serve as the basis but has been passive in preparing manpower and financial resources to enable the system to operate in practice. Korea’s budget related to suicide prevention is 1/160 of Japan's as of 2020,73) and there are media reports stating that the problems are appearing in the implementation of basic suicide prevention policies, such as the poor working conditions and lack of staff at the suicide prevention hotline (1393), with the response rate dropping from 64% in 2019 to 42% in 2020.74) Rural areas have higher suicide rates than cities,75) but local resources and capacities to prevent and address suicide among local residents are lacking. According to the ‘National Mental Health Status Report 2019’ (National Center for Mental Health, 2019), there are 37 cities, counties, and districts without mental health institutions, and these regions have difficulty securing psychiatrists and mental health specialists. Even if there are specialists, it will be difficult for a small number of experts to identify and support high-risk groups in a wide area. They have to support the transfer of suicide attempters to hospitals located in other regions for outpatient treatment, and problems may arise during the follow-up care and with the regional connection of the suicide attempters after being discharged. C) Suicide Prevention Policy Evaluation and Need for Efforts Although the national suicide prevention strategy has been implemented for nearly 20 years since the five-year basic plan for suicide prevention in 2004, the suicide rate in Korea, as of 2022, has not reached the level targeted by the central and local governments. There are already reference-worthy overseas cases, such as Denmark, Japan, Finland, UK, etc., in which the suicide rate was significantly lowered by national policies, suicide prevention laws are being implemented, and various projects are being carried out by the central and local governments, civil society and the media; however, it is necessary to carefully evaluate whether such efforts are sufficiently effective, and if not, what is the reason. 73) Maeil Business News, Japan's suicide prevention budget is 160 times that of Korea... “Must be tripled every year,” Jul. 6, 2021. 74) Kukmin Ilbo, “Suicide Prevention Helpline Lack of Counselors, and Early Resignation Continues,” Oct. 5, 2022. 75) The reason why the suicide rate is high in rural areas, urban-rural complexes, and regions where small and medium-sized cities are concentrated is due to the high proportion of the elderly and the high suicide rate of the elderly. 31