Assignment: Health Care Access

The result that suicide attempters more willing to seek help were more likely to be diagnosed with mental illness might seem counterintuitive, but consideration of literature on help-seeking behavior offers further insight into suicide attempts. Help-seeking behavior requires self-awareness of the problem, willingness to seek assistance, and social norms that encourage help-seeking [50]. Those willing to seek help might not have done so prior to the suicide attempt, due to

stigma. Fear of stigma is prevalent in Asian societies [23]. Possible factors preventing suicide attempters from seeking help might include lack of knowledge of available services and difficulty in taking the initiative to seek help [51]. Such factors could be explored in future research through in-depth interviews.

It is noteworthy that in our sample, 25% were diag- nosed with mental illness; this phenomenon is consistent with trends found in other Asian countries [17, 19]; this percentage is relatively low, as compared to Western coun- tries [20]. A recent Asian study found that a risk factor for repeated suicide attempts included somatic complaints, which suggested the possibility that due to fear of stigma [25], Asian suicide attempters might be more willing to report physical symptoms rather than psychiatric concerns [29, 33], which could then lead to underdiagnosis of mental illness and exacerbate the risk of repeated suicide attempts.