LifeLine International sat down with Policy Director, Dr. Alan Woodward, an expert in mental health and suicide prevention, to delve into the complex interplay between the decriminalisation of suicide, government Mental Health Acts, and national suicide prevention strategies. His insights shed light on the crucial role of decriminalisation, where suicide remains a crime, as the linchpin in that nation’s efforts to tackle suicide. While all three components are necessary for a comprehensive national approach to suicide prevention, Dr. Woodward argues that decriminalisation is the foundation upon which effective suicide prevention strategies must be built.
Dr Woodward was asked to unpack the nuances between these three critical elements to a nation’s response to the issue of suicide, and people experiencing a suicide related crisis.
To begin, Dr. Woodward strongly argues that the decriminalisation of suicide is the bedrock proposition for effective suicide prevention. In countries where suicide remains a criminal act, significant barriers to meaningful prevention efforts remain.
“Laws that actually punish people who exhibit or disclose suicidal behaviour and or intent are counterproductive, out of step with effective suicide prevention, and really are a human rights violation,” Dr Woodward said.
“We would absolutely like to encourage laws and the related policy and service environments that they enable, to ensure that crisis support and other services for the prevention of suicide are accessible to all people. And we actively encourage countries to have laws that provide for universal access to mental health care with a view of preventing the onset of mental ill health.”
Dr Woodward goes on to state that Mental Health Acts, however, have a pivotal role in regulating mental health services, protecting those with mental health issues, and addressing the provision of care. These acts provide a legal framework for mental health and govern a nation’s approach to interventions and care.
“What a Mental Health Act can also do is address the provision of care, including the licencing, accreditation or registration of people who work in the field, the standards of care and the provision of budgets and resources for services. So, mental health legislation can cover a range of things,” Dr Woodward said.
To illustrate these points further, and to show the importance of a unified approach, Dr. Woodward provided examples from various countries.
For example, the various States of Australia have enacted Mental Health Acts to ensure the proper regulation of mental health services, quality and safety, oversight and accountability measures, guaranteeing individuals with mental health issues receive the necessary care and support they need. These related to national standards and policies.
National suicide prevention strategies, on the other hand, tend to serve as policy statements, to articulate and create a shared understanding across multiple stakeholders of a country's commitment to suicide prevention. They encompass a range of activities, programs, support services resources, and partnerships aimed at reducing suicide rates. These strategies can be, but do not need to be, set in legislation.
For instance, in the United States, the National Action Alliance for Suicide Prevention, is a partnership between government, businesses, and communities, dedicated to reducing suicide rates through collaboratively developed strategies, priority actions, and promotion of services and programs. The US National Suicide Prevention Strategy was developed with the involvement of the National Action Alliance for Suicide Prevention.
And in Japan, they have used a Basic Act on Suicide Prevention to set a national objective for suicide prevention that informs the national suicide prevention strategy as well as creating the environment through which government funding, resources and requirements for activities across all areas of government, at national and regional levels throughout the country are undertaken on suicide prevention.
Dr. Woodward suggested an ideal pathway for addressing suicide prevention starts with decriminalisation as the foundational step, followed by the update or creation of Mental Health Acts, and finally, the development of national suicide prevention strategies.
While the ideal approach involves addressing all three components comprehensively, Dr. Woodward acknowledges that countries may adopt other pragmatic approaches. Some nations may establish suicide prevention strategies before fully decriminalising suicide or implementing comprehensive mental health acts, demonstrating flexibility in suicide prevention efforts.
“Kenya would be really good example of where they've established a national suicide prevention strategy, without doing the law reforms to decriminalise suicide. Pragmatically, in taking some steps of progress as a country to establish a suicide prevention strategy, that is aiding the cause of suicide prevention and that is good for the people of Kenya,” Dr Woodward added.
“Is it the complete set of work that needs to be done? No. But it’s start. We will just have to continue to advocate for law changes.”
“Resourcing services, community outreach, crisis lines, strategies, programmes, all that sort of stuff is vital, but if you still got laws that criminalise suicide, they will never be as effective as they can be.”
Dr. Woodward also highlights the often-overlooked impact of laws on individuals bereaved by suicide. In countries where suicide is criminalised, these individuals may struggle to express their grief openly and access support services, compounding their experiences.
“This is one of the most impactful issues to address because the numbers of people, frankly, who have been impacted, in terms of their own mental health and wellbeing, by suicide is much greater than the numbers who have died by suicide. If you have laws in place that are really constraining those people from even talking about and dealing with that grief and loss, that's very harmful to them,” Dr Woodward said.
Dr. Alan Woodward's insights emphasise the importance of decriminalising suicide as the cornerstone of effective suicide prevention. While Mental Health Acts and national suicide prevention strategies are integral, they are most effective when built upon the foundation of decriminalisation. Comprehensive suicide prevention involves a commitment to all three components, alongside addressing the challenges faced by individuals affected by suicide laws.
