Although China's suicide rate has declined drastically in the past two decades, medical experts from China and abroad agreed at an ongoing meeting that suicide remains a major public health issue for the country.

Official statistics released by the Chinese Center for Disease Control and Prevention (China CDC) at the 26th World Congress of the International Association of Suicide Prevention showed that 30 out of 100,000 Chinese committed suicide annually in the early 1990s, compared to 15 out of 100,000 in 2009.

Wang Xiangdong, Mental Health and Injury Prevention team leader for the World Health Organization's Western Pacific Regional Office, said that no single factor could trigger such a significant decline.

Higher living standards following rapid economic development, restrictions on pesticide production and sales, and awareness campaigns in communities, schools and workplaces may have all contributed to the decline, said Wang.

Michael Phillips from the Shanghai Mental Health Center identified the improving situation in rural China after a comparative analysis of statistics released by China's Ministry of Health, China CDC, and World Health Organization.

Currently about two-thirds of suicides in China occur in rural areas, while the rural-urban suicide ratio stood at 3:1 20 years ago. Additionally, the suicide rate among Chinese women has dropped to the same level as that of Chinese men. In the past, suicide rates were 25 percent higher for females than males, said Phillips.

He also noted that rural women aged 15 to 35 were almost at the highest risk for suicide 20 years ago. The latest statistics showed, however, that this situation has changed for the better.

Attributing the changes to better education in China's rural areas and the mass migration to urban areas, Wang Xiangdong said that many rural women were no longer subordinates in their families.

He said rural communities now have stable access to the outside world via broader use of the Internet, mobile phones and other communication channels.

"Women who suffer domestic violence can turn to the law or divorce their husbands nowadays, but in the old days, all they could think of was committing suicide," said Phillips.

He said suicide remains a major public health concern in China as an estimated 200,000 people commit suicide each year, accounting for more than 30 percent of the world's total suicide cases.

Unemployment, intergenerational conflict, and mental disorders, among other factors, may still contribute greatly to the despair felt by residents in both rural and urban areas, said Wang Xiangdong.

Wang called on individuals to take their share of responsibility in suicide prevention by caring for their own mental health.

"Referring to people who attempt suicide as 'them' is misleading, because any one of 'us' may become one of 'them' in the future when we have to deal with psychological pains," said Wang.

Other experts suggested establishing a national strategy to guide and coordinate suicide prevention efforts by educational authorities, public security mechanisms, agricultural departments, women's federations and other organizations and institutes.

"The Ministry of Health can only do a small share of work in an effective 'family-workplace-community-medical institution' prevention system China needs to establish," said Phillips.

Despite the challenges ahead, experts said they were optimistic about making further progress in suicide prevention.

"It used to be taboo to talk about suicide in China and the data was confidential, but people are more open and tolerant now," said Paul S.F.Yip, director of the Center for Suicide Research and Prevention at Hong Kong University.

Huang Yueqin, chair of the congress's organizing committee, echoed Yip, saying China's general public has become increasingly aware that suicide is not only a social issue, but also a clinical and scientific one.

More than 460 researchers, clinicians and policy makers from over 50 countries will attend the six-day meeting due to close on Saturday.