ABSTRACT
Dimensions of distress are generally similar in studies of Chinese adolescents, in comparison with Western studies, and it is appropriate to use translated measures of mental health. However, additional measures may be necessary to capture aspects of a Chinese cultural identity. Impaired self-esteem, depression, suicidal ideas and behaviour were in a number of studies, interlinked in populations of Chinese adolescents. The once stable suicide rate in Chinese youth in Hong Kong showed a marked rise in the early 1990s, and although this rate has now stabilised, suicide remains a major cause of death in Hong Kong youth. Suicide in females relative to rates found in males, are particularly high. This could be linked to a preferred method of self-harm - jumping from high buildings - which is almost inevitably fatal. Identified risk factors are a sense of anomie or normlessness in a material and rapidly changing culture; a decline in family cohesion and strengths; sexual and relationship problems, including sexual abuse, and negative stereotypes surrounding an emerging gay identity; continued educational pressures and a high rate of school drop-out; and continuing levels of poverty and income inequality. At the same time, there have been increasing rates of substance abuse, and increasing rates of juvenile crime, increases which may share causes with pressures which lead some adolescents to consider or attempt suicide. Case studies of adolescent suicide are presented to illustrate these pressures. Schools could play a major role in suicide prevention, but large classes, the traditional role of the teacher, and a dearth of school counsellors have largely prevented this.
