Youth Suicide and Music Therapy

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In recent years and months, Hong Kong has seen an insurgence in student suicides. Hong Kong is an incredibly high-stress environment, even if you aren’t a student – but to be at a school that is high competition and academically driven, can be incredibly difficult. The schools put stress on their students to do well, and parents also, unfortunately, place pressure on their children to be top of the class and to get into good universities. According to the HK Social Welfare Department, the Child Mortality reviews show that in 2006, 29% of suicides were related to academic pressures. In 2011, that number raised to 42%. Since 2013, there have been 70 student suicides. 25 of the cases occurred last year. In February, 7 suicides occurred, and another suicide was attempted. One suicide was a joint suicide, in which two friends jumped to their death together. Another two suicides occurred on the same day, despite the two deaths having no links. Several of the latest suicides have been in circumstances of which the suicide could have been prevented. One student was leaving depressing messages on Instagram days before his death. Another student had talked to his parents several days before his suicide, about his unhappiness at school and the stresses he was under. Of these 7 suicides that occurred in 2016, the oldest student was 16, and the youngest was 12. (

Possible reasons for suicide in youth, data collected 2013 – the highest possible cause was listed as school factors at 27.5%

[The University of Hong Kong – An Epidemiological Study of Suicide Deaths in Hong Kong SAR: Characteristics of Youth Suicide – Risk Factors in Youth Suicide (April 2016)]

[The University of Hong Kong – An Epidemiological Study of Suicide Deaths in Hong Kong SAR: Characteristics of Youth Suicide – Lifetime Prevalence of Risky Behaviours in HK Youth (April 2016)]

[The University of Hong Kong – An Epidemiological Study of Suicide Deaths in Hong Kong SAR: Characteristics of Youth Suicide – Help-Seeking Behaviour in HK Youth (April 2016)]

The education system in Hong Kong places incredible pressure on the future – if you suffer now, you will do well later in life. Many students who suffer from learning disabilities receive little help in local schools, and often times, students hide their own mental health issues, due to the stigma surrounding mental health issues. Hong Kong’s Education Bureau is attempting to create a suicide watch on students during times of intense pressure, such as during exam time. However, many are concerned that this will not be enough, and that proper counselling is required all year round, as well as providing students with resources should they feel any need for assistance. (

In a discussion with the Minister for Education, a young student expressed her concerns over the education difference between local schools and international schools in Hong Kong. Most alarmingly, she discussed how at local schools, all she did was take mock exams, but the teachers never taught. She was not allowed to us the toilet, eat, or even drink water. During recess and breaks, she could not do the things she wanted to do, and she stayed up until midnight doing her homework.


Student stress starts young – primary schools in Hong Kong begin students a high academic pressure. According to the Territory-Wide System Assessment HK (TSA), a standard for Hong Kong’s schools, students at primary schools attend class 191 days a year, for 5.1 hours each day – above the global average. Primary students spend about 2.38 hours on homework a day – one of the highest averages in the world, and higher than students in Singapore, Taiwan, and certain areas of China. It is reported that some primary students are given over 20 assignments to complete each weekend, an incredible task to be given to a young child to complete over the course of two days, when they should be spending time outside playing and building motor and social skills. Tutoring is also a major ‘issue’ in Hong Kong, with many feeling that children are taught more than is required, with 67.8% of students receiving additional tutoring outside of school. The TSA also discussed the sleeping patterns of primary students, with 60% of students sleeping under 7 hours a day. Students as young as 5 are given additional homework if a teacher decides their schoolwork is not up to par with that of their peers. (

One of the most stressful events of the school year is the Hong Kong Diploma of Secondary Education (HKDSE). The HKDSE is an exam taken by all public schools in HK, similar to A-levels in the UK. The examination is high-stakes – it is considered as the prime source of academic resource for universities. Even when students achieve high grades, there are often disappointments. One such student, who gained one of  the highest grade, a 5**, in 2016’s HKDSE, was disappointed in his results for Chinese, stating that it would be “near impossible for me to become a good lawyer”, stating that it was hard to be happy with his score, when he knew he could’ve done better. Of the 68,128 students who sat the exam in 2016, only 11 were considered top students, with earning 5** in 7 subjects.

So why have students become more stressed? In 2009, a new system for education was drafted and was fully implemented in 2012. The new system was called the 3-3-4 scheme. The 3-3-4 scheme requires 3 years of secondary education, focusing on four ‘core’ subjects – Chinese, English, Maths, and Liberal studies, as well as three ‘elective’ subjects. These seven subjects are what the HKDSE exam is taken on. In order to advance to university, you must pass all four core subjects. This new system eradicated the sixth form, and combined the two yearly exams into one. Many are objective to the fact that the students must now take one exam – while before the first of the two exams was seen as a ‘practice’, students are placed under considerably more stress, with one large exam seemingly deciding their future. Receiving below a 3 in any of the core exam results means you are not allowed to continue on to university, and you must receive additional secondary education to retake the exam.

