Wang Cuiling sat and massaged her ears, which had become sore after wearing headphones. Almost all of her 30 colleagues do the same thing after they've said goodbye to their callers and hung up the phones.

A staff member at the Beijing Suicide Research and Prevention Center receives a call on the center's hotline. The center is the first in Beijing to provide a free suicide intervention service. [Zhang Wei / China Daily]

They are hotline operators at the Beijing Suicide Research and Prevention Center (800-810-1117 / 010-82951332), the first in the capital to provide free advice and a friendly voice to those contemplating suicide.

Their 30-square-meter office is divided into 10 small cubicles, each containing a desk, chair and computer.

The 24-hour hotline receives more than 50 phone calls daily on average. The operators provide psychological counseling and, more rarely, physical intervention to callers in distress.

"The person I just talked to was a girl in her 20s. She tried to commit suicide before, but was rescued in time. She told me she wanted to kill herself because of work and family pressure," Wang said.

She has been working on the hotline since it opened in 2002, and her years of experience told her that the girl needed urgent attention.

Wang listened patiently to her complaints and then helped her analyze the difficulties and explained ways of relieving the pressure.

"The conversation went well and her emotions gradually calmed down. I recorded her contact details and will make trace calls twice in the next three days to make sure she is safe," Wang said.

Since most high-risk suicidal callers are deeply depressed, anxious or agitated, the time spent on each one is often lengthy. "Last year I talked with a man for more than three hours. Successfully persuading someone to give up suicidal behavior is the best reward for our efforts. However, compared with the huge number of suicides every year, the people we help are still so few," she added.

Societal pressures

Wang's caller may not be alone in feeling helpless in the face of societal pressures. "China is in a special period of rapid social transformation in which we often have social contradictions and conflicts. Social consciences tend to be underdeveloped and less observed, especially when societies are obsessed with profits. People's spiritual values may be being ignored," said Hu Xingdou, a professor of economics at the Beijing Institute of Technology. Of course, there are other reasons too: An unhappy love affair, the death of a close relative or friend, and depression, are among them.

Statistics from the Beijing Suicide Research and Prevention Center show that suicide has been the fifth-biggest cause of death in China during the last 20 years. In the 15 to 34 age group, it was the number one cause of death. Since 1991, approximately 287,000 people have committed suicide every year in China. During that time, the suicide rate has been falling, but it remains a major public health problem.

Statistics show that 2 million people in China attempt suicide every year. As a result, many become disabled and their families face huge economic uncertainty. Approximately 1.7 million people a year are psychologically affected by the suicide of family members or friends.

"The effects of the serious psychological shadow can last more than a decade or even a lifetime. Suicide is a major public health problem in China, one that significantly affects social and economic development and needs the special attention of both the government and society as a whole," said Li Xianyun, associate director and senior psychiatrist at the Beijing Suicide Research and Prevention Center.

Data from the Chinese Center for Disease Control and Prevention show that the suicide rate in rural areas is three times that in cities and that women are far more likely to take their own lives than men.

Firefighters rescue a woman who attempted to jump from a 12th-floor window in Dongguan, Guangdong province on April 18. The woman was suffering from family problems. Fang Guangming / for China Daily

In a bid to lower the number of suicides, China has established a number of centers in big cities to study causes and prevention, provide preventive services, and train personnel. However, except in large cities such as Beijing, Shanghai and Nanjing, counseling services are still not widely available.

"The proportion of the population that is suicidal is still very high and our current psychological and medial resources are lacking. China has a great shortage of institutes and professional staff to provide preventive services," Li added.

Meanwhile, an increasing number of grassroots organizations have been established by concerned individuals. Wu Fangzhou's name was one among the thousands that appeared when I entered "suicide prevention services" in a search engine. Wu, 37, an official in Gansu province, founded a suicide prevention organization with a friend in 2005. Unlike most hotlines, they mainly provide online advice.

Now, the organization has more than 1,000 registered volunteers nationwide and provides counseling in disaster-hit regions, while members travel to rural areas and mountainous regions to promote psychological knowledge. Wu himself has counseled more than 13,000 people so far.

"It's not a number to be proud of, because only around 100 people were saved. When I think of the rest losing their lives, I'm very sad, but it makes me more determined to continue with this work," said Wu.

He spends almost all of his free time online. His wife often complains and suggests that he should "marry his computer" instead.

"I owe my family a huge amount, but I don't regret it. During national festivals, I receive a lot of messages on my phone. The content is very simple, usually just two words "Thank you". It is my happiest moment when I receive those messages because it means those people are still alive," he said.

"The prevention of suicide is the duty of every person. If society as a whole holds the same point of view, more people will be saved," Wu said.

"Only a small proportion of suicides occur without warning signs. If we pay more attention to the people around us, find those signs in time and deal with them properly, suicide can be prevented," said Li Xianyun.

Statistics from the Life Rescue Team in Chongqing municipality show that since 2003, their hotline has received more than 10,000 calls, among which more than 6,000 callers had serious psychological problems and about 4,000 had suicidal intentions.

"The establishment of suicide prevention hotlines is a very effective way of finding and helping those likely to commit suicide," said team leader Zhu Wanli.

Lack of funding

Despite making a great contribution to society, many organizations face problems. Zhao Guangjun, the founder of the Guangzhou Life Rescue hotline, which has more than 1,500 volunteers, fully understands the difficulties after 15 years in the field: a shortage of funds, the misgivings of friends and family, public skepticism about the role they play the list goes on.

The lack of funding is the biggest problem facing most of the organizations, so much so that the majority established in the 1990s have now closed. Retiree Zhou Zhou opened a hotline in 2006 and helped more than 200 people. However, the size of the phone bill meant he was forced to cancel the hotline in 2008.

"A lack of professional talent is another bottleneck. Suicide prevention work makes high demands on those involved, testing their enthusiasm, psychological know how and communication skills. One wrong word or the wrong approach from a volunteer may further upset callers and the consequences are too dreadful to contemplate," he said.

New proposals

"Compared with many countries, suicide prevention work in China is still in its infancy. The central government has attached greater importance to tackling suicide than previously, but capital and research investment are still very limited. The lack of funds means that outstanding talent is hard to recruit and retain," explained Li Xianyun.

At China's annual legislative assemblies, known as the two sessions, Lan Minbo, a professor of chemistry at East China University of Science and Technology in Shanghai, suggested that the government should consolidate the scattered resources into one body and make better use of volunteers. Moreover, medical schools and universities should establish courses to train more professionals.

Meanwhile, Li suggested a national suicide prevention strategy should be established and urged that officials be made responsible for the promotion of suicide prevention. "It's crucial that we develop a network of government-supported suicide research and prevention centers and a broad-based national prevention organization that systematically monitors the pattern of successful and attempted suicides around the country," she said.

Wu Fangzhou agreed, but thought it would be better if suicide prevention activities were to be backed up by new laws. "China's current suicide prevention program still has many difficulties that need to be solved through the rule-making process, such as establishing a nationwide system to report deaths and preventing easy access to lethal agents, such as pesticides," he said.

During their many years of experience and analysis of suicide cases, Wu and his volunteers worked out a draft of suicide prevention law. "Only the law can clearly specify society's obligations and the responsibility to persuade people not to take their own lives when things are tough," he said.

Contact the reporter at hena@chinadaily.com.cn