Coco Lee’s death reminds us fame and success are no protection from mental health struggles

People still struggle to grasp that celebrities, healthcare workers and others who appear outwardly successful can suffer from mental health issues
We need a systematic change in our understanding of mental health and to destigmatise mental illness

Yunyu XiaoandPaul Yip

Published: 8:15am, 11 Jul 2023

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Pop star Coco Lee’s death by suicide has been a shock to fans in Hong Kong, across Asia and beyond. Reports suggest there were signs of common risk factors for suicide in her life, such as her long struggle with depression, recovery from major surgery and the aftermath of her divorce.

All these factors are known to have an adverse effect on a person’s mental health. Lee’s death is another reminder of the impact of depression. Early prevention and intervention are crucial to mitigate its effects. In this case, societal expectations were also a factor affecting self-acceptance, personal growth and mental health.

We often perceive celebrities like Lee through their moments on the stage – their smiles, talent and seemingly unfaltering strength. However, such societal expectations can exert crushing pressure on high-profile people. Regrettably, it is often only in the wake of a crisis that we begin to question the impact of these expectations and how they can be prevented.

It is not just celebrities who are at risk, either. Similar incidents have occurred within other high-risk populations. Studies show a significant increase in suicide attempts among youth who think they are not meeting their parents’ high standards.

Healthcare workers – who are frequently described as “angels” and “heroes” – are another high-risk group. This “angel” narrative has intensified during the Covid-19 pandemic, but this well-intentioned praise can lead to an unrealistic belief that these professionals can cope with adversity without needing support.

We must acknowledge that these “angels” are human, too, and deserve our care and attention. Even angels can feel the need to cry.

Medical workers in Hong Kong receive bouquets from a foundation on International Women’s Day on March 8, 2020, in appreciation for their work during the Covid-19 pandemic. Photo: Handout

According to our calculations based on data from the US National Violent Death Reporting System, more than 77 per cent of people who died by suicide did not disclose their intention. Among those who did, 31 per cent still died despite receiving mental health treatment.

Likewise, a study of coroners’ reports in Hong Kong suggested that only 25 per cent of those who died by suicide had received psychiatric treatment. These findings debunk several myths surrounding suicide.

The myth that suicide is not preventable isn’t accurate. Often, the person’s intent is simply not recognised or sufficiently addressed. Some of the early signs can easily be overlooked. And psychiatric treatment only is not sufficient.

Contrary to the belief that all suicidal individuals are depressed, there are other social determinants of health. Factors such as family relationships and self-perception can also act as risk factors.

The notion that only certain types of people can become suicidal is also misleading as various predisposing conditions, especially when they intersect, can lead to suicide attempts or deaths.

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Finally, the myth that effective suicide intervention can only come from professional therapists is a misconception. We need to move beyond a medical care model to a population health model.

The pandemic’s impact on mental health came from more than just the virus itself. Our studies show a variety of pandemic-related social determinants of worsening mental health, including food insecurity, financial disruptions, vaccinations, social isolation and more. We need to create and cultivate a more supportive and connected environment for people who are in distress. They need to feel like they have not been forgotten and left behind.

Everyone within the social networks of at-risk individuals can help. Holistic interventions involving families, friends and the broader community are crucial to building a protective shield around those in need.

It is also important to pay attention to the reporting around celebrity suicides as copycat attempts could follow. Sensational or excessive reporting should be avoided. Print media has become better at handling such incidents with care in the past decade, but social media is more difficult to control. It is important for people to express their sadness, but social media posts could have unintended consequences for others, especially people who are emotionally or otherwise vulnerable.

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Hong Kong music icon Coco Lee dies aged 48 after suicide attempt, sisters say

There are many ways to cope with events such as this. Hopefully more encouraging examples of celebrities being public about their struggles and working to fight depression will emerge. Lee’s death should galvanise community awareness around the societal norms and “angel” narratives that can unintentionally harm the people they are meant to celebrate.

It can be difficult to understand how successful people can struggle so profoundly that suicide appears to them to be the only way out. We must remember that mental health issues can affect anyone, and that words and actions from friends, family or the media can have a profound impact. We should make use of this opportunity to pay more attention to people who might be affected by this sort of news.

To achieve a “Happy Hong Kong”, we must be kind to the “angels” among us, asking not just “Are you OK?” but “Is there something you need to let out, do you want to cry?” We need a systematic change in our understanding of mental health and to destigmatise mental illness to improve the wellness of Hongkongers.

Yunyu Xiao is an assistant professor of population health sciences at Weill Cornell Medical College

Paul Yip is the founding director of the Centre for Suicide Research and Prevention and an associate dean (knowledge exchange and development) of the Faculty of Social Science at the University of Hong Kong

If you have suicidal thoughts or know someone who is experiencing them, help is available. In Hong Kong, dial +852 2896 0000 for The Samaritans or +852 2382 0000 for Suicide Prevention Services. In the US, call the 988 Suicide & Crisis Lifeline at 988 or +1 800 273 8255. For a list of other nations’ helplines, see this page.