#MHForAll webinar: Creating hope through action on suicide
At the 50th MHForAll webinar, a series of experts discussed suicide prevention and decriminalisation ahead of World Suicide Prevention Day, reflecting on key learnings, and recommendations that can help drive legislation reform at a national level. Our esteemed panel explored the ongoing journey towards the decriminalisation of suicide and the sensitisation of this issue in India, Ghana, Australia and Kenya.
The expert panel for this session included:
Taha Sabri - Chief Operating Officer, Taskeen Health Initiative
Emmanuel Nii-Boye Quarshie - Senior Lecturer, University of Ghana
Duncan Nkhoma - Executive Committee Member, Global Mental Health Peer Network
Naomi Anyango - Medical Social Worker, Ministry of Health Kenya
John Brogden - President, LifeLine International
Priti Sridhar - CEO, Mariwala Health Initiative; Secretariat Alliance for Suicide Prevention; Member Suicide Decriminalisation Working Group
John Brogden of LifeLine International discussed how social attitudes towards suicide have changed in Australia, acknowledging that individuals in need of support are able to get connected to medical emergency services almost immediately through suicide helplines such as LifeLine - a service that is possible because suicide was decriminalised over 60 years ago. John highlights that Australia has made strides in recent years, with much of the population becoming more sensitised to this issue through open discourse about suicide in local communities. Positive media reporting of the issue and the bravery of high profile individuals speaking candidly about their personal experiences and struggles have played a significant role in driving societal change.
He flags, however, that there is a need to recognise the ongoing struggle of those that have had, and continue to have, mental ill health and suicidal ideation. For many, these issues may persist for a number of years. He suggests replacing the phrase “lived experience” with the term “living experience” to capture the true nature of these struggles which are often not just in the past, but continue through to the present and can also be prevalent in someone’s life in the future.
In India, despite the implementation of the Mental Health Care Act in 2017 and subsequent de facto decriminalisation of suicide, slow progress is being made in suicide prevention efforts. Priti Sridar of the Mariwala Health Initiative explained that much of the population is still unaware of the change in the law. As a result, law enforcers and health professionals have not received adequate training and are unable to provide the appropriate support to survivors of suicide or bereaved families.
The decriminalisation of suicide in legal terms is, however, important to help frame this issue as a public health concern, says Priti. Such framing can lead to better reporting and data, and important considerations about how to “reduce illness, identify risk factors and have targeted policies and interventions,” which would help facilitate suicide prevention efforts. Priti ends with a message of hope - collaborative work with people with living experience and international organisations is made possible through the de facto law change and these conversations are essential in ongoing effort to raise awareness of the issue in-country and implement greater suicide prevention tactics.
Similarly to India, the policy to criminalise suicide in Ghana is a remnant of the colonial era. Emmanuel Nii-Boye Quarshie of the University of Ghana reflected on the national advocacy efforts in Ghana to decriminalise suicide and explained that a preliminary petition submitted to parliament was not valued as there was not a “sufficient basis to push for this grand agenda.” He recalls two key lessons from this experience:
“Decriminalisation of attempted suicide requires contextually relevant and culturally sensitive research.”
“The views and voices of key political and legal actors must be considered in the advocacy… for mental health policies and legislation.”
Progress came when a holistic approach was adopted and the attitudes and voices of young people, teachers, the police, judges and magistrates, media personnel, community leaders, mental health professionals, religious leaders, lay persons and members of parliament were considered.
Establishing a strong evidence base was an essential component of the recent success in Ghana, says Nii, where advocates and activists were able to participate in a Parliamentary Select Committee meeting to push the agenda forward. A private members bill is being drafted and once this is reviewed it will be tabled for first reading in parliament - a pivotal step towards decriminalisation.
Naomi Anyango from the Ministry of Health, Kenya also shared a message of hope. Big wins in the country include the launch of the National Suicide Prevention Strategy, the first of its kind in the region. The strategy outlines clear goals and objectives, and aims to reduce suicide mortality by 10% by 2030. The next step is to operationalise the national strategy and work on the decriminalisation of suicide by repealing section 226 of the penal code, says Naomi.
Similarly to Nii’s reports from Ghana, Naomi highlights that there is a need for a holistic approach and collaboration with all sectors on this issue. Naomi explains that there are plans to collaborate with the Ministry of Agriculture to tackle pesticide control, and develop new curriculums for the education sector and media outlets to sensitise more of the population and reduce stigma. Mobilising financing to improve access to comprehensive care is an essential aspect of suicide prevention efforts in the country and there are plans to introduce a national suicide prevention helpline to provide support for individuals before mental health crises escalate and lives are lost.
Our panellists concluded the session by reflecting on this year’s World Suicide Prevention Day theme. We can create hope through action on suicide by…
Priti Sridar, “Designing, supporting and financing programs that have a psychosocial, public health and community based approach and centre the lived experience.”
Emmanuel Nii-Boye Quarshie, “Through empathetic listening… genuine listening.”
Naomi Anyong, “Normalising the conversation around suicide and by destigmatising the people who attempt to take their lives and their families, rather than neglecting them.”
John Brogden, “Using high profile people in our communities, brave people in our communities, to break the stigma.”
Click here to see the full webinar recording