Content warning: This article discusses sensitive topics such as suicide that some readers may find distressing.
Bangladesh, a country of 169 million people, records approximately 10,000 suicides every year; a figure researchers say is steadily increasing.
Suicide and suicide attempts are classified as criminal offences in Bangladesh. Section 306 of the Indian Penal Code 1860 which Bangladesh inherited as a colonial tradition, provides police with the authority to arrest and courts to punish people who attempt suicide.
As a result, patients frequently leave hospital without completing treatment to avoid legal proceedings. People are generally afraid of sharing suicide intent or seeking help or admitting previous suicide attempts to avoid social or legal harassment.
There is a debate in Bangladesh on the issue of decriminalisation of suicide and suicide attempts. Some argue that without addressing fundamental issues such as a national suicide database, surveillance systems, appropriate prevention strategy and implementation and research, decriminalisation might not bring the expected outcome.
Another argument is that decriminalisation will provide better access to healthcare services, reduce stigmatisation and guilt, avoid legal complications, and empower legal authorities to care for the at-risk population.
The debate around the issue of criminalisation in Bangladesh is strongly embedded in the knowledge of Islamic thoughts and values which do not recognise the right to die voluntarily since it falls into the category of suicide. The Quran explicitly forbids suicide and the sayings (Hadith) of the Prophet confirm: “He who kills himself by something is tortured by it in the day of final judgment.”
As such, many Muslim countries, including Bangladesh, consider suicide and suicide attempts as punishable criminal offences.
It could be assumed religious faith would discourage suicidal behaviour in Bangladesh but evidence shows otherwise. The decriminalisation of suicide and attempted suicide could be carefully united with suicide prevention initiatives. Empirical data does not necessarily support that suicide rates are lower in countries where suicide is a punishable offence, rather it is the tendency of deliberate underreporting which keeps rates at a minimum.
The Bangladesh Mental Health Act 2018 does not provide any specific provision to deal with the decriminalisation of suicide or suicide attempt. Decriminalisation could have been prioritised in the Act so at-risk people receive treatment rather than punishment. Bangladesh is alone among the eight South Asian countries where suicide (and attempted suicide) is still a crime. Even Pakistan, a Muslim-majority nation, decriminalised suicide in December 2022.
Given the socioeconomic, cultural, and religious context of Bangladesh, it would be advisable for policymakers to consult widely and thoughtfully about the pros and cons of decriminalising suicide and its attempt before enacting a national suicide prevention strategy so it does not hamper the expected policy outcome and other associated issues such as data registry and support interventions.
Moral, philosophical, ethical, religious and human rights aspects of self-harm could also be carefully reviewed.
As a part of a prevention strategy, many countries have decriminalised suicide. However, without addressing other fundamental issues such as national suicide database, prevention strategies, suicide surveillance system, proper research and implementing evidences into policy, decriminalisation by itself would not bring any positive effect for Bangladesh.
Changing attitudes toward suicide which would help reduce social stigma. That comes with improving media reporting, among other things. Changes in the legal status of suicide would help reduce social stigma, legal harassment and unnecessary fear of seeking or providing medical care after suicidal behaviour.
Bangladesh is yet to formulate any comprehensive national suicide prevention strategy or a central suicide prevention database or a comprehensive suicide surveillance system.
Although evidence shows that suicide can be reduced with simple initiatives, the Bangladeshi government continues to neglect it. While there are studies on selected populations, suicide data is primarily drawn from often inconsistent and contradictory media reports and records. Hence, the magnitude and distribution of suicides and attempts are likely to be misrepresentations due to under-reporting and misclassification.
Suicide is a silent epidemic in Bangladesh. The absence of a national suicide prevention plan, lack of quality suicide surveillance data along with the under-reporting and misclassification of suicide deaths due to social, religious and cultural stigma or taboo and financial barriers to maintain national suicide reporting system are the key challenges.
Despite these barriers, Bangladesh could address suicide as a serious public health concern through systematic and comprehensive policy interventions. The current Mental Health Act is a missed opportunity. Bangladesh clearly needs a specific, inclusive and robust mental health policy that incorporates suicide prevention.
Anisur Rahman Khan is an Associate Professor in the Department of Sociology, East West University, Dhaka, Bangladesh. His research interests are the Sociology of suicide, Masculinity, and Social Policy.
He declares no conflict of interest.
Originally published under Creative Commons by 360info™.
