Measures to Prevent Suicide, indicating that efforts will be particularly directed at enhanced assistance to prevent suicide by women, children, and young people.^2,3

The COVID-19 pandemic, which started in 2020 and continues at the time of writing, has had an effect. Suicides in Japan decreased annually from 32,845 in 2009 to 20,169 in 2019,^2,4 increased to 21,081 in 2020, and then remained at approximately the same level with 21,007 suicides in 2021. There were 23,472 suicides by men in 2009; since then, that number has decreased for consecutive 12 years, with a total of 13,939 in 2021. Suicides by women increased from 6091 in 2019 and 7026 in 2020 to 7068 in 2021.

Suicides by female junior high and high school students increased after 2020 (suicides by female junior high school students: 46 in 2019, 69 in 2020, and 74 in 2021; suicides by female high school students: 80 in 2019, 140 in 2020, and 145 in 2021). In addition, suicides by individuals at the ages of 10–19 years and in their twenties have increased markedly since 2020 compared to the number in 2019.^3–5

A comparison of the average number of suicides from 2015 to 2019 (the earlier period) and in 2021 (the later period) in terms of whether the person who committed suicide was cohabitating with someone ³ indicated that there were no significant changes in the number of suicides by women who were cohabitating with someone between the two periods. However, suicides by women living alone increased 17% in the later period compared to the number in the earlier period. Suicides by men who were cohabitating with someone decreased 12% in the later period compared to the number in the earlier period, and there were no significant changes in the number of suicides by men living alone between the two periods.

To summarize these findings, suicide prevention efforts targeting people who live alone are vital, as are Enhanced Measures to Prevent Suicide by Women, Children, and Young People. Enhanced Support for Women to prevent suicide includes support for pregnant and parturient women and enhanced efforts in light of issues raised by the COVID-19 pandemic. ¹ The Ministry of Health, Labour and Welfare recommends Enhanced Measures to Prevent Suicide by Children and Young People, including conducting detailed studies and analyses, creating a team to deal with the suicide crisis among children, promoting education to correctly understand and appropriately respond to calls for help and psychiatric disorders, enhanced suicide prevention during long breaks from school, using tablet PCs to ascertain suicide risks, and creating a system to promote measures to prevent suicides by children and young people in collaboration with the Children and Family Affairs Agency. ¹ In order to prevent suicide by people living alone, preventive measures need to be devised in conjunction with measures to deal with loneliness and isolation, and a system for counseling via social media must be created.

Individual measures to prevent suicide need to be implemented by welfare and other government agencies, medical facilities, the police, the community, schools, workplaces, and organizations engaged in suicide prevention, and those bodies need to work together to implement suicide prevention efforts when necessary. Social medicine and clinical medicine need to join forces in devising preventive measures based on the results of detailed studies on suicides, suicide attempts, and related problems (suicidal ideation and self-harm).