Content warning: This article discusses sensitive topics such as suicide that some readers may find distressing.
Countries that used to criminalise suicide attempts are beginning to realise punishing individuals doesn't prevent them from acting on suicidal thoughts but simply denies them from seeking help.
Pakistan finally decriminalised suicide late last year and Ghana has approved amendments to the Criminal Offences Act of 1960, which previously made attempted suicide a criminal offence. Malaysia too is following in the footsteps by reviewing and repealing Section 309 of the Penal Code which criminalises suicide attempts.
In 2021, 20 countries still criminalised suicide through their common or civil law (this number is now down to 17 in 2023). Fifteen of these are British Commonwealth countries, which may have inherited the British common law. Ironically, the United Kingdom has decriminalised suicide attempts since 1961.
The suicide rate of these 20 countries varies widely, from 2.5 per 100,000 in Brunei to 40.9 per 100,000 in Guyana. In 2019, seven of these 20 countries including Ghana, Kenya, Malawi, Somalia, Uganda, Guyana and Pakistan had a higher suicide rate than the global average of 9.0 per 100,000 population. These figures would indicate there may be factors other than criminalising suicide attempts which contributed to the suicide rates of these countries.
There may be a reluctance in these countries to decriminalise suicide due to the fear that removing this deterrent may increase suicide rates.
In countries that have decriminalised suicide attempts, there have been mixed results on its effect on suicide rates. Research by psychologist David Lester found that there was an increase in suicide rates in Canada after attempted suicide was decriminalised in 1972. In Sri Lanka, however, suicide rates have decreased after suicide attempts were decriminalised, possibly due to the increase in various suicide prevention programmes. In Ireland, even though the suicide rate did not change significantly after decriminalisation in 1993, the number of undetermined deaths had dropped, possibly indicating that undetermined deaths due to suicide had decreased.
One study showed that countries which criminalised suicide attempts had a smaller drop in suicide rates, while the suicide rate fell at greater percentages in countries in which suicide attempts were not criminalised. This may be because those who were contemplating suicide were more open to seeking help
According to the World Health Organization (WHO), more than 700,000 individuals died by suicide in 2019, which translates to nine out of every 100,000 people. This is lower than in 2000 when the suicide rate was 14 out of 100,000 people. This shows that the suicide rate has been decreasing yearly.
There were many reasons proposed for this decrease, such as increasing economic prosperity in certain countries such as China. Public health efforts have also been used to prevent suicide, such as educating the public about the importance of mental health, destigmatising seeking help for mental health problems and restricting access to materials for suicide (such as banning highly hazardous pesticides in India).
There could be other supportive legislation to help prevent suicide such as enacting laws that enable an individual to obtain help. In Malaysia, someone who is considered dangerous to themselves or others may be taken in for assessment and treatment in a psychiatric facility, as stated in the Mental Health Act 2001, together with the Mental Health Regulations in 2010. In light of the Malaysian government's proposal to decriminalise attempted suicide, the Mental Health Act will be amended to ensure that those who attempt suicide receive medical treatment within 24 hours of their rescue.
Criminalising attempted suicide is not only detrimental but can be superseded by other laws which are more effective in preventing suicide attempts and facilitating the rehabilitation of the suicidal individual to prevent future attempts.
Another way of preventing suicide is through means restriction, which seeks to eliminate or reduce the lethal means an individual may use in their suicide attempts. In Sri Lanka, the restriction of several pesticides, including paraquat, led to a 50 percent reduction in suicide deaths attributable to pesticide ingestion. Ethical reporting of suicide, such as not glorifying the death or describing in detail the method is another way to reduce suicide attempts. Gatekeeper suicide training, a practice of educating people to provide basic skills in identifying individuals at risk of suicide and referring them to mental health professionals, is another public health effort that could raise awareness, reduce stigma, and help individuals seek necessary treatment.
National suicide prevention policies, and collaboration between ministries, and public and private organisations to prevent suicide have also yielded promising results. In Kazakhstan, where suicide was the leading cause of death among 15 to 19 year olds, the Adolescent Mental Health and Suicide Prevention programme helped more than 10,000 adolescents who were at high risk of mental health and suicidal behaviour problems between 2017 and 2018. In addition, 116,000 school staff and school psychologists received gatekeeper training. This led to a 36.1 percent decrease in suicidal thoughts or behaviour among adolescents in one of the regions in which this programme was implemented.
Clearly, there are various ways to prevent suicide attempts other than criminalising them.
There are multiple causes of suicidal behaviour. One is immense psychological pain. A law which increases psychological pain and deters people from seeking help, such as criminalising attempted suicide, may not prevent suicide in the long run, but may even make things worse for the affected individual and their family members.
If this article has raised issues for you, or if you’re concerned about someone you know, visit https://findahelpline.com/i/iasp.
Dr Siau Ching Sin is a senior lecturer in the Faculty of Health Sciences, at Universiti Kebangsaan Malaysia. Her research interest is in suicide and its prevention.
Originally published under Creative Commons by 360info™.
