By Annan Boodram – The Caribbean Voice
The International Association for Suicide Prevention (IASP) earlier this year, made a call for the global decriminalization of suicide. The IASP, “recommends the decriminalisation of attempted suicide on the grounds that this will:
- Reduce social stigma;
- Help remove barriers to obtaining adequate mental health care;
- Increase access to emergency medical services, foster suicide prevention activities;
- Improve the well-being of people who are vulnerable to engaging in suicidal behaviours;
- Contribute to more accurate monitoring of suicidal behaviours.
On the other hand, “The criminalisation of attempted suicide undermines national and international suicide prevention efforts and impedes access among vulnerable individuals and groups to suicide prevention and mental health services”. Also, “the criminalisation of attempted suicide impedes the prevention of suicidal behaviour”. Thus, the IASP “encourages countries where suicide attempts are currently illegal or punishable to develop and implement legislation that decriminalises suicide attempts”.
As well, the IASP recommends “firm advocacy on the part of professionals, volunteers, and also by those who are afflicted with suicidal impulses” to promote the implementation of effective approaches to suicide prevention. “This may involve advocacy at the legislative level, for example in decriminalising suicidal behaviour in those countries where this has not yet been achieved.”
The IASP’s policy position statement asserts that while suicide has been decriminalised in many countries, attempting suicide still represents a punishable offence in 45 countries, where legal penalties range from a small fine or a short period of imprisonment to life imprisonment, resulting in significant added distress and upheaval for vulnerable individuals who have engaged in a suicide attempt and often have serious mental health problems, which need treatment.
Furthermore, “the deleterious effects of the criminalisation of suicide attempts go beyond the persecution of the individual, by undermining the provision of appropriate care following an attempt, and exacerbating the social stigma associated with suicidal behaviour, which impedes help-seeking”. It also, “hinders the surveillance of suicidal behaviours, resulting in an underestimation of their true prevalence and thus creates obstacles to the planning and implementation of appropriate suicide prevention interventions”.
On the other hand, decriminalization recognizes that:
- People who attempt suicide often have a reduced capacity to make an informed decision as a result of mental illness, substance abuse and/or an extreme crisis;
- Suicidal behaviour is unlikely to be deterred by the criminal status of suicide attempts and the threat of legal sanction;
- Imprisonment exacerbates suicide risk, leaving those incarcerated for attempting suicide with a lack of, or inadequate, requisite psychological and psychiatric support;
- Should lead to increased recognition and treatment of suicidal behaviour as a public health and social justice concern;
- Reduce stigma and increase help-seeking among vulnerable individuals; “encourage tolerant and compassionate attitudes in healthcare and welfare agencies towards those who attempt suicide;
- Is highly unlikely to lead to an increase in actual suicidal behaviour, although it might result in a greater willingness to report suicidal behaviour.
Decriminalisation is most effective when supplemented by:
- A national suicide prevention strategy and action plan (WHO, 2014);
- A comprehensive surveillance system to monitor the characteristics of, and trends in, suicidal behaviour (WHO, 2016);
- Education and training for law enforcement, healthcare and social services staff responsible for the provision of care to those who engage, or are likely to engage, in suicidal behaviour;
- Improvements in the quality and accessibility of community- and hospital-based care for suicidal individuals and persons experiencing mental health difficulties;
- The implementation of measures to reduce the social stigma associated with mental ill-health and suicidal behaviour.
Within this context, the IASP resolves to:
- Advocate for the decriminalisation of attempted suicide in countries where this behaviour remains illegal or punishable;
- Support the implementation of legislation that decriminalises attempted suicide, through the provision of letters, research data and endorsements to support those promoting decriminalisation within their country;
- Support representatives in countries where attempted suicide is currently punishable and illegal to advance the decriminalisation of attempted suicide in their country.
Over the past two centuries, there has been a worldwide shift in attitudes and responses to suicidal behaviour, from fear, condemnation and punishment to compassion, understanding, treatment and support. However, the continuing criminalisation of attempted suicide perpetuates individual suffering, exacerbates the stigmatisation of suicidal behaviour and inhibits help-seeking. The decriminalisation of attempted suicide, where it is illegal or punishable, is vital to ensure that persons who engage in a suicide attempt obtain the help they need, and are supported by national policies, which value the lives and contributions of all the members of society.
It is to be noted that suicide is still criminalized in most of the Caribbean except Anguilla, Antigua and Barbuda, Bermuda and the Cayman Islands. Last year in Guyana’s director of the Mental Health Institute, Dr Util Richmond-Thomas, was quoted in the media as being “in full support of the decriminalisation of suicide and self-harm”. The director was one in a long line of government officials who have made this call over the years. Non-Guyanese who have also made this call include British High Commissioner Greg Quinn and PAHO/WHO representative, Dr William Adu-Krow.
A bill to decriminalise suicide and self-harm was moved in parliament by the political opposition in 2016. Piloted by Dr Vindhya Persaud, the bill came about partly through the work of The Caribbean Voice, more specifically Dr Frank Anthony, a member of TCV’s board of directors. Although the government spoke in support of the bill, they argued that the manner in which the legislation was framed both politicised and trivialized the issue, but no explanation was ever provided to indicate how this was so.
In 2015, minister Khemraj Ramjattan had called for the decriminalisation of suicide when he spoke at the launch of the Suicide Helpline. Yet he was most vociferous in declaring that government would not support the motion in parliament in 2016. In October 2018, attorney general, Basil Williams, was quoted in the local media as stating that plans were afoot to decriminalise suicide. Two years later no move has yet been made towards this end.
While consultations that minister Ramjattan promised in 2015 never took place, a 2016 poll commissioned by The Caribbean Voice found that most Guyanese (74 percent) agreed that suicide should be decriminalised.
In 2016, after the government voted against the decriminalization bill, TCV called for a bipartisan committee to prepare and take another bill to parliament but there was absolutely no response from the politicians. TCV now urges the new government to be installed to set up this bipartisan committee to craft another bill so as to eliminate ‘Politicising and trivialising’ and ensure that the bill becomes law. We also urge that this new legislation makes provision for psychological assistance for suicide survivors, something Dr William Adu-Krow had alluded to in his call for decriminalization. Surely these are measures that all Guyanese politicians can agree on?