indebtedness and suicidal ideation in hong kong dr. edward k.l. chan department of social work and...
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Indebtedness and suicidal ideation in Hong Kong Dr. Edward K.L. Chan Department of Social Work and Social Administration The University of Hong Kong. What ’ s wrong? . Impact of indebtedness on the individual and on society Debt as a health risk to the individual - PowerPoint PPT PresentationTRANSCRIPT
Indebtedness and suicidal Indebtedness and suicidal ideation in Hong Kong ideation in Hong Kong
Dr. Edward K.L. ChanDr. Edward K.L. ChanDepartment of Social Work and Social Department of Social Work and Social
AdministrationAdministrationThe University of Hong KongThe University of Hong Kong
What’s wrong? What’s wrong? Impact of indebtedness on the Impact of indebtedness on the
individual and on societyindividual and on society Debt as a Debt as a health riskhealth risk to the individual to the individual Debt as risk factor of Debt as risk factor of suicidesuicide Reducing productivityReducing productivity Debt, as a main cause of Debt, as a main cause of bankruptcybankruptcy, ,
threat to financial system threat to financial system
Individual indebtednessIndividual indebtedness VoluntaryVoluntary InvoluntaryInvoluntary
Voluntary indebtednessVoluntary indebtedness Undertaken to increase personal Undertaken to increase personal
satisfaction, consumer benefit drivensatisfaction, consumer benefit driven Types include: Types include:
Mortgage Mortgage Study loanStudy loan Cash advance - overdraft for any purposeCash advance - overdraft for any purpose Credit Card debtCredit Card debt Business loanBusiness loan Speculative activitiesSpeculative activities
Financial instruments Financial instruments investment in nature investment in nature Gambling Gambling entertainment in nature entertainment in nature
Involuntary indebtednessInvoluntary indebtedness Driven by externalitiesDriven by externalities
Family Life Cycle – maternity/ paternity, going to Family Life Cycle – maternity/ paternity, going to college / universitycollege / university
Lifetime crisis – unemployment, illness, injury, death of Lifetime crisis – unemployment, illness, injury, death of family members, divorcefamily members, divorce
Previously voluntary debt become dead weight debt due Previously voluntary debt become dead weight debt due to interest repayment trapto interest repayment trap
Credit card: multiple credit card, paying only the minimal amountCredit card: multiple credit card, paying only the minimal amount Speculative activities: margin call Speculative activities: margin call Cash advance / overdraft: compound interestCash advance / overdraft: compound interest
Personality impairmentPersonality impairment Compulsive buying disorderCompulsive buying disorder Problem / pathological gamblingProblem / pathological gambling AlcoholismAlcoholism Substance abuseSubstance abuse
What is Debt?What is Debt? Broad definitionBroad definition
A promise to pay tomorrow, for a A promise to pay tomorrow, for a consumption made todayconsumption made today
Core: Core: FutureFuture repayment, repayment, presentpresent consumptionconsumption
Underlying Underlying uncertaintyuncertainty many variables many variables involvedinvolved
About the studyAbout the study Targets: enquirers of the “Healthy Targets: enquirers of the “Healthy
Budgeting- Family Counseling Budgeting- Family Counseling Programme” , by Tung Wah Group of Programme” , by Tung Wah Group of Hospitals (TWGHs) Hospitals (TWGHs)
783 subjects were recruited from 783 subjects were recruited from Oct., 02 – Feb., 03Oct., 02 – Feb., 03
Distribution of enquirers by Distribution of enquirers by sexsex
52.0%48.0%
Male Female
Age profile of enquirersAge profile of enquirers
1%
19%
37%33%
10%
0%
23%
43%
28%
6%
0%
10%
20%
30%
40%
50%
Below 20 20 - 29 30 - 39 40 - 49 50 - 59
Male Female
Marital status of enquirersMarital status of enquirers
32%
60%
8%
1%
32%
50%
17%
1%0%
10%
20%
30%
40%
50%
60%
70%
Single Married Divorced or separated Widow/widower
Male Female
Percentage of enquirers by Percentage of enquirers by total amount of debttotal amount of debt
16%
29%
20%17%
10% 9%
0%
10%
20%
30%
40%
Below$100,000
$100,000-$199,000
$200,000-$299,000
$300,000-$499,000
$500,000-$999,000
$1 million orabove
Number of credit cards with Number of credit cards with outstanding loansoutstanding loans
3%
11%
17%
13%
10% 10%8%
7%
3%
13%
0%
5%
10%
15%
20%
One Two Three Four Five Six Seven Eight Nine Ten orabove
Main reasons of Main reasons of indebtednessindebtedness
3%
19%
10%
18%
18%
17%
11%
11%
11%
3%
0% 10% 20% 30%
Household expenses exceeds income
Unemployment
Unemployment of spouse
Investment losses
Need cash for friends/relatives
Poor financial management
Business losses
Job change, reducing income
Gambling
Need cash for medical expenses
About 17% or 136 subjects had About 17% or 136 subjects had thought about committing suicide.thought about committing suicide.
