PURSUING DECRIMINALISATION OF SUICIDE IN MALAYSIA: PUSHING BOUNDARIES WHILE BUILDING BRIDGES

PURSUING DECRIMINALISATION OF SUICIDE IN MALAYSIA_PUSHING BOUNDARIES WHILE BUILDING BRIDGE.

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Lee Zi Ke, zikelee0814@gmail.com 

Lim Hong Zhe, limhongzhe@gmail.com

Abstract

The decriminalisation of suicide represents a significant shift in Malaysia’s mental health and legal landscape, heralding a historic milestone in the nation’s approach to addressing mental health challenges, against the backdrop of this post-COVID-19 era reflecting global epidemiology issues posed by psychiatric disorders. This article critically examines the implications ensuing from the abolishment of the impugned suicide criminalisation law in Malaysia, notably S. 309 of the Penal Code, along with the amendments to the related provisions, paving the way for the introduction of the Mental Health (Amendment) Bill 2023 which serves as a bastion of legal redress fortifying protections to the psychiatric suicide attempters. By drawing on insights from mental health research, this article explores the intricate dimensions of suicide criminalisation, including its historical roots, contributing factors, the global prevalence of suicidal behaviours and its multifaceted impact, calling for its decriminalisation worldwide. The authors then scrutinise the loopholes of suicide criminalisation law in Malaysia before the amendments by probing the legal procedures and the sentencing trend and subsequently casting light on the scope of the amendment following the transformation of Malaysia’s mental health legal framework. Through a comprehensive and comparative analysis from a legal standpoint across various jurisdictions, the authors then evaluate the efficacy and sustainability of suicide decriminalisation frameworks in Malaysia in navigating the viable pathways forward. Ultimately, this article contributes to ongoing discussions on mental health law reform and suicide prevention initiatives in Malaysia. Eventually, the authors conclude by underscoring the need for a holistic approach that integrates legal, medical, and socio-cultural perspectives to address the complex challenges associated with suicide and mental illness in the country.

Keywords: Decriminalisation, Criminalisation, Suicide, Attempted Suicide, Section 309, Penal Code

A. INTRODUCTION

Suicide persists as a significant global public health concern, casting a sombre shadow over the communities worldwide. The World Health Organization (WHO) reports an annual toll exceeding 700,000 lives lost to suicide, reflecting an estimated suicide rate of 9.0 per 100,000 individuals annually. Notably, suicide ranks as the fourth leading cause of death among 15 to 29-year-olds, underscoring its pervasive impact in 2019. Each suicide not only claims a life but also reverberates, affecting approximately 135 others left to grapple with its aftermath.

The emergence of the COVID-19 pandemic in 2020 further exacerbated and unleashed a wave of unprecedented post-acute ramifications when it further challenged mental health issues worldwide. Consequently, the global landscape witnessed a distressing surge in suicide related phenomena, magnifying the urgency of addressing human psyche concerns.

Currently, scholarly research illuminates the nexus between suicidal behaviour and its underlying mental or psychiatric conditions, advocating for a paradigm shift away from punitive perspectives toward a more compassionate approach. Within the Malaysian context, legislative endeavours such as the Criminal Procedure Code (Amendment) (No. 2) Bill 2023 have recently received endorsement from both Houses of Parliament, effecting to abolish the archaic statutes like S.309 of the Penal Code (PC) that previously criminalised attempted suicide in the nation and to amend other related provisions. This legislative stride aligns harmoniously with the recommendations set forth by the International Association for Suicide Prevention (IASP) and WHO by prioritising the accessibility of support for individuals experiencing suicidal crises, while also working to dismantle societal taboos and mitigate the alarming suicide rate.

Correspondingly, the new amendment to the Mental Health Act 2001 is also yet to take effect after the passing of the Mental Health (Amendment) Bill 2023 in a move to decriminalise suicide in Malaysia. In this regard, the former Deputy Law Minister Ramkarpal Singh, a proponent of this rehabilitative approach, envisions a future where legal reforms would whittle away the fear of punishment and inspire public confidence in seeking assistance and embracing therapeutic interventions for individuals struggling with mental health challenges.

