Involving the community when it comes to suicide prevention

Being compassionate is key for community members to help those among them who are thinking about suicide. — 123rf.com

At the beginning of the current parliamentary sitting, the Dewan Rakyat approved bills to amend the Penal Code and the Mental Health Act to decriminalise attempted suicide – syukur, Alhamdulillah.

These amendments were as follows:

• To repeal Section 309 of the Penal Code, which classifies suicide attempts as a criminal offence.
• To boost Sections 305 and 306 in order to increase penalties on those who aid and abet suicide attempts.
• To establish the role of crisis intervention officers, including the power to apprehend under the Mental Health Act 2001.

Given the steady calls to decriminalise attempted suicide over the years, and the mental health crisis that the country witnessed in 2021 at the height of the Covid-19 pandemic, the historic move is music to the ears of so many.

I wish to convey my heartfelt thanks and congratulations to those who have advocated tirelessly on this matter.

This is a win for the country, but most of all for those who suffer in silence.

It is a progressive step in the wider scheme of destigmatising suicide (its ideation and attempts too), and indeed, mental health altogether.

Decriminalisation is one battle that we have won in the war to break the stigma on mental health here at home.

Supporting decriminalisation

My organisation, the Green Ribbon Group (GRG), champions a community approach to mental health, based on the simple premise that as individuals, we ourselves are an untapped resource.

GRG believes it is possible to empower individuals to learn to support themselves and one another, in order to lighten the load or lift the burden off mental health professionals, non-governmental organisations (NGOs), existing helplines and government agencies.

This is the sole purpose of my advocacy and that of my organisation.

When GRG was first set up in 2021, our advocacy on decriminalisation rested on the notion that the current system already offers a psychiatric assessment of those who attempt suicide without automatically penalising these individuals.

We said that current provisions in the Mental Health Act 2001 are adequate to direct those who attempt suicide to undergo a psychiatric evaluation before a decision is made on their “offence”.

Back then, we were mindful of the different layers involved in reviewing legislation, what more to amend or repeal altogether.

And we understood the sensitivities and concerns of other stakeholders around the table, from the Attorney General’s Chambers to key ministries, the police and religious authorities.

In the two years since, I am humbled to see that greater strides have been made to not only repeal Section 309 altogether, but to also ensure that our legislations pertaining to suicide attempts will be made even more robust.

For instance, the amendments to Sections 305 and 306 now mean that cyberbullies cannot get away with aiding or abetting children or those with severe psychological decompensation, to attempt suicide or to complete the act itself.

I applaud our Parliamentarians for allowing the prosecution of those who should be prosecuted.

The law should come down hard on those who seek to harm, coerce or intimidate vulnerable individuals.

Moreover, we know that prosecuting those who attempt suicide does not decrease suicides.

We also know that decriminalisation does not increase suicides either.

But preventative measures for suicide and its attempts must go beyond legal revisions, simply because stigma and prejudice remain mountains to climb.

Advocate and include

Because we are all stakeholders in mental health, we have a responsibility – within the context of decriminalisation – to increase our efforts towards building and strengthening a community approach to suicide prevention and awareness.

How do we do this?

My answer is advocacy and inclusion.

For advocacy, we must do more to fact-check and correct misperceptions and negative connotations about suicides altogether.

The assumption that talking about suicide encourages one to commit suicide is what I hear most often.

It must be eradicated completely and replaced by statements of fact to educate.

Suicides are preventable, ideations can be overcome, and attempts do not necessarily mean that individuals will eventually die by suicide.

These statements must ring loud and clear now that these amendments are made.

On World Suicide Prevention Day in 2020, I stated that connectedness is crucial to those vulnerable to suicide.

We have a duty to reach out to them and provide them with support and companionship.

The onus is on us to make them feel included in their communities, whether it is at home, at school, or in their workplaces.

Inclusion also refers to an all-hands-on-deck approach, by absorbing communities into the mental health talent pool.

We can learn to encourage help-seeking behaviour not only amongst those who are vulnerable to suicide, but also those who are experiencing mental health problems in general.

Setting an example by walking the talk is another means of helping to destigmatise mental health.

The more we talk about it, the more we impact those around us.

Talking about suicide

GRG, in collaboration with the Malaysian Mental Health Association (MMHA), initiated its own suicide prevention and awareness programme called “A Conversation on Suicide” in 2021 based on these principles.

It focused on early detection, prevention and intervention via interim help.

Responding to a suicide attempt or approaching someone we suspect may be thinking of attempting suicide must be done carefully and with the assumption that the person is likely to be mentally distressed.

During the rollout of the programme, we were able to capture some data on suicide prevention and awareness – another ongoing challenge for mental health policy in Malaysia and the region.

For instance, we learnt that there is interest to learn more across multiple communities in the country – Malay, Chinese and Indian – which indicates that similar initiatives should be conducted in multiple languages to cater for diverse communities.

We also learnt that men were generally more interested in learning about suicide than women, who preferred to know more about general mental health first aid.

Programmes like “A Conversation on Suicide” can further complement current efforts by the government.

While it offers the basics of suicide prevention and awareness – such as increasing literacy and ensuring that more and more people are able to offer interim help – amending the Mental Health Act 2001 to establish crisis intervention officers provides an additional layer of support for those who are equipped with the basics.

While an innovative and sound policy addition, the move must come with parameters that clearly distinguishes these officers from others, e.g. those who have attended the “A Conversation on Suicide” programme.

Such parameters should also include the training these officers will undergo, their certification and qualifications.

The public should also be made aware of who these officers are in order to ensure a more streamlined effort towards preventing suicides.

Be compassionate

Compassion is the solution and the only path forward towards building and strengthening a community approach to suicide prevention.

Those who experience suicidal ideation or attempt to commit suicide may feel helpless, but they are never hopeless with the support of their community.

A little compassion really does go a long way.

Never underestimate the power of compassion and empathy.

Tengku Puteri Iman Afzan Al-Sultan Abdullah is the co-founder and president of the Green Ribbon Group. For more information, email [e-mail]. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.