Recently, researchers have been raising the issue of decriminalisation of suicide in the legal system of Bangladesh which is a vital requirement for ensuring appropriate suicide prevention environment in the country. Suicide is a major public health problem globally, whilst rate of suicide has been increasing day by day in Asian countries where Bangladesh is not an exception. As a part of prevention strategy, decriminalisation of suicide has been done in many countries. However, without addressing the basic issues of national suicide database, national suicide prevention strategies, suicide surveillance system, adequate research and implementation of policies, decriminalisation would not be beneficial.
Suicide is a poorly researched public health problem in Bangladesh which is often neglected by almost every stakeholder in the country. Recent systematic review along with evidences revealed that the country lacks central suicide data base, national suicide surveillance system, national suicide prevention strategy and nationwide study on suicide. Thus, reliable source of suicide information is a real challenge in the country thereby actual rate of suicide is yet to be estimated. Countrywide epidemiological study has not been done yet, nor any psychological autopsy study been initiated. Thus, epidemiology of suicide is yet be revealed completely. Psychiatric disorders as risk factors have been grossly under-studied and inadequate psychiatric services prevail in the country to manage the suicidal burden. Recently, prevention activities have been initiated in sporadic, unstructured fashion, yet those are supposed to be inadequate.With the thrust of improving the media reporting of suicidal behaviours, authors recommended decriminalisation of suicide with a view to changing the overall attitude towards suicide which in turn would help reduce social stigma as well. Changing the legal status of suicide would be beneficial to reduce social stigma, undue legal harassment and unnecessary fear to receive and provide medical care post suicidal behavior. However, this change should be harmonised with other efforts, otherwise it would not ensure adequate benefits towards the stressed people.
Suicide is the end product of complex interaction of multiple risk factors such as genetic, psychic, social and cultural factors where interaction happens complexly depending on several factors such as culture, religion, gender, age, personal belief, occupation, educational status and life events. Hence, prevention of suicide in a country demands harmonised efforts from the government, non-governmental organisations, local and international stakeholders, namely the World Health Organisation and inter-sector forces; because prevention of suicide is everyone’s business. Single efforts in any sector would be insufficient. Synergistic initiatives from suicidologists, academicians, clinicians, educationist, politicians, law makers, law enforcers, media personnel, sociologist, mental health professionals, other health professionals, social welfare department and other related stakeholders are needed. A central strategy focusing on suicide prevention is a precondition for benefits by coordinating the multisectoral involvement, which has been lacking in Bangladesh.
Decriminalisation would certainly be beneficial for preventing suicides in Bangladesh which could be a part of legal system and should be harmonised with everything and anything related with suicide. Moreover, a central suicide prevention strategy, suicide surveillance system, national suicide data base, quality studies covering nationwide suicide cases, psychological autopsy studies, implementing evidences into practices, national and international willingness are necessary preconditions.
Dr SM Yasir Arafat, The writer is a mental health physician and psycho-social researcher with Bangabandhu Sheikh Mujib Medical University