Opinion: Effective suicide prevention starts with decriminalization

As a psychiatrist with decades of experience, I understand how conversations around suicide can evoke a myriad of emotions. It is a topic that intersects with personal, societal, cultural, and religious values. Transcending these values, however, should be the fundamental belief that, at times of mental health crisis, people deserve compassion, not condemnation. The thought of locking someone up for attempting to take their own life is disturbing. And yet, in at least 25 countries across the world, that is the reality affecting at least 850 million people. My birthplace, Nigeria, is one of those countries. It is a place where attempted suicide can land someone in prison for up to a year. To me, it seems incomprehensible that when a person is at their most vulnerable, in desperate need of support, they could be condemned and treated as a criminal. Such laws compound the stigma around mental health, with families struggling to process the discovery that a loved one has tried to take their own life. Decades of research and real-world experience have shown us that compassion is the best form of suicide prevention. --— Decriminalizing suicide While I grew up in Nigeria, my entire 45-year medical career has been in the United Kingdom. My patients here have undoubtedly benefitted from the positive effect of Britain’s decriminalization of suicide in 1961. It is now overdue for other countries to make similar reforms. In Nigeria we are seeing positive signs of change with the recent presidential signing of the National Mental Health Act, 2021, but unfortunately even though this heads in the right direction, it hasn’t gone far enough because suicide remains a crime. The African continent currently has the world's highest rates of death by suicide. Many countries where suicide is still a crime are in Africa. Critically, though, there is no evidence that such laws are an effective deterrent against suicide attempts; rather, these laws are often associated with a higher rate of people attempting to take their own life. While religion undoubtedly plays a fundamental role in many cultures, it should not be used as an argument to retain such laws. Decriminalization is not an affront to faith, but rather paves the way for better suicide prevention. For those who believe the act of suicide to be a sin, I would argue decriminalization helps prevent people reaching the point where they choose to take their own life in the first place, allowing them to seek help without fearing retribution. LifeLine International, a global civil society organization with a focus on suicide prevention, has recently launched “Decriminalise Suicide Worldwide,” a global campaign to reduce rates of suicide. Taking into account the full range of religious and cultural nuances, the campaign aims to question and reform legal stances in nations where suicide is still criminalized, advocating for compassion and assistance over punitive measures. Global progress on suicide prevention The winds of change are already stirring: In recent years, suicide has been decriminalized in Ghana, Malaysia, Pakistan, Singapore and perhaps most strikingly, Guyana. In 2014, a World Health Organization report found Guyana had the highest suicide rate in the world: 44.2 suicides per 100,000 deaths, almost four times the global average. Faced with such a stark reality, policymakers and campaigners, including LifeLine International, galvanized support for a change in the law and better suicide prevention: a “Mental Health Action Plan” was developed in 2015. By the end of 2022, the law had not only been changed, but the country's parliament had passed the Suicide Prevention Act. Decriminalization was recognized as the first step toward effective suicide prevention, offering a blueprint for other countries that still have such laws. Decades of research and real-world experience have shown us that compassion is the best form of suicide prevention. Decriminalization is not diminishing or underplaying the weight of the act or dismissing cultural and religious values. Instead, it is about aligning with our innate human instinct to protect and support. Momentum is building, but there is still a lot of work to be done: laws criminalizing suicide are a barrier to effective prevention. They take, not save lives. It is time to decriminalize suicide worldwide.