Homework and extra exams are given regularly and are graded and required, with both the homework and mock exam results being counted towards a grade. Students in Hong Kong face about 10 hours of homework each week, significantly higher than the global average of 6 hours of homework a week.

[Hong Kong South China Morning Post – Hong Kong prisoners get more exercise time outside than our schoolchildren, research reveals (March 2016)]

The government has recently received a large amount of outcry from their handling of prevention for student suicides. One such example, which received major backlash, was the releasing of a document on their web page titled “The Package on Prevention of Student Suicide” which tried to teach students how to reach out to friends who might have suicidal tendencies. It included several possible ways a student could communicate to their friends, with an example of something to say being “If you die, your boyfriend may be sad for a few days, but he will soon find a new girlfriend and live normally. It is not worth doing such a silly thing for him!”  (

Despite this, the government is trying. In 2016, they set up the Committee on Prevention of Student Suicides. They have teamed up with the Food and Health Bureau, the Hospital Authority, and the Social Welfare Department to provide support to students in Hong Kong, and the system was piloted in 9 schools during this year, with plans to introduce it to all local schools in Hong Kong. This system introduces teacher training in Early Detection, Intervention, and Postvention (EDIP), as well as introducing School Crisis Management in suicide, to provide resources and counselling to students in the unfortunate case of a suicide. Finally, a treatment and support system for students struggling with mental health illnesses will be available for students. Educational workshops are being set up to discuss with secondary students the resources available for suicide prevention as well as providing tools for friends and families of those who might be contemplating suicide. The government is also issuing psychiatric nurses at these 9 pilot schools to individually assess each student’s mental health and provide them with resources and proper treatment if required.

Many are concerned for those aiming to seek treatment outside of school – a consultive psychiatrist appointment can take between one or two years to book, in a stable case, and private doctors costing between 2,000 HKD – 20,000 HKD. However, Hong Kong does have many doctors, and several organisations, such as Christian Action, and Hong Kong Federation of Youth provide cheaper alternatives and free consultations.

How does music affect stress? How can music help people cope with depression? Music contains several ‘secrets’ into our bodies and minds. When one listens to music, our body changes – small, minute changes that can help relieve stress. Our breathing slows down or speeds up. Slow, meditative music can slow your breathing and lower your heart rate. Fast-paced music can increase your breathing and speed up your heart rate. Music can lower your blood pressure. According to scientist Dr. Peter Sleight, at the University of Oxford, music can “alleviate stress…improve movement in neurologically impaired patients with stroke or Parkinson’s disease” ( Listening to music also reduces chronic pain, by up to 21%. When you listen to music, your brain releases endorphins, which combat the pain. In fact, there is a whole type of therapy that revolves around these ideas. Music therapy. Music therapy is used to treat a wide variety of problems – from chronic pain, to addiction, as well as helping to aid those with depression and anxiety. We’ve all probably seen this video, of Henry, a sufferer of Alzheimers and depression, living in a care home. When they give him an iPod and play his favourite music, he comes to life. This is one example of music therapy.

So what IS music therapy? A trained music therapist assesses a patient, before setting them on a path of music recovery. This can include simply listening to music, dancing, or singing, and allowing the mind to wander, or writing and recording music for a therapeutic benefit. While music therapy lightly links back to the 1800s, it began to become a proper field of research during World War II, when the benefits of music were used on war veterans and shell-shocked soldiers. Using psychoacoustics (the study of how the brain perceives music), psychiatrists were able to properly understand how using music could benefits certain aspects of the brain, increasing the density of certain areas of the brain. One specific part of music therapy linked to helping relieve stress and depression is binaural beats. Binaural beats are when two notes are played together, at different pitches. When a research was done with recovering alcoholics, with one group listening to binaural beats on a daily basis for twenty minutes each time, on top of normal therapy versus a group which just did normal therapy, they found the first group, which listened to binaural beats, had a significantly lower relapse rate. Binaural beats play at a frequency similar to that of brain waves. Listening to the beats that match the frequency of the brain waves helps the mind to move into that state. Also similar to binaural beats are isochronic beats – short pulses with a small gap between of one stable pitch. Monaural beats are more similar to binaural beats except that it is one pitch, rather than two separate pitches.

If you are suffering from depression or anxiety, it is not recommended to rely on music therapy, rather it is suggested as a supplement to better support your treatment.

I wrote a song that I performed on piano. I am no pianist, but I hope it conveys a sense of calm and relaxation. I’ve entitled it “Acha” – a loose Indian term used for acknowledgement, to exclamation, a word which shows understanding and attention. I’ve also created a playlist, including songs that many find to be relaxing, as well as some songs that have scientifically been crafted to relax your body, such as Weightless, by the Marconi Union, designed to feel as if you were getting a massage.


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