Smash the stigma, stop the suicides


  • Along The Watchtower
  • Wednesday, 08 Jan 2020

SINGAPORE beat us to it again, this time in decriminalising suicide. Last week, it became the latest country to repeal archaic laws that made suicide attempts a criminal act.Unlike in Malaysia, where experts have been mulling over the issue since 2012, Singapore’s Penal Code Review Committee appraised outdated laws and came up with recommendations in August 2018.

Its parliament passed the Criminal Law Reform Bill on May 6,2019, and the law came into effect on New Year’s Day.

Why is this significant? Based on the World Health Organisation’s findings, about 90% of suicide cases are associated with mental disorder.

Globally, suicide is among the top 10 causes of deaths and is the second biggest among those aged between 15 and 29.

Every 40 seconds, someone commits suicide somewhere in the world. In Malaysia, there are 2,000 suicides a year, or more than five such deaths a day.

Five years ago, a National Health and Morbidity Survey found that one in three Malaysians had a mental health condition, while mental health problems among those aged 16 and above was already 29.2%, a big jump from 10.7% in 1996.

A similar study in 2017, on students between 13 and 17, showed suicidal thoughts were prevalent among 10% compared with 7.9% noted five years earlier. The depression rate among teenagers was 18.3%, with one in five suffering depression, two in five facing anxiety and one in 10 stressed.

Malaysia launched its National Suicide Prevention Strategic Action Plan in 2012, aimed at removing barriers and stigma associated with seeking mental healthcare, limiting access to methods of suicide (such as pesticides and poisons), introducing responsible reporting of suicides, raising public awareness on mental health disorder and improving the reach of mental healthcare.

Two years later, the government adopted the World Health Assembly’s Comprehensive Mental Health Action Plan 2013-2020 and WHO’s World Suicide Report, which raised the criminal status of suicide in 25 countries then, including Malaysia.

This led to moves by the Malaysia Law Reform Committee to review Section 309 of the Penal Code, which punishes those who survive a suicide attempt with up to a year in jail, a fine, or both, if convicted.

But the experts have been dragging their feet for eight years now.

Last October, de facto law minister Datuk Liew Vui Keong told Parliament that the Attorney General’s Chambers was studying possible amendments to laws related to suicide.

He said a review of the laws, including Sections 309,305 and 306 of the Penal Code, for attempting and abetting suicide required detailed study, adding that there would be consultations with several ministries, the police, Fire and Rescue Department, Jakim, the Department of Islamic Development and the Malaysian Psychiatric Association.

But it is not just about the decriminalisation of suicide.

There are now only about 7,000 psychiatrists for our population of 32 million.

The ideal ratio of psychiatrists to the population is 1:10,000 but in Malaysia it is 1:200,000.

Difficulties in getting access to treatment is still a major problem.

Those seeking help have to go through government clinics to get a referral for an appointment with a psychiatrist but the stigma of being mentally unwell prevents many patients from disclosing their actual problems.

At the workplace, people with mental health issues are unlikely to admit so, again due to the shame attached to it. In most cases, mental health is also not covered under employees’ insurance.

It has been estimated that the economic cost of mental illnesses could be as high as RM105.47bil by 2030.

Depression in the workplace already costs billions of ringgit in absenteeism and presenteeism (the problem of employees being at work but because of their conditions, they are not fully productive).

According to Datuk Dr Andrew Mohanraj, president of Malaysian Mental Health Association and one of the international contributors to the UN Convention on the Rights of Persons with Disabilities, Malaysia needs to widen the leadership in mental health, beyond the scope of the Health Ministry.

He said Malaysia should move more quickly towards the promotion of a compassionate society by destigmatising mental illness, shifting mental health issues to the mainstream, and safeguarding the interest of persons with mental illness and their families.

Like in many other countries, stigma, discrimination and neglect prevent care and treatment from reaching people with mental disorders.

To take a holistic approach and tailor appropriate inclusive interventions, associations representing mental health patients and their families must be involved in the conversations concerning access to appropriate health care and the right to living lives with dignity.

On the plus side, Dr Andrew said it was heartening to see celebrities, politicians and even royalty coming out to support efforts to destigmatise mental illness.

In Australia, mental health has become such a big issue that there are even ministers holding the portfolio in two states, while others have commissioners for mental health and ombudsman-type bodies.

In Thailand, there is a director-general for mental health but in Malaysia there is not even a division for this in the Health Ministry.

Perhaps, it is better that representation is reflected at our highest law-making body – Parliament.

Traditionally, Malaysia has one seat in Dewan Negara reserved for a representative of organisations for those with physical disabilities.

It is time to expand this to at least two representatives from physical disability associations and one from the mental health sector.

The upper house would provide the space for a dignified representation and better decision-making processes concerning mental health issues and care for this segment of society.

Media consultant M. Veera Pandiyan likes this observation by Johann Wolfgang von Goethe: We do not have to visit a madhouse

to find disordered minds; our planet is the mental institution of the universe. The views expressed here are entirely the writer’s own.

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