B. STATEMENT OF PROBLEM

Research findings indicate that Malaysia’s suicide rate stood at 5.8 per 100,000 individuals in 2019, ranking second highest among selected Muslim-majority nations, and fell within the median range among ASEAN countries, albeit lower than all G7 nations except Italy.5 Also, the observable spike in suicide incidents within Malaysia, evidenced by a 10% increase from 981 cases in 2022 to 1087 cases in 2023, underscores an alarming trajectory demanding immediate attention, especially in this post-COVID-19 landscape.

As S.309 of the Malaysian PC is in pari materia with the Indian PC and had been abolished in India, this provides a compelling impetus for repealing this obsolete statute in Malaysia, for it fails to evolve with the contemporary societal norms. In that vein, Senior Lecturer Ching Sin Siau from the Centre for Community Health Studies in Selangor, Malaysia, aptly notes, “Criminalising suicide attempts merely scratches the surface of this alarming trend.”6 Indeed, there have been global initiatives to decriminalise attempted suicide, and it prompts crucial deliberations on whether such measures will effectively mitigate suicidal behaviours. That being so, a thorough examination of the historical context and underlying factors contributing to the criminalisation of suicide is imperative, informing the rationale for advocating its decriminalisation.

In this matter, it is also hoped that this paper will shed light on the efficacy and sustainability of the forthcoming implementations of the Mental Health Act 2001, particularly in light of the repeal of suicide criminalisation legislation and the pertinent amendments made to the PC in Malaysia. By comparing and analysing various suicide decriminalisation models and legal frameworks from diverse common law jurisdictions, this study aims to provide insights into navigating the viable pathways forward.

Methodologically, this paper employs doctrinal research to systematically uncover, expound, scrutinise, and analyse facts, contemporary legal issues or the operational dynamics of specific laws or legal institutions. By undertaking a comprehensive legal inquiry into the adequacy of existing laws and policies concerning suicide in Malaysia, this paper seeks to contribute substantively to the discourse surrounding this complex and pressing societal concern of specific laws or legal institutions. By undertaking a comprehensive legal inquiry into the adequacy of existing laws and policies concerning suicide in Malaysia, this paper seeks to contribute substantively to the discourse surrounding this complex and pressing societal concern.

C. LITERATURE REVIEW

1. Definition and History of Criminalising Suicide

According to the Black’s Law Dictionary, “suicide is the willful and voluntary act of a person who understands the physical nature of the act, and intends by it to accomplish the result of self-destruction.” As such, self-killing committed by an insane person is not suicide since suicide refers to the “deliberate termination of one’s existence, while in the possession and enjoyment of his mental faculties.” As an extension, attempted suicide is defined in criminal law as an effort or endeavour to accomplish suicide, which do not result in death, and is commonly regarded as a criminal offence.9 It amounts to “more than mere preparation or planning for it, which, if not prevented, would have resulted in the full consummation of the act attempted, but which, in fact, does not bring to pass the party’s ultimate design.”

To have a holistic overview of this issue, it is of vital importance to delve into the historical context surrounding the classification of suicide attempts as a criminal act. Since times immemorial, suicide has been a controversial and extensively debated topic, entrenched in deep-seated taboos such as in religious, monarchical, and colonial frameworks. In the 19th century, the Church of England expressed a cautious approach toward decriminalising suicide as it would be tantamount to “aiding and abetting suicide,” constituting a punishable offence under the felo de se common law principle Moreover, major world religions have condemned suicide as an unpardonable sin against their teachings. For example, Islam portrays a grim fate for those who commit suicide, condemned to perpetually relive their abhorrent act in the fires of hell. Similarly, the Catholic Church forbade proper funeral rites and consecrated burial grounds for suicide victims.

