Long delay in passage of mental care bill to decriminalise suicide

The new Mental Health Care Bill is languishing in Parliament, delaying the proposed decriminalisation of attempted suicide. Introduced in the Rajya Sabha on August 19, 2013, the bill repeals the Mental Health Act of 1987.

Social, psychological, cultural and other factors can interact to lead a person to suicidal behaviour, but the stigma attached to mental disorders and suicide means that many people feel unable to seek help, according to a WHO report. Despite the evidence that many deaths are preventable, suicide is too often a low priority for governments and policy-makers in India.

Suicide — a taboo, a trauma, a social stigma, a mental imbalance, a decapitating depression, an escape or just a state of mind “It takes a lifetime to die and no time all”, writes poet Charles Bukowski, and how very accurate.

Throughout history, cultures and societies have been grappling to merely understand the term and the act of suicide. Some cultures celebrate it as courageous heroism while others condemn it as an immoral/unholy act.

It was only towards the end of 17th century, that the rise of scientific and medical discourse paved way for modern notions of suicide. Attitudes towards suicide began to change; nervous illness, melancholy and suicide were linked.

Even now, many societies and individual cultures treat suicide as an immoral act. Mental illness is a taboo and all psychological conditions become a symbol of abnormalcy, weakness, and shame. And any individual representing such a condition is segregated.

According to WHO, over 800,000 people die due to suicide every year and it is the second leading cause of death in 15-29-year-olds. There are indications that for each adult who died of suicide there may have been more than 20 others attempting suicide.

The 2012 report places India at the top — the country with the largest number of suicides.

“India accounts for nearly a third of the global total and more than twice as many in China, which is second on the list. India has also witnessed a spur in farmer suicide cases because of drought and debts,” states the report titled Preventing Suicide, A Global Imperative. In 2012, 258,075 people committed suicide in India, out of which, 99,977 were women and 158,098 were men.

However, National Crime Records Bureau data says that on an average, more than 1 lakh persons committed suicide every year during the decadal period from 2004 to 2014. Experts explain this anomaly by pointing at the new/revised categories under the NCRB’s Accidental Deaths & Suicides in India 2014 report. Noted expert on farmer suicides P. Sainath argues in a report that “the fall in farmer suicides accompanies a stunning increase in suicides by ‘others’.”

Currently, attempting suicide is considered a criminal act in India. The Law Commission has recommended that “attempt to suicide may be regarded more as a manifestation of a diseased condition of mind deserving treatment and care rather than an offence to be visited with punishment.”

One of the key features of the Mental Health Bill is the decriminalisation of attempted suicide and prohibition of electro-convulsive therapy. “A person who attempts suicide shall be presumed to be suffering from mental illness at that time and will not be punished under the Indian Penal Code,” the Bill says. Leading psychiatrists across the country have unanimously welcomed the proposal.

Dr Rajesh Sagar, assistant professor, department of psychiatry, AIIMS, says, “As a professional I welcome the proposed bill. A person who attempts suicide should be dealt with utmost care and needs professional guidance, rather than penalisation. There are various reasons an individual might attempt suicide; economic, sociological to demographic factors are among the few. Depression is highly common, it is a disease usually brings with it a high level of disability.”

Healthcare professionals are waiting for the new Bill to be implemented. “Decriminalising attempted suicide can be a tricky issue. The proposed law should entail safeguards for distinguishing between cases, especially cases of abetted or incited suicide. However if the bill is implemented correctly, a lot of people can be saved from the trauma and abuse they face while already in a state of hopelessness,” says Dr Deepak Raheja, founder and director of Foundation Hope and secretary-general of the Delhi Psychiatry Society.

There are a million questions surrounding the act suicide: Why does a person end his/her life voluntarily What is it that compels an individual to take such a drastic step How does one find the confidence to commit oneself to such a perpetual and permanent decision. The very act of contemplating suicide hints at the value one attaches to life.

Most prefer to distract themselves off the very subject. Often it is only the ones who survive the terrible loss of a living soul, who understand the absurdity of the act of suicide. It is indeed extremely unfortunate to see another human being choose to forcibly end this difficult but ethereal experience of living.

Tomorrow: The lack of infrastructure and the plight of the mentally-ill