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Crossing Continents Wednesday, 19 March, 2003, 13:39 GMT
Suicide 'epidemic' among Japan's elderly
Suicide is often seen as a matter of honour in Japan


With its population ageing faster than any other country, Japan is faced with a dramatic rise in the number of suicidal and depressed elderly.

"Suicide has become a national epidemic," the Japanese Government announced after the number of people taking their own lives reached an all time high of 30,000 in one year.

And the group most at risk is the elderly.

We do not want to be a burden on our families. We have been through a lot, and we are not afraid of death

Satsu Takahashi

The birth rate is dropping sharply, and the population is ageing rapidly, leading to fears that the weak economy will not be able to bear the strain of a top heavy society.

Satsu Takahashi is in her 70s. Her family are rice farmers in Akita, in northern Japan.

But rice growing is a declining industry. Both Satsu's brothers hanged themselves, and she has also attempted suicide.

"It was because of our financial problems," Satsu Takahashi explains.

She had a rope in her hands but stopped herself in time.

A matter of honour

Satsu Takahashi
Satsu Takahashi has contemplated suicide

"It was because of pride," she continues.

"We do not want to be a burden on our families. We have been through a lot, and we are not afraid of death."

Suicide in Japan is not only regarded as a way out of depression.

In a proud, stoical society it is also seen as matter of honour. The history of the kamikaze pilots and the samurai warriors are illustrations of this in history.

Mrs Takahashi's generation survived the Second World War. They were the ones who help re-build Japan out of the ashes.

And Japan became the envy of the industrial world.

But now Mrs Takahashi and others are bearing the brunt of Japan's recession.

Too proud to talk

The town of Yuri in remote, snow-bound Akita is notorious for having the highest rate of suicide amongst the elderly.

Doctors and nurses in Japan are not trained to recognise depression

Naoki Watanabe, doctor

They do not talk to therapists or doctors about their problems.

"We like to keep it within the family," Mrs Takahashi says.

One doctor, an expert in suicide and depression, Naoki Watanabe, commutes regularly from his university in Tokyo, to Akita, to try to help.

"Generally, doctors and nurses in Japan are not trained to recognise depression. And old people feel shame talking about their problems," he explains.

"Traditional family life in Japan is breaking down, so there is little support for them," he continues. "Their children are leaving the countryside and going to the cities to work and live."

Loneliness

Echio Sato on traditional mats in front of sliding doors
Echio Sato feels neglected by her family

Echio Sato is 81 years-old. She lives with her son and his family but they do not talk to her, or involve her in family life.

And she cannot afford to move to a retirement home.

She weeps every day.

"My food is left in the kitchen for me and I eat on my own... I would like to be happy for just one hour a day."

However, many of Japan's old people do enjoy good health and wealth.

They hold half the country's savings and private health care is booming.

A lucrative "silver market" offers goods specially suited to the elderly, such as extra-loud alarm clocks and tailor-made holidays.

And luxurious private nursing homes are making up for a shortfall in state care.

But in rural areas like Akita it is a different story. There is poverty and a culture of silence.

Confronting the problem

The government - local, regional and national - has been shocked by the suicide statistics.

Some money is being put into raising awareness. Telephone help lines are available and GPs are being taught how to treat depression.

I now know that we share the same problems

Echio Sato

The elderly are also being encouraged out of their homes into new community centres, which hold special activities for the elderly.

Echio Sato, the 81 year-old great-grandmother, now attends a keep fit class in Yuri's community centre once a week.

"I also do origami and love dancing!" She giggles.

She is happy when she sees her friends. "I can talk to the other old people when we meet up. I now know that we share the same problems."

But Japan has a long way to go before it reduces its suicide rate.

It is a society going through a major upheaval, with lessons for all ageing, greying societies.

BBC Radio 4's Crossing Continents was broadcast on Thursday, 20 March, 2003 at 1102 GMT.

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