Adegboyega Ogunwale, Neuropsychiatric hospital, Aro, Abeokuta
Suicide – self-inflicted injury with a fatal outcome – has been part of human history since ancient times. According to the World Health Organization, about 700,000 suicides occur across the globe every year. For every completed suicide, there are at least 20 unsuccessful attempts.
About 79% of suicides occur in low- and middle-income countries although suicide rates are highest in high income countries.
In no fewer than 20 countries, suicide is a crime. But that has never succeeded in eliminating it. Research findings show reservations as to whether legal or religious sanctions can actually serve to prevent suicides. While moral and religious objections to suicide may reduce suicidal behaviour, legal sanctions hardly have any discernible effect. For instance, in the UK, suicide rates did not increase after it was decriminalised.
In Nigeria, the legal position is that suicide is not a crime but attempted suicide is. Section 327 in the Criminal Code Act (which applies to southern Nigeria) states that:
Any person who attempts to kill himself is guilty of a misdemeanour, and is liable to imprisonment for one year.
Similarly, section 231 of the penal code (applicable to northern Nigeria) asserts that:
Whoever attempts to commit suicide and does any act towards the commission of such offence, shall be punished with imprisonment for a term which may extend to one year or with fine or with both.
Despite the criminalisation of attempted suicide in Nigeria, the rate of suicide is still considerably high at 6.9 per 100,000 of the population in 2019. This translates to roughly 7,019 people a year. The current rate is less than the average global rate of 9.0 per 100,000. While the suicide rate in Africa appears to be lower than the global average, it is still worrying.
Impact of law
The impact of criminalising attempted suicide is multi-dimensional.
First, it turns a distressed human being into a criminal. Research has shown that about 90% of those who attempt suicide have a mental health problem. A considerable proportion – 20.8% to 35.8% – of those would be suffering from depression.
Second, it may impel the person to attempt suicide again so as not to suffer the legal consequences.
Third, it distracts society from focusing on care and treatment. Instead, it directs resources towards punishment, which has not been shown to have any significant deterrent effect.
Need to decriminalise suicide
There are several good reasons to urgently decriminalise attempted suicide in Nigeria.
First, it is inconsistent to legally define as a crime the attempt of something that in itself is not a crime.
Second, the legal definition of an attempt comprises intention, preparation and the actual attempt. Legal deterrents can only confront deteriorating mental well-being at the last stage – attempted suicide. Mental health assessments on the other hand could easily identify the earliest stages of suicidal ideation (intention) and preparation. In terms of effectiveness of deterrence, help is better than punishment. Research has shown that most that attempt suicide would be suffering from mental disorders and it would be patently unjust to punish the sick instead of caring for them.
Finally, if attempted suicide wasn’t a crime, the associated stigma would be removed and people might feel more able to talk about it and obtain the help that they needed.
The WHO has formulated steps that may be taken to prevent suicide.
First, governments must provide leadership in establishing policies. Parliament should decriminalise attempted suicide so that people can get care instead. The Lagos State government, via its 2011 criminal law, has already made a move by providing a hospitalisation order in cases of attempted suicide.
Governments must also develop and implement culturally appropriate and evidence-driven preventive interventions. It requires a vision with targets and a definite time frame.
Governments as well as citizens can play a part by reducing access to the various means of committing suicide. For example, it has been shown that 30% of suicides are achieved through the use of pesticides.
Young people also need to be helped to develop personal resilience: building life skills, improving self-esteem, developing problem-solving skills, embracing realistic optimism and even using spirituality.
The media should report suicide-related news responsibly, which will help to avoid “copycat suicides”. There are media guidelines for responsible suicide reportage.
At the family and individual level, it is crucial to give and receive social support (paying attention, active listening, sharing encouraging words) from one another. This will help distressed members of the family to cope with adversity.
Finally, early identification of people at risk (particularly those with mental disorders and recent traumatic life events) can translate into prompt treatment and the restoration of well-being.