China needs to establish national prevention strategies to help maintain a declining suicide rate, a top specialist said.

"Given suicide's complexity, to maintain an ever-declining trend requires an all-out effort by all of society and various government departments," said Huang Yueqin, director of the National Center for Mental Health, on World Suicide Prevention Day, which was Wednesday.

The nation's suicide rate has been declining over the past two decades and now stands at 8.7 out of 100,000 people, according to a World Health Organization report on Sept 4. In the mid-1990s, it was 23 out of 100,000, the report said.

However, China lacks national strategies for prevention of suicide, which the WHO recognizes as a public health challenge, said the report. Twenty-eight countries have such strategies, highlighting commitment by national governments to the establishment and implementation of a coordinated prevention plan.

For instance, said Huang, a Ministry of Agriculture ban on highly toxic pesticides - commonly used in suicides in rural areas - lowered the suicide rate after 2003, particularly in rural areas, which accounted for the majority of suicides.

The problem "couldn't be addressed by health authorities alone," Huang said.

In 2003, the suicide rate among rural women was nearly 17 out of 100,000, mostly by pesticide poisoning, health authority statistics showed. The figure is now about 8.5 out of 100,000.

Li Xianyun, deputy director of the Suicide Research and Prevention Center at Beijing Huilongguan Hospital, attributed the decline to improved medical programs, economic development, and more social support to women in rural areas, in addition to the strengthened pesticide limits.

Due to a rural-urban gap in socioeconomic development, rural residents have had a far higher suicide rate than China's urban residents, Huang said.

Currently, however, resources for intervention such as hotlines and community-level mental health programs remain scarce in rural areas, Li said.

Also, under the New Rural Cooperative Medical Program, a government health policy covering 99 percent of rural residents, medical bills incurred by suicide are not refundable, she said.

The health authority has in recent years invested heavily in addressing serious mental illness, establishing a nationwide patient registration system and offering highly subsidized treatment.

But "coordinated efforts targeting specifically suicide prevention need to be improved," Li said.

Studies have found that 63 percent of people who committed suicide had a mental illness, mostly serious depression.

However, only 10 percent of depression sufferers in China have been diagnosed and properly treated, official statistics showed.

"We should closely look at risk factors including mental and substance use disorders, poor living conditions, loss of loved ones, unemployment, lack of social support and immigration," Li said.

Huang agreed and said that such an effort could start with details like constructing elderly-friendly neighborhood communities and installing windows that only open slightly in high-rise buildings.

Worldwide, about 800,000 people a year commit suicide, with 75 percent of suicides occurring in low- and middle-income countries, according to the WHO report.

shanjuan@chinadaily.com.cn