Malaysia’s parliament passed three bills last week related to decriminalizing suicide, marking a momentous shift in how the largely taboo topic is treated in the country and making the Southeast Asian nation of over 33 million people the latest in a growing list of countries that are amending suicide legislation.

In March, Ghana’s parliament passed a bill to decriminalize attempted suicide. Guyana did the same in November last year, followed by Pakistan in December. India and Singapore changed their laws in 2018 and 2020, respectively. These reforms come amid a global push by mental health advocates and academics to overturn punitive approaches to preventing suicides.

Still, attempting suicide remains illegal in at least 19 countries—including Nigeria, Bangladesh, Tanzania, and Myanmar—many of which inherited their rules on the matter from British common law. But while the U.K. decriminalized suicide in 1961, it has taken decades for some former colonies to do the same. (Meanwhile, Jordan just criminalized attempting suicide last year, and sentenced a man to a month of imprisonment for the charge earlier this month.)

As Malaysia deals with rising suicide rates and concerningly high suicidal ideation among teenagers in particular, mental health advocates have long criticized the use of Section 309 of the country’s Penal Code, which carries up to one year in jail, and/or a fine, for those attempting suicide. As recently as 2020, a Malaysian man was sentenced to six months in jail after a suicide attempt, sparking calls for reform to what experts say is, at its root, a mental health issue.

“The existence of Section 309 was a provision from the 19th century because it was seen at the time that criminalizing suicide would be an act of prevention,” Deputy Law Minister Ramkarpal Singh said in May. “But nowadays, medical treatment, and not prosecution, is the best way to address the matter, based on approaches by other countries.”

What’s wrong with criminalizing suicide?

According to a 2022 study by a team of medical researchers across Asia, there was “no substantial evidence” showing that countries where attempted suicide is criminalized have lower suicide rates compared to the global average.

Kenny Lim, executive director of Befrienders Kuala Lumpur, which runs a 24-hour suicide helpline in Malaysia, tells TIME that the illegality of suicide appears to have done little to steer people away from it. Instead, it has only added another layer of complexity to the emotional distress experienced by those contemplating suicide.

“We have heard from people who say things like, ‘With this law that criminalizes a person who attempts suicide, if I were to do it, I would make sure, I will die,’” he says. “It actually instills fear into people who are struggling, and it sort of prevents people from reaching out for help.”

Another study in 2022 that focuses on Malaysia found that the criminalization of suicide attempts may result in legal processes taking precedence over mental health care for suicide survivors, which can “significantly delay treatment.”

“When you criminalize suicide, effectively, the people who attempt suicide, you are discouraging them from coming forward,” says Caryn Mei Hsien Chan, a Malaysia-based psychologist who studies mental health and suicide risk. Chan tells TIME that instead of alleviating suicidal thoughts, criminalization sends a chilling message to people who are struggling: “If you survive suicide, you’ll actually be thrown into jail potentially.”

It can also affect how caregivers treat people, Chan says. “Sometimes medical doctors and healthcare professionals are reluctant to brand [cases] as a suicide because there’s so many connotations, there are legal ramifications. … When that happens, the patient may not necessarily be referred to services that he or she requires.”

What comes after decriminalization?

In the short term, Malaysia’s suicide rates may actually appear to go up—but that’s because there would be more people willing to report suicide attempts, Ching Sin Siau, a researcher at the National University of Malaysia’s Centre for Community Health Studies, tells TIME.

Across the world, accurate data on suicide and suicide attempts are already difficult to collect and underreported, in large part due to social stigma, with many suicides instead categorized as undetermined deaths or accidents. Siau is hopeful the decriminalization of suicide will lead to more accurate results in suicide data collection.

“We do not want a suicide [attempt] to be masked as something else because [people] are scared of being criminalized. It really hinders our ability to get the real statistics on suicide,” Siau says. “So when we decriminalize suicide, we really hope that [these] statistics will be more forthcoming so that we can intervene better.”

But experts say that decriminalizing suicide is just a first step toward building a more comprehensive framework for suicide prevention and rehabilitation. Chan and Siau both pointed to the need for accompanying policies that would make getting help more accessible to those at risk of suicide, such as requiring insurance providers to include therapy and counseling services in their coverage. Along with the decriminalization last week, Malaysia also introduced new provisions that would allow crisis intervention officers to rescue individuals who are attempting suicide.

Meanwhile, Lim from Befrienders Kuala Lumpur calls for efforts to go beyond the legality and remove the social stigma surrounding suicide. In Malaysia, for example, suicide remains a taboo subject, he says, in part due to religious reasons (it’s forbidden in Islam).

“I think by decriminalizing, we will be able to encourage more people to talk about it,” says Lim. “I think the next step is… the awareness or campaign has to take place, to educate people about suicide.”

If you or someone you know may be experiencing a mental-health crisis or contemplating suicide, call or text 988. In emergencies, call 911, or seek care from a local hospital or mental health provider.

Source : Time

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