Views of those who had Views of those who had thought about committing thought about committing
suicidesuicide
2% 7%
18%
71%
68%
16%
37%
3%
19%
16%
10%
8%
45%26%
90%
23%
56%
2% 14%
32%
11%
21%
0% 20% 40% 60% 80% 100%
Think about death
Think about committing suicide
Family members would behappy if they die
Commit suicide if know themethod
Bring family members togetherin committing suicide
Worry about family members ifthey die
Never Seldom Sometimes Often
Characteristics Suicidal ideation
Non-suicidal ideation
p-value
Respondent’s Sex Male 42.6 54.3 0.01 Female 57.4 45.7
Total amount of debt (ten thousand)
Mean 50.40 41.14 0.44SD 97.02 129.07
No. of credit card with outstanding loan
Mean 6.29 5.30 0.01SD 4.21 3.58
Amount of credit card debt (ten thousand)
Mean 19.12 16.14 0.060.06SD 19.59 15.46
Impact of indebtedness Suicidal ideation
Non-suicidal ideation
p-value
Stalking 55.97 27.82 0.00
Impact of indebtedness Suicidal ideation
Non-suicidal ideation
p-value
Aspects most affected 0.00
Work performance 19.51 18.39
Family relationship 41.46 30.38
Social activities 5.69 5.42
Self-confidence 33.33 27.59
Not affected 0.00 18.23
Total 100.00 100.00
Impact on physical health Suicidal ideation
Non-suicidal ideation
p-value
Insomnia 79.41 44.05 0.00
Headache 64.71 33.38 0.00
Muscle pain 19.85 6.18 0.00
Loss of appetite 36.03 8.96 0.00
Feeling tired 44.12 17.00 0.00
Dependent on alcohol and drug 11.76 2.47 0.00
Impact on mental health Suicidal ideation
Non-suicidal ideation
p-value
could not concentrate 54.41 31.84 0.00
Nervous 72.06 61.98 0.02
Frighten 49.26 38.79 0.03
feeling agitated 47.79 43.74 0.39
depressed 63.97 28.13 0.00
RecommendationsRecommendations Debt CounselingDebt Counseling
Retain workforceRetain workforce Restore repayment capability/motivationRestore repayment capability/motivation Reduce family stress/tragediesReduce family stress/tragedies
1. Debt Counseling1. Debt Counseling Three strategies:Three strategies:
1.1. Debt avoidanceDebt avoidance2.2. Debt repaymentDebt repayment3.3. Coping with debtCoping with debt
Debt avoidanceDebt avoidance Increase protection over high-risk individuals Increase protection over high-risk individuals
(children of debtors, problem gamblers, (children of debtors, problem gamblers, individuals with addicted behaviors) individuals with addicted behaviors)
Skills and assistance in financial Skills and assistance in financial managementmanagement
Value “saving for a rainy day” Value “saving for a rainy day” 未雨綢繆 未雨綢繆 over over “spending future money” “spending future money” 先洗未來錢先洗未來錢
Speculative behavior of Hong Kong peopleSpeculative behavior of Hong Kong people Recognizing the reality of potential debt from Recognizing the reality of potential debt from
the status symbol (the gold credit card, the the status symbol (the gold credit card, the prestigious store charge card)prestigious store charge card)
Debt repaymentDebt repayment Amount of credit line usedAmount of credit line used
Formal Formal InformalInformal
Assessment of individual and Assessment of individual and Family Repayment CapacityFamily Repayment Capacity Prioritizing the debtsPrioritizing the debts Improve communication, show effort in payingImprove communication, show effort in paying
Encourage the borrower to respond rather than keeping their heads low Encourage the borrower to respond rather than keeping their heads low (typical behavior which tends to lead to more aggressive collection (typical behavior which tends to lead to more aggressive collection method)method)
Reduce debt/income ratio – avoid incurring new debtsReduce debt/income ratio – avoid incurring new debts Re-asses repayment periodRe-asses repayment period
Coping with DebtCoping with Debt Build / improve / restore resilience in debtors and Build / improve / restore resilience in debtors and
high risk individualshigh risk individuals Ability to cope with significant adversity: Problem-solving skills, Ability to cope with significant adversity: Problem-solving skills,
Social competence (flexibility, communication), Autonomy (self-Social competence (flexibility, communication), Autonomy (self-efficacy and self control), a sense of purpose and future (success efficacy and self control), a sense of purpose and future (success orientation, motivation and optimism)orientation, motivation and optimism)
Improve social integration of debtors, in particular Improve social integration of debtors, in particular their relationship with their family and significant their relationship with their family and significant social nucleussocial nucleus Alleviate stress, even provide financial safety net for debtorsAlleviate stress, even provide financial safety net for debtors
2.Low Income Families Deserve Attention
Low socioeconomic status / Socially Low socioeconomic status / Socially disadvantaged:disadvantaged: low income, low income, unemployed, single parent, chronic unemployed, single parent, chronic illness patient and family, sudden illness patient and family, sudden lifetime crisislifetime crisis
3.Cross Sector CollaborationCreditor Market Information
Debt Relief
Arrangement
Financial
PlanningFamily Casework
Budgeting Education
Families-in-debt
Wish you …Wish you … Free of debtFree of debt Free of interpersonal debtFree of interpersonal debt
Thank YouThank You