The relationship between normative beliefs towards suicide and support for suicide prevention in Taiwan: addressing suicide as human rights, individual choice, or irrationality

Abstract

East Asian countries are known to take a more permissive attitude towards suicide. However, the nuanced beliefs fostering these attitudes remain unexplored. This study aimed to examine socio-demographic and clinical factors associated with the three normative beliefs on suicide in Taiwan – suicide as human rights, suicide as an individual choice, and that suicide is irrational – and the association of these beliefs with supportive attitudes towards governmental suicide prevention measures. A nationally representative survey, based on calls to landlines and mobile phones, was conducted in 2020 with a sample size of 1,087. Logistic regression analyses were employed to examine the associations between socio-demographic variables, mental health status, normative suicide beliefs, and attitudes towards suicide prevention. We found that the prevalence rates for the three normative beliefs were 55.3% for human rights, 26.7% for individual choice, and 73.7% for irrationality, respectively. Human rights belief was more prevalent among younger, unmarried, and highly educated individuals. Individual choice belief was more common among the younger, those in the ‘other’ marital group, less educated individuals, and those without mental conditions. The irrationality belief was more likely to be endorsed by the unemployed group. Regardless of participants’ normative suicide beliefs, a significant majority (89.0%) supported governmental investment in suicide prevention. However, human rights and individual choice beliefs were associated with diminished support for governmental suicide prevention measures (aOR = 0.6, p = 0.003, and aOR = 0.6, p = 0.005, respectively). Taiwanese society overwhelmingly supports governmental suicide prevention measures, suggesting a leaning towards hard paternalism. However, those who believed that suicide is a human right and individual choice were less likely to support governmental suicide prevention efforts. Our findings suggest that health education addressing these two normative beliefs, particularly among the youth and unmarried individuals, could be potential strategies in future suicide prevention measures.

Keywords:

• Suicide
• normative belief
• human rights

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethics

The study was approved by Taipei City Hospital Research Ethics Committee (TCHIRB-10803013). Verbal consent was obtained from all participants before the survey took place.

Additional information

Funding

YYC is supported by the National Health Research Institutes (NHRI-EX110-10818PI), the Taiwan Ministry of Science and Technology (MOST 108-2314-B-532-007-MY2), and the Department of Health Taipei City Government (10901-62-008). KCCW is supported by the Taiwan Ministry of Science and Technology (MOST 105-2410-H-002-027-SS3). The funders had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication.