Mental health comes first

According to a WHO study, at last one per cent of the total world’s population dies by suicide every 40 seconds across the world. It further states that 5.0 per cent of people in the world try to kill themselves at least once during their lifetime.

Over three-quarters (77 per cent) of global suicides in 2019 occurred in low- and middle-income countries, according to a WHO report published in 2021. There is no significant change in this trend and a high suicide rate continues to be a serious and pressing concern in Pakistan as well.

Every other day, there are posts on social media describing a suicide case where someone has either died by suicide or attempted to take their lives. Pakistan has had a consistent suicide rate – 8.9 suicides per 100,000 people – since 2000. This is a deeply concerning social issue that holds significant legal implications as well.

Till December 2022, suicide was classified as a criminal act in Pakistan under Section 325 of the Pakistan Penal Code which imposed a punishment of one-year imprisonment along with a fine for those convicted of attempted suicide.

The government recognized that the purpose of the law should be to deter people from committing this act and identify key contributing factors that urge people to end their lives. The existing legal framework was not fulfilling this purpose which was evident from the persistent high suicide rates throughout the years.

This section was ultimately repealed by the government in 2022. However, merely repealing the criminalization of suicide does not present a solution to this deeply entrenched suicidal problem. The suicide issue in Pakistan necessitates a comprehensive methodology that can address the root causes and challenges faced by those who may experience a deep sense of hopelessness and despair leading to suicidal thoughts.

The causes of suicides in Pakistan are multifaceted, rooted in a complex interplay of social, economic, cultural, and individual factors. Socioeconomic challenges, such as poverty and unemployment, have a significant contribution towards this, given the economic crisis in the country with high inflation rates and political instability. Gender disparities, prevalent in aspects like workplace harassment of women, rape cases, and instances of domestic violence, also play a role in elevating suicide risks.

Cultural pressures and societal expectations, including the pressure to conform to traditional norms and meet familial expectations also drive a sense of isolation. All of these issues ultimately cause severe mental health problems. In the majority of cases, no medical assistance is sought due to a lack of awareness, social stigma attached to it and limited opportunities created by the government to address this cause. As a result, people often see suicide as the only option.

The government can play a pivotal role in fighting this issue and adopting strategies to deal with it. A high suicide rate in the country reflects the government’s failure to take measures to develop a strong and effective mental health policy. Initiatives that prioritize mental health funding, training healthcare professionals, and establishing mental health facilities can be supported through legislative measures.

Follow-up care by health workers for people who have attempted suicide is critical since they are at great risk of trying again. Social support within communities can help protect people who are vulnerable to suicide by building their coping skills. Communities must provide nurturing environments to those who are vulnerable, and governments can set a good example to enable them to do so.

A major aspect of this is awareness among people regarding the sensitivity of this issue and the ways to deal with it. Responsible media reporting has also been shown to decrease suicide rates. This includes educating people about suicide, risk factors and where to seek help, and avoiding the detailed descriptions of suicidal acts.

Governments can help the media with these efforts by releasing public service announcements that raise awareness, identifying and treating mental disorders as early as possible, and ensuring that those vulnerable to suicide receive the care they need before it is too late. Mental health policies should be integrated into overall healthcare services, and governments should ensure sufficient funding to improve these services.

The existing major legislative framework governing mental health is the Mental Health Ordinance of 2001 under which each province has adopted its own legislation. However, the missing factor is that none of these frameworks lay out a detailed scheme or plan to handle issues which are the major factor of high suicide rates in Pakistan.

It is crucial to adopt a holistic approach that encompasses mental health awareness, socioeconomic development, legal reform, and cultural shifts towards fostering a more supportive and understanding society. By integrating legal measures with broader societal initiatives, Pakistan can work towards creating an environment that prioritizes mental wellbeing and provides support for those in need.

One of the initiatives undertaken by the Pakistan government is the launch of a mental health app called ‘Humraaz’ in March 2023. This app aims to give access to and help anyone with suicidal thoughts or any form of a mental health emergency, providing treatment to patients under complete confidentiality. This app allows arranging appointments with psychiatrists and psychologists, and the government has pledged to work towards hiring and training professionals to combat the epidemic of mental health illness.

However, this also has certain limitations. It is not equally accessible for all since a majority of Pakistan’s population is based in rural areas with limited insight into the technological world. Thousands of people are not even aware of this app, and there are a lot of those who might not be able to make use of it even if they are informed of this app as either they do not possess the skills, or they are still living in that circle where seeking mental assistance is not perceived as something normal. What is needed is a grassroots campaign that targets those living on the edge of poverty and illiteracy.

Improved surveillance and monitoring of suicide attempts is required for effective suicide prevention strategies. This includes registration of suicide cases, hospital-based registries of suicide attempts and nationally representative surveys collecting information about self-reported suicide attempts. All these measures collectively can have an impact on improving the living standard in Pakistan and fighting mental health issues over time to develop a flourishing society that provides a safe breathing space to all.

The writer is a law student.