Are these low rates of mental illness in Chinese suicide victims reliable? Zhang et al. used a Chinese version of the Structured Clinical Interview for DSM-IV (SCID) with proxy informants to make psychiatric diagnoses. All psychological autopsy studies employ proxy informants to make diagnoses, so this should not in itself explain the lower rate of mental disorders in Chinese suicide decedents. But in China a low proportion of individuals with mental illnesses ever receive treatment (5), so unlike in Western studies, the proxy-based diagnoses cannot be augmented by referring to information in clinical records. Studies have found that the SCID can be used reliably in China (5), but clinicians need to be flexible in their use of the SCID probes to make the instrument sensitive to cultural variation in the manifestation and expression of symptoms. Thus, the main methodological concern with the Zhang et al. study is whether or not the use of nonpsychiatric interviewers—who may be less able to flexibly change probes when respondents do not understand the standard SCID probes—led to an underestimation of the rate of mental illness. Interrater reliability was assessed by having interviewers code three taped mock interviews. But three interviews are too few to assess diagnostic reliability, and this method assesses interviewers' ability to code a standard interview conducted by someone else—it does not assess their ability to independently conduct the interview. And the much lower rate of mental illnesses in the 416 comparison subjects (3.8%) relative to that reported in community members 18—34 years of age (12.5%) who participated in a large psychiatric epidemiologic study in China in which the SCID was administered by psychiatrists (5) suggests that the interviewers in the Zhang et al. study may have been less thorough in their investigation of comparison subjects or that the proxy informants of living comparison subjects may have been more reluctant to report psychological problems in their associates. Despite these caveats, the close similarity of the study's reported prevalence of mental disorders in young suicide decedents to that of the previous independent psychological autopsy study (48% and 45%, respectively) gives us some reassurance that the overall prevalence reported in the suicide decedents is reasonably close to the actual rate.