The role of Health Care Systems in Suicide Prevention

Published on 4th February 2025

Authored By: Ojaswi Chandrakar
Bharati Vidyapeeth, New Law College, Pune

Abstract

There is one famous saying “Suicide is- A permanent solution to a temporary problem.” I think in today’s world everyone is well aware of what a suicide is, and what does it brings to the people who are left behind. For a common man suicide is taking one’s own life due to various life problems including mental problem, health problem, financial problem, false allegations, etc, which is to the most of the part correct. According to WHO (World Health Organisation), every year more than 720 000 people die due to suicide. It is most common among people of age 15 to 29 years, with the third leading cause of death among teenagers. It is most common among low and middle- income countries, with 73% of global suicide rate. India and China together account for 49% of global suicide. India is also labelled as “Suicide Capital of South East Asia” as it has reordered the highest number of suicide in south east Asia, according to WHO report[1]. Suicide helps to get the people out of the problem but people don’t know it is very difficult for the people left behind. It makes their life worse thinking about them and how they couldn’t help to get out of the pressure they had in their mind which ultimately led them to commit suicide. Suicide is a serious public health problem, but it can be prevented with timely and evidence-based interventions. It is a tragic event that affect the whole family, society, communities, and country as whole and has a long-lasting effect. In today’s modern society it is one of the major social problem.

Meaning and Definition of Suicide

To understand the word Suicide, lets break the word in two parts, “sui” and “caedes” both are derived from Latin word, which means “oneself” and “to kill” respectively, which means “an act to kill oneself”. It is also defined as “A fatal act that represents the person’s wish to die.”[2]

Suicide is an intention death. A person who commits suicide losses hope, they think that things can never improve, think that things will never be fine later on as well, and think that they can not fight through the problem, they can’t save their family, and ultimately the only solution which comes to their mind is nothing but suicide.

Elements of suicide-

  1. Wish to kill
  2. Wish to be killed
  3. Wish to die

Person who injure themselves by different ways including ingestion of pesticide, hanging, self- mutilation (e.g., cutting the skin), and firearms etc. People who commits suicide are usually in their 20’s. Female is to male ratio is almost 3: 1. Person who commits suicide are significantly more introverted, neurotic, and hostile.

In the book, “Le Suicide” written by Durkheim, which was published in 1897, Durkheim analysis the concept of suicide. The book is analysis of a phenomenon regarded as pathological (social problem) intended to throw light on the evil which threatens modern industrial societies that is anomie (depression). According to Durkheim, suicide refers to every case of death resulting directly or indirectly from a positive or negative death profound by the victim himself and which strives to produce this result. Durkheim was interested in explaining difference in suicide rates that is, he was interested in why one group had a higher rate of suicide than other[3].

Types of Suicide

  1. Egoistic suicide

When the person is so isolated and feels he has no place in the society, he destroys himself. This suicide is committed by self-centred person who lacks feelings and is cut off from the society.

For example, Mr. A didn’t get love from his family and he thinks no one in the family loves him, so he commits suicide, He is said to do egoistic suicide.

  1. Altruistic suicide

When the person or the group is too close and intimate to another person than he commits such type of suicide. This type of suicide result from over integration of the individual into society.

For example, Widow women take their own life by way of performing sati, people who sacrifice their life for nation, freedom fighters, army, Airforce, and navy.

  1. Anomic suicide

When person commits suicide due to certain breakdown, such as loosing a lottery, or bankruptcy. Anomic suicide take place in a situation has brought sudden losses.

For example, Unemployment, loss of job, failure, etc.

  1. Fatalistic suicide

When a person commits suicide due to over regulation in society, which one has to follow and the victim is unable to follow the rule in overregulated society.

For example, when a barren woman commits suicide or when a servant commits suicide, etc.

Causes of Suicide

  1. Mental illness

This is the most common cause of suicide. People who are mentally ill don’t know what is right and what is wrong and what is good for them and what is not, so they think the best way to get out of the problem is to commit suicide.

  1. Depression

Depression is also a leading cause of suicide in the world. People who are depressed are unable to do anything and become frustrated and ultimately commits suicide. But, it can be cured if it is treated within time. People who are depressed feel pressured and no happiness in life. 90% of the people who commits suicide suffered from untreated depression.

  1. Anxiety

Panic attacks, OCD (obsessive compulsive disorder), social phobia are the common anxiety problem suffered by people. It is difficult for people to maintain relationship with family, friends, or even to do job. The fear to be left alone can compel a person to commit suicide.

  1. Traumatic Experience

Any traumatic experience can lead to people feel lonely, ashamed, guilty and helpless. It includes sexual abuse, physical abuse, or traumatic experience of war, or PTSD (Post traumatic stress disorder). Thus, traumatic experience can lead to suicide.

  1. Bipolar disorder

It means fluctuations of mood from depression to good mood. The mood fluctuations can make it difficult for people to maintain relationship and balanced life, and has it leads to person committing suicide.

  1. Schizophrenia

It is one of the types of mental illness with symptoms including depression, hallucinations. If a person suffers from this illness, it makes it difficult to function in life and most of medication to treat this illness have side effects. And, hence people suffering from this illness commits suicide. About 20% to 40% of people suffering from this illness commits suicide.

  1. Physical abuse

Victim of physical abuse either while growing up or in a relationship, may develop feeling of guilt, shame. And, is repeated several times which becomes unrecognised and unreported. A person who has been a victim of physical abuse is left with no option but suicide to escape their situation.

