Date: 12/09/2022

Relevance: GS-2: Issues relating to the development and management of Social Sector/Services relating to Health, Education, Human Resources.

Key Phrases: Suicide, Mental health, Section 115, Section 309 of the IPC, Suicidal behaviours, Decriminalization, Mental Healthcare Act 2017, Protective environments, Problem-solving skills, Criminal offence.

Why in News?

• Responding to an appeal to repeal Section 309 of the Indian Penal Code (IPC) that criminalises attempt to commit suicide, Justice V. Ramasubramanian of the Supreme Court of India, said the Mental Healthcare Act, 2017, has come up with some kind of a solution but wondered if it has provided a solution in entirety.

Key facts:

• According to the latest report of the National Crime Records Bureau 2019-21, 4.7 crore, including more than 17.56 lakh women, ended their life by taking recourse to various means to commit suicide in the 54 years for which records are available with the organisation.
• Rate of suicides in India assumed alarming proportions from 1998 when 104,713 persons, including 43,027 women hung themselves to death.
• The rate of increase in suicides started going up steeply from 1998. Since that year, the number of reported suicides went into six digits.
• The numbers reached a peak in 2021 when 1,65,033 suicides were reported, as compared to 1,53,052 and 1,39,123 in 2020 and 2019, respectively.
• Suicide is the fourth leading cause of death among 15-19 year-olds.
• 77% of global suicides occur in low- and middle-income countries.
• Ingestion of pesticide, hanging and firearms are among the most common methods of suicide globally.
• Daily wage earners remained the largest profession-wise group among suicide victims in 2021, accounting for 42,004 suicides (25.6%) in India.
• The suicide rate among Indian girls and women continues to be twice the global rate, though it has dropped in the last decade or so.

What is Suicide?

• Suicide is when people harm themselves with the goal of ending their life, and they die as a result.
• A suicide attempt is when people harm themselves with the goal of ending their life, but they do not die.
• Suicide is a serious public health issue and an immeasurable tragedy for the surviving families, friends, and communities.
• Suicide is often related to mental health conditions, such as depression, anxiety, and substance use disorders; particularly if undiagnosed or untreated.

Law related to suicide in India:

• Section 309 of the Indian Penal Code:
  • The law, brought in by the British in the 19th century, reflected the thinking of the time, when killing or attempting to kill oneself was considered a crime against the state, as well as against religion.
  • Section 309 of the IPC said an attempt to commit suicide was punishable with imprisonment, which may extend to one year or with fine or with both.
• Mental Healthcare Act, 2017:
  • Section 115 of the Act says that notwithstanding anything contained in Section 309 of IPC, any person who attempts to commit suicide shall be presumed, unless proved otherwise, to have severe stress and shall not be tried and punished under the said code,

Negative impacts of criminalisation of suicide:

• A report of United for Global Mental Health, pointed that suicide has four negative impacts on the society
  • It leads to suppression of data,
  • Results in not treating suicide as a public health issue,
  • Results in compounding of stigma
  • Places people with mental health issues in places where such issues get aggravated.

Court Stance on Decriminalising suicide:

• 1970-71: Law Commission of India recommended the deletion of the offence of the attempt to commit suicide from the penal code.
• In 1985, Decisions by Delhi High Court in State v. Sanjay Kumar Bhatia condemned the penal provision as "unworthy of human society".
• In 1986, Bombay High Court held it to be ultravires on the ground that it violates Articles 14 and 21 of Indian Constitution
• In 1994, A 2-judge bench of the Supreme Court in P Rathinam Vs Union of India struck down Section 309 of IPC (attempt to suicide) as unconstitutional.
• In 1996, In Gian Kaur's case, a Constitution bench of the five judge overruled the 1994 verdict stating that the right to life does not include right to die and upheld the validity of Section 309.
• In 2011, Supreme Court had recommended to Parliament to consider decriminalizing attempt to suicide, saying the provision had become anachronistic, while giving guidelines for passive euthanasia.
• Recently, The Kerala High Court observed that Criminal prosecution followed by conviction and imposing substantive sentences and fine on those convicted of suicidal behaviours are believed to constitute an affront to human dignity.
• Justice K. Haripal (since retired) observed that suicidal behaviour was typically a symptom of psychiatric illness or an act of psychological distress, suggesting that the person requires assistance in his personal and psychological life, not punishment with imprisonment or fine.
• The Supreme Court in Common Cause v. Union of India and another case in 2018 had recommended Parliament consider decriminalising the offence, saying the provision had.

Measures to prevent Suicide:

• Suicide is preventable and everyone has a role to play to save lives and create healthy and strong individuals, families, and communities. Suicide prevention requires a comprehensive public health approach. Like:
  • Strengthen economic supports
    • Strengthen household financial security.
    • Housing stabilization policies.
  • Strengthen access and delivery of suicide care
    • Coverage of mental health conditions in health insurance policies.
    • Reduce provider shortages in underserved areas.
    • Safer suicide care through systems change.
  • Create protective environments
    • Reduce access to lethal means among persons at risk of suicide.
    • Organizational policies and culture.
    • Community-based policies to reduce excessive alcohol use.
  • Promote connectedness
    • Peer norm programs
    • Community engagement activities
  • Teach coping and problem-solving skills
    • Social-emotional learning programs
    • Parenting skill and family relationship programs
  • Identify and support people at risk
    • Crisis intervention
    • Treatment for people at risk of suicide
    • Treatment to prevent re-attempts

Way forward:

• With a shift in official position from ‘legal’ to a ‘medical’ model of attempted suicide, an important challenge from a policy perspective is to provide an access to mental health care for all those with attempted suicide.
• Patients presenting with an attempted suicide should be advised for a psychiatric consultation in all cases. In this context, there is a tremendous need to allocate the necessary resources for strengthening the primary mental health care services in all districts of the country.
• There is a need to further increase the emphasis on the public health approach to suicide prevention e.g. increased awareness generation, restrictions on access to commonly used lethal methods of suicides (insecticides, prescription medications) and control over facilitating factors such as alcohol.
• There is a need to develop an effective framework integrating the mental health with social welfare, education and other related sectors.
• To conclude, the recent steps to achieve decriminalization of suicide in India are commendable, but were long overdue. Decriminalization will reduce the trauma and potential prosecution in the aftermath of a suicidal attempt. However, there is a need to improve the mental health coverage and provide a framework to deliver essential mental health services to all those who attempted suicide.

Sources: The Hindu

Mains Question:

Q. “Suicide is a serious public health problem; however, suicides are preventable with timely, evidence-based and often low-cost interventions”. Discuss [250 Words].