IN August, a 16-year-old girl from Rahim Yar Khan died by suicide. After battling with depression, and fearing criticism from her family, she took her life after locking herself in her room. Another girl from Hunza was found dead shortly after her exam results were announced. Along with increasing teenage suicide rates, Pakistan is also witnessing an alarmingly high number of adult male suicide rates caused by financial problems and poverty. Recently, a 42-year-old father of two from Rawalpindi took his life after being unable to pay back loans. He saw no way out except for death, even if it meant leaving his family behind.

In December 2022, a bill signed by the president repealed Section 325 of the Pakistan Penal Code which treated suicide as a criminal act, a monumental feat in Pakistan’s history. Parliament agreed that the criminalisation of suicide was a draconian law and a colonial remnant that directly violated universal human rights and only served to persecute survivors and their families. But lack of implementation of the law continues to force survivors and their family to go through unnecessary stigmatisation and harassment at the hands of law enforcers.

Last year, suicide claimed around 20,000 lives in Pakistan, with over 200,000 people attempting it and two million thinking about it. Mental illnesses are already heavily stigmatised in Pakistani society. Seeking help is perceived as shameful and leads to social repercussions for patients and their family. Lack of implementation of the law adversely impacts thousands of patients affected by mental illness, preventing them from seeking help. The criminalisation of suicide makes the process of seeking mental health services even more difficult.

With the ongoing socioeconomic crisis causing high distress levels in the population, attempted suicide rates are expected to rise. Amidst the rising cases, evidence-based treatments present hope for tackling this epidemic but to provide the appropriate services it is crucial that we have the relevant data. Criminalisation of suicide prevents us from collecting this data since the families of patients usually get the cause of admission changed by bribing medico-legal officers, thereby preventing an accurate record of the true statistics. Implementing decriminalisation can change this by allowing accurate reco­rding and reporting of suicide attempts so that the appropriate interventions can be developed for the relevant regions.

Last year, suicide claimed around 20,000 lives in Pakistan.

Additionally, the implementation of suicide decriminalisation will allow private and public healthcare facilities to cater to cases quickly and efficiently without the need for redundant medico-legal facilities. Instead of overburdening the public healthcare infrastructure, decriminalisation will encourage medico-legal officials to dedicate their limited resources to cases that require their services. Private healthcare institutes can also get involved in providing mental health support to patients of suicide attempts thereby reducing the burden on already saturated public healthcare services.

Critics may argue that decriminalisation of suicide may lead to the removal of a deterrent against it leading to an increase of cases as witnessed in the recent petition admitted by the Federal Shariat Court. However, the truth of the matter is that most patients who attempt suicide are not even aware that it is a criminal act until they reach the emergency departments of hospitals. While the reporting of suicides may increase after decriminalisation, it will be due to reduced fear of criminal consequences. It will also help bring much-needed public atte­ntion to this on­go­ing epidemic, which is necessary to encourage and enable our system to provide treatm­ent to those in need. This law only serves to cover up the issue, thereby compounding the misery of those affected.

The recent repeal of Section 325 places policymakers, mental health advocates and people with lived experiences in a unique position to lobby for the implementation of the legislation by the interior ministry. We can lobby the interior ministry for making rules of business for the implementation of the decriminalisation of suicide, and then send a notification to the relevant home ministries of the provinces. Provincial governments can then adapt the law to their provincial contexts and discontinue the practice of involving medico-legal officials in cases of suicide.

This suicide prevention month, let us advocate for the implementation of the decriminalisation of suicide so those experiencing mental health problems can receive compassionate support rather than fear oppressive criminalisation.

Taha Sabri is a public health practitioner focusing on mental health and co-founder of Taskeen Health Initiative. Mariyam Sibghatullah is a public health professional and works at Taskeen Health Initiative.

Published in Dawn, October 10th, 2023