Is Decriminalizing Suicide Enough?

“Giving no regard to the procedural aspects and simply declaring suicide to be non-criminal does no good. As old methods will still be continued, the rights of the patients will be denied along the way.”

India, just like any other nation, experiences a disconcerting rise in suicides. Research shows that in 2021, over 164,000 people were reported to have died by suicide in the country, a 7.2 per cent increase in the number of suicides compared to 2020.[1]

After years of being critically blamed for ineffective and outdated legislation – the Mental Healthcare Act, of 1987, which did nothing to protect the rights of the populace or even attempt to assist them in any way, the Government finally passed the Mental Healthcare Act, 2017.

Not to be overly pessimistic, this Act has made significant positive changes in our health laws. However, it also left behind damaging, exploitative lacunas.

For example –

1) Although the act limits involuntary admissions, it doesn’t outline specific standards for assessing whether such admissions are appropriate. Legal authorities and medical practitioners should avoid potential abuse and incorrect application of this law by following clearer instructions.

2) The act creates Mental Health Review Boards to regulate how the act is put into practice. However, it needs to outline the structure, requirements, and operating processes for these boards, which could cause disparities in how effective they are in certain areas.

3) The act does not provide any further clarification on the informed consent procedure for many facets of mental healthcare, such as therapy, study, and the use of psychotropic drugs. The autonomy of people can be better protected with such specific rules, etc.

Some positives of the Act could be that – It clarifies key concepts like mental illnesses and incorporates patient or people’s rights that were previously missing. One of the most anticipated changes—the “decriminalization of suicide”—is also reflected in the Act.

But this also raises the following queries:

1)      Whether or not decriminalization is a wise move for India? AND,

2)      Whether this adjustment is enough on its own?

To address the first question, Let’s discuss the pros and cons of decriminalization of suicide by the Mental Healthcare Act of 2017:

There are many benefits of decriminalizing suicide in India, in fact, it was one of the steps our healthcare laws most eagerly awaited. India lagged behind other Asian nations and the rest of the world when it came to the decriminalization of suicide. Most countries have done so for a long time now.

Listed below are some of the pros: 

•   One of the main benefits of decriminalising suicide is that it contributes to lowering the stigma attached to both suicide and mental health concerns. People may be discouraged from seeking treatment if suicide is viewed as a crime out of concern for possible legal repercussions. The statute encourages people to seek out mental health support by removing legal consequences.
• The act adopts a more sympathetic and humanitarian stance toward people who are already experiencing hardship. It emphasizes that people who attempt suicide frequently require mental health care and support rather than further penalizing them.
• The Mental HealthCare Act of 2017 is in compliance with UDHR (Universal Declaration of Human Rights) principles and gives such rights and remedies in accordance with not only our constitution but also international laws, which was a missing piece in earlier legislation.
• Decriminalization can enable people to talk openly about their mental health problems, get professional assistance, and take part in early intervention. This may result in improved mental health outcomes and a reduced rate of suicides over the years.

Thus, the Act intends to lessen stigma, promote mental health treatment, and enhance overall mental healthcare in the nation by decriminalizing suicide and recasting it as a public health issue rather than a criminal one.

However, doing so is not so easy, and here are some Problems associated with the same:

•   Decriminalization reduces the law’s inhibitory effect, which could lead to an increase in suicide attempts, particularly among vulnerable persons. Suicide may be viewed as a more acceptable option.
• Suicide decriminalization may generate ethical concerns about assisted suicide or euthanasia, which can be difficult to address. There is a need for law that distinguishes between self-harm and situations in which persons are assisted by others.
• Decriminalization may have an unintended impact on suicide prevention initiatives. Police and healthcare providers may be less proactive in reacting to suicide threats or attempts, thus missing out on intervention possibilities.
• Some people and organizations may have moral or ethical reservations about decriminalizing suicide. They can argue that society should not transmit the message that suicide is a viable option.
• In terms of mental healthcare facilities and resources, India has considerable obstacles to progress. Decriminalization may not be enough to meet the population’s mental health needs.
• There may be instances where individuals aid someone in committing suicide, creating legal ambiguity. It can be difficult to distinguish between cases of influence and cases of compassionate aid.
• However, one of the main reasons critics are dissatisfied with this Act is that it is incomplete! It has significant gaps in many crucial sections. Most notably Section 115 of the Act above, which discusses decriminalizing suicide!

According to this section, a person who has attempted suicide is under severe stress. The statute encourages governments to give mental health care and rehabilitation rather than punishment. However, Section 115 of the Mental Healthcare Act technically does not abolish Section 309. Instead, Section 115 is an interim move that compromises Section 309.

To understand it better,

In practice, when a suicidal patient arrives at a medical facility, the occurrence is recorded as both a medical and legal case, and the police are notified. The police contact the patient’s relatives and interrogate him or her, and while they rarely punish the patient, they routinely harass and extort them and their family.

Considering Section 115 of the Mental Healthcare Act, governments have also not offered any instructions to either doctors or police on how to deal with attempted suicide, enabling these old methods to persist.

With proper direction and training, the police’s handling of attempted suicides could be improved. However, the felony of attempted suicide in India discourages early intervention since people are afraid of being prosecuted and harassed if they seek help before the potentially life-threatening effects occur.[2]

Giving no regard to the procedural aspects and simply declaring suicide to be non-criminal does no good. As old methods will still be continued, the rights of the patients will be denied along the way.

This answers the second question by itself: No, the adjustment by itself is insufficient. It is only a theory, and as long as the provision is silent, the practical side suffers.

Here are some solutions or adjustments that could help the Act achieve its objectives:

• To address assisted suicide scenarios, laws or regulations can be enacted that specify the limitations and circumstances under which it is acceptable.
• It is imperative to keep funding mental health services and suicide prevention programs. To close this gap, law enforcement and medical personnel should receive training on how to deal with suicidal people. And such provisions must be incorporated with no ambiguity.
• Increased funding for mental health services, professional mental health training, and the construction of more mental health facilities, particularly in rural regions, are necessary to address resource limitations. Along with proper guidelines on the allocation of such funds and other necessary protocols.
• Proper rules or provisions on actions or procedures to be followed in such instances are a must.

Decriminalizing suicide in India offers many benefits, but it’s crucial to address potential difficulties. Strengthening mental health support networks, informing the public about available resources, clarifying rules for assisted suicide, and investing in suicide prevention and mental healthcare services are some of the obvious remedies. Balancing suicide decriminalization with strong mental health support and prevention measures is essential for the well-being of those in distress.

As a result, while decriminalizing suicide was and is a wise decision for India, it is lacking in other necessary guidelines or provisions.

 Footnotes

[1] Tanya Nicole Fernandes and Soumitra Pathare,  How India Continues To Punish Those Who Attempt Suicide, (https://thewire.in/health/how-india-continues-to-punish-those-who-attempt-suicide), 18 April, 2023.

 [2] Tanya Nicole Fernandes and Soumitra Pathare,  How India Continues To Punish Those Who Attempt Suicide, (https://thewire.in/health/how-india-continues-to-punish-those-who-attempt-suicide), 18 April 2023.

This article has been contributed by Khushi Upadhyay, a student at Presidency University, Bengaluru.