  1. Sexual abuse

There are many forms of sexual abuse, any form of sexual abuse cand lead to person depressed and ultimately lead to suicide.

  1. Bullying

Bullying is very common among teenage population. Children studying in school and colleges face bullying in various forms including ragging. Person victim of bullying feels depressed, hopeless, and worthless and can commit suicide.

  1. Unemployment

When a person is unemployed, this develops the feeling of isolation and feel as if they are useless to family, no purpose in life and can’t help the family financially. It leads to people feel depressed and commit suicide.

  1. Drug Addiction

People who are addicted to drugs or alcohol are depressed and feel hopeless of their current life situation. Drug can provide short term relief but its long-term effect tends to alter brain functioning which ultimately leads to suicide.

  1. Social Isolation/ Loneliness

People totally isolated from the society can take a toll on mental health and can lead a person to become depressed and ultimately commits suicide.

  1. Interpersonal difficulties

Interpersonal difficulties include conflicts with spouse and other family member, which may lead to depression and suicide ultimately.

  1. Academic difficulties

India’s population mostly consist of youth population, people at that age face many academic problems which may lead to anxiety and depression and can also lead to suicide if they don’t know how to cope up with the situation.

  1. Financial Problems

Most of the people who face financial problem find their way out to or to cope up with the situation. But many people who are unable to find their way out feel depressed, and may consider suicide as the only way to escape the situation.

Method to commit suicide

In India, Hanging was the most frequently reported method.

Second most frequently reported method was self- poisoning (often ingestions of organophosphate pesticides).

Followed by, Drowning in water bodies.

Other reported methods of suicide include jumping off heights, being run over by a train and using a firearms.

Men mostly chose hanging, while significantly women chose drowning and burning as modes of suicide.[4]

Legal Aspects on Suicide

Before, Section 309 of Indian Penal Code (IPC) criminalized attempted suicide as well as suicide assistance, with imprisonment of one year or with fine or both.[5]

Although Section 309 of IPC was still in effect, the Mental Healthcare Act, 2017 (enacted on July 2018) has restricted its application. The relevant provisions of the new act states:

Notwithstanding anything contained in section 309 of the 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.[6]

The Mental Health Act of 1987 was superseded by the 2017 Act, which provides a precise definition of mental illness. It was passed in order to bring India’s legislation into compliance with the convention on the Rights of person with Disabilities and its Optional Protocol, with the goal of revolutionizing the nation’s mental healthcare system. According to the Act, the government will be responsible for providing care, therapy, and rehabilitation to an individual who has attempted suicide and is under a lot of stress in order to lower the likelihood that they would attempt suicide again.

Thus suicide has been effectively decriminalised by the Mental Healthcare Act, 2017. This Act seeks to view the accused as a victim of mental stress and is considered to be in a temporary loss of his intellect. Thus it gives a different purview of the so called offence of a suicidal attempt. The mental healthcare act is indeed a progressive act quite modern in its approach and contrasting to its conventional counterparts like the IPC.

This is in tune with the 210th Report of the Law Commission of India titles Humanisation and Decriminalisation of Attempt to Suicide.

The IPC was replaced by Bharatiya Nyaya Sanhita (BNS), which came into effect on July 1, 2024. The BNS does not include an equivalent clause to Section 309 that criminalized attempted suicide in India, hereby attempted suicide was officially decriminalized in India through the introduction of BNS.

Case Laws

Maruti Shripati Dubal v. State of Maharashtra[7]

In this case Bombay High Court, the court provide the reasoning to strike down Section 309 of IPC. Desire to die and right to die are both natural human emotions. Person who commits suicide are considered as the victim of mental health and not of suicide.

Atul Subhash Suicide Case

This is the very recent and famous case of suicide, wherein Atul committed suicide as his wife filed fake harassment case on to him. Which ultimately lead him to depression and suicide. Now, his wife has been arrested by Karnataka Police.

Difference between Suicide and Euthanasia

In a suicide a man voluntarily kills himself by stabbing, poisoning or by any other way. No doubt in suicide one intentionally attempts to take his life. It is an act or instance of intentionally killing oneself On the other hand, in euthanasia there is an action of some other person to bring to an end the life of a third person. In euthanasia, a third person is either actively or passively involved i.e. he aids or abets the killing of another person.

In, Naresh Maratra Sakhee vs Union of India, [8]observed that, “suicide by its nature is an act of self-killing or self-destruction, an act of terminating one’s own act and without the aid or assistance of any other human agency. Euthanasia or Mercy killing on the other hand means implies the intervention of other human agency to end the life. Mercy killing is thus not suicide and the provision of section 309 does not cover an attempt at mercy killing.

Conclusion

Thus, Suicide has been decriminalised and it is no more a crime in India. New law, that is, BNS doesn’t include any section relevant to criminalisation of suicide. They are treated as the victim of mental health. Suicide has a very devastating effect on the people left behind. However, attempt of suicide can be prevented with timely, evidence- based and low-cost intervention.

 

References

[1] World Health Organisation (WHO)

[2] Wikipedia < https://www.wikipedia.org >

[3] Durkheim, Le Suicide (1897)

[4]   World Health Organisation (WHO)

[5]   Indian Penal Code, 1860

[6]  The Mental Health Act, 1987

[7]  Maruti Shripati Dubal v. State of Maharashtra (1987) Cr LJ 743

[8] Naresh Maratra Sakhee v. UOI (1996) BOM CR 92

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