Malaysia's Anachronistic Response To Suicide Does More Harm Than Good

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There are indications that for each adult who died of suicide, there may have been more than 20 others attempting suicide.

In a statement in 2019, the World Health Organization (WHO) director-general Dr Tedros Adhanom Ghebreyesus cautioned that while there are significant and impactful progress worldwide at addressing this public health crisis, "one person still dies every 40 seconds from suicide".

What's notable in this crisis is that suicide is preventable through a nation's commitment towards building and enforcing a national suicide prevention strategy.

In a 2019 report, Malaysia's age-standardised suicide rate for all ages in 2016 was 6.2 per 100,000 for both sexes. The rates were 8.7 per 100,000 and 3.6 per 100,000 for males and females respectively in Malaysia.

It is reported that about 7% of adolescents in Malaysia have the intention to attempt suicide with half reporting a history of attempting suicide. The Malaysia Psychiatric Association estimated that seven people, comprising mostly of youth and young adults attempt suicide daily.

While there is multiple research published attempting to quantify the numbers in Malaysia, the crisis is a lot more elusive in this part of the world.

Efforts have been made by the Malaysian government to monitor suicides through the development of the National Suicide Registry Malaysia. However, the registry brought upon fundamental limitations such that it only registers suicide and not self-harm which is a significant predictor of suicide.

In addition, it only registers medically reported suicide leaving out completed suicides and attempted suicides that are not medically reported. The WHO cautioned that Malaysia's data had quality issues that rendered the death registration information unavailable or unusable.

The inconsistencies and difficulties in gathering data for suicide and suicidal behaviour in Malaysia can be attributed to the stigma associated with suicide in Malaysia.

Malaysian law criminalises suicide attempts under Section 309 of the Penal Code.

Imagine this, you lost your job and are unable to cope with the overwhelming stress.

With the lack of resources to help you both mentally and financially, you attempt to end your life but you survive that attempt. While still struggling with the initial circumstances that brought you to that point, you are now investigated for committing a criminal offence and subsequently sentenced to a month in jail for your actions.

As you manoeuvre through court orders, you can't help but wonder if a death sentence rather than a month's jail time would have been a more justified punishment.

Unfortunately, for 42-year-old Jacob Stanley, this is his reality.

He was sentenced to a month's jail by Magistrate Aina Azahra Arifin as he pleaded guilty to attempting the act at a low-cost flat unit in Sentul at 11pm on 17 May 2020.

To add to this dystopian reality, on 2 February 2020, 38-year-old disabled Malaysian Mohamad Sani Isa, pled guilty to attempting suicide when the charge was read in front of Magistrate Nordiana Abd Aziz and was thereafter sentenced under Section 309 of the Penal Code which states that "whoever attempts to commit suicide, and does any act towards the commission of such offence, shall be punished with imprisonment for a term which may extend to one year or with fine or with both".

Punishing those who are already in distress as a method to curb this issue only serves to worsen the crisis as it pushes individuals to choose more irreversible means of harming themselves to ensure that their attempt is successful to avoid prosecution should they survive.

We were quick to report and repost when Malaysia was ranked No 1 in the world's best healthcare category in the 2019 International Living Annual Global Retirement Index for our world-class service and infrastructure. But how could we be both a nation of "world-class health care service" and a nation with an anachronistic response to mental health and suicidal behaviour?

It seems like the decriminalisation of suicide in Malaysia will not happen any time soon as Malaysia grapples with its unstable political environment which is further exacerbated by the ongoing pandemic and its inevitable negative effects on the economy.

For Malaysians that are seeking for more mental health services, while yes a suicide attempt will have legal consequences, you still do have access to Malaysia's growing mental health services both in the private and public health sector. Moreover, there are more affordable services provided by centres with trainee psychologists and counsellors.

You have two options for your initial point of contact.

You can reach out to a general practitioner (GP) at a nearby clinic who will be able to consult and refer you to a psychiatrist or a psychologist to have a more complete and thorough assessment of your mental health.

What's important is to be as detailed and honest about how you are feeling and if you have thoughts of self-harm. In addition, be honest if you have concerns over the financial cost of mental health services.

Your GP would be able to redirect you to professional resources based on your circumstances. To get mental health services from a public hospital, you would require a referral letter from a GP.

Your second option would be to directly engage with a private mental health care provider.

This means a counselling service or clinical psychologist. Be sure to do your research and ensure that the centre you are engaging with is a licensed and professional provider.

If you are seeking treatment from a trainee counsellor or psychologist, be sure that they are working under a licensed and/or recognised centre.

1. BEFRIENDERS KL
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2. TALIAN KASIH
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Contact: 15999
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For a more thorough directory of resources, head over to the Malaysian Mental Health Association's website.