Executive Summary
Around the world, 700,000 people die by suicide every year – in 2019, more than one in every 100 deaths globally was due to suicide.[1] Reductions in the number of deaths by suicide is the measure by which improvements in mental health are tracked according to the UN Sustainable Development Goals (SDGs) for 2015-2030. Moreover, decriminalising suicide was agreed by all health ministers as an effective measure to help end deaths by suicide when they approved the World Health Organization (WHO) Mental Health Action Plan for 2021-2030 (in May 2021).
In Pakistan, tracking of suicide cases remains difficult due to under-reporting, stigma and the overall criminalization of suicide. In 2012 the WHO estimated that the rate of suicide in Pakistan is 7.5 per 100,000 population[2], which is an alarming figure.
Many countries have made progress in their efforts to reduce the rates of deaths by suicide. For example, in recent years legislation criminalising suicide has been successfully repealed or superseded by new legislation in the Cayman Islands, Cyprus, Lebanon, Singapore and India. In most countries suicide is not a criminal offence. But in 20 countries it is. In these countries those who have attempted suicide can be arrested, prosecuted and punished by fines and typically one to three years in prison. Assuming one of the main intentions is to deter people from taking their life – alongside other reasons such as religious tradition – the evidence shows criminalisation is counterproductive. Criminalising suicide does not deter people from taking their lives – however, there is well documented evidence of effective means to do so, from improved mental health and psychosocial support services, to restricting the means of suicide, such as pesticide control.[3] [4] [5] [6]
Pakistan is one of the 20 remaining countries where suicide is criminalised since the introduction of the law during the British Era in 1860. Since there is a legal structure criminalising suicide under Section 325 of its penal code, cases are often not reported as a means of preventing litigation against those in acute mental distress and to prevent police harassment. Families of those attempting suicide often hide attempts and this adds onto the stigma against suicidal behaviour and mental ill health. It also makes it difficult to offer help to those affected, even though a large percentage of all attempts have a history of mental illness or acute distress.
Lack of access to mental health services, suicide prevention services or overall awareness of suicide prevention, makes the Pakistani population especially vulnerable. As a low-middle income country, Pakistan has a large portion of its population that is living below the poverty line. Individuals become trapped in the disease-poverty cycle, where any physical and mental illnesses exacerbate poverty, and lack of resources discourages them from seeking help, further worsening their illness, making them even very vulnerable.
In a situation where their mental illness increases in severity and individuals attempt suicide, they are further criminalised and prosecuted under the law. Fines, police harassment and stigma can induce further trauma and discourage them from seeking help. Families of those attempting suicide may spend more time hiding the attempt rather than addressing the underlying psychological problems leading to the attempt. All this results in victims of suicide being further traumatised by their encounters with law enforcement.
Criminalisation of suicide, therefore, disproportionately affects underprivileged Pakistanis and further pushes them down the disease-poverty cycle, while ensuring that access to help and mental health services is reduced.
Pakistan attempted to repeal its criminalisation of suicide in 2017. At this time it engaged the Council of Islamic Ideology (CII) to address the religious concerns around the issue. The ruling by CII identified suicide, and attempted suicide, as a medical issue and not a criminal one. Although, suicide is considered a sin in Islam, the council and later fatwas have clarified that criminalisation of attempted suicide has no precedence in Islam.
Although the initial attempt failed due to lack of political traction, there is still ongoing campaigning to have the law repealed.
[1] WHO (2021), Suicide worldwide in 2019. https://www.who.int/publications/i/item/9789240026643
[3] WHO (2019), Preventing suicide: a resource for pesticide registrars and regulators. https://www.who.int/publications/i/item/9789241516389
[4] WHO (2019), Suicide prevention: toolkit for engaging communities https://www.who.int/publications/i/item/suicide-prevention-toolkit-for-engaging-communities
[5] WHO (2021), LIVE LIFE: An implementation guide for suicide prevention in countries. https://www.ho.int/publications/i/item/9789240026629
[6] WHO (2014), Preventing suicide: A global imperative https://www.who.int/publications/i/item/9789241564779