Retrospectively, the enduring legacy of suicide as a criminal offence continues to shape contemporary perceptions and attitudes, perpetuating a heavy stigma surrounding its decriminalisation, particularly in jurisdictions influenced by English common law, such as Malaysia. In fact, S.309 of the Malaysian PC is rooted in 19th-century ideologies that initially aimed at the prevention of suicidal behaviour by taking a legislative approach to criminalising them.13 This historical milieu gains relevance amidst instances where individuals even resort to suicide as a desperate means or “sadistic shield” to evade legal repercussions and criminal liabilities.14 Another rationale for the criminalisation is to deter individuals from modelling suicidal behaviours by imposing unpleasant punishments to eradicate such observation and emulation. Ultimately, the existence of the contentious section is predicated on the notion of God’s will in dictating human life, serving as a deterrent against suicide and reinforcing the sanctity of life.

2. Factors and Prevalence of Suicidal Behaviours

A meticulous scrutiny of the fundamental determinants influencing suicide is essential for guiding national policy-making and enacting legal reforms, intricately crafted to address root causes and specifically tailored to allay suicidal ideation and behaviour.

When we first examine the factors of suicidal behaviours, it is observed that mental disorders exhibit a robust correlation with suicidal tendencies, with studies indicating that nearly ninety per cent of individuals who die by suicide have been diagnosed with a psychiatric disorder at the time of their death. Among these disorders, depression emerges as the prevailing condition, affecting approximately one in every three women and one in every five men globally, other than conditions such as schizophrenia, bipolar and anxiety disorder, and others. Meanwhile, other factors such as life crises, encompassing financial hardship, relationship breakdowns, and persistent physical suffering due to diseases, also contribute significantly to this severe social problem. Over and above that, societal marginalisation and discrimination, affecting groups such as refugees, migrants, indigenous communities, and individuals identifying as LGBTI, as well as those incarcerated, adds to the risk. Additionally, experiences of conflict, natural disasters, violence, abuse, or profound loss, coupled with a pervasive sense of social detachment, further compound susceptibility to suicidal tendencies. Also, the advent of the COVID-19 pandemic has aggravated these risk factors, with measures like social distancing straining interpersonal connections, intensifying the feelings of isolation, ennui, disengagement, and impeding access to vital healthcare services.

When it comes to suicidal prevalence, interestingly, studies reveal that 77% of global suicides worldwide transpire within low-income and middle-income nations.16 Besides, the World Health Organization (WHO) highlights that seventy-nine per cent of worldwide suicides in these countries stem from financial hardships and relationship break-ups, precipitating mental health challenges. Formidably, suicide attempts surpass actual suicides by over 30-fold on a global scale, with males exhibiting a purportedly higher prevalence of suicidal inclinations than females, attributed to the breadwinner culture of the traditional male role.

3. Why Decriminalise Suicide Attempts?

Recently, the global movement toward destigmatising suicide has prompted a call for its decriminalisation in many countries. In this regard, WHO identifies more than 50 nations worldwide, including regions in North America, Europe, majority parts of South America, and certain Asian portions, that have embraced suicide decriminalisation, committing to develop new legislation and policies concerning mental health to advance both quality care and the rights of individuals with mental health conditions and psychosocial disabilities.

Effectively, this global paradigm shift marks a commendable stride toward combating entrenched stereotypes and biases, which frequently portray suicide attempters as attention seeking, inept, emotionally frail, self-centred, or morally deficient. Also, the impugned provision targeting those who attempt suicide is not only counterproductive but also perpetuates discrimination, leaving victims with scars deeper than any prison sentence would impose. In truth, suicide criminalisation law serves as a cruel imposition exacerbating the anguish of those already enduring unbearable suffering, with scant hope for happiness in life, thus prompting them to seek relief through death. To date, empirical evidence also fails to support the notion that the threat of incarceration serves as a deterrent against suicide attempts. Instead, it manoeuvres the vicious cycle of instilling fear in the “fractured mind” and dissuading them from seeking vital assistance. Ergo, criminalising suicidal acts in an attempt to discourage individuals from committing suicide has proven infructuous in providing the appropriate solution.

Conversely, within these legal tightropes, such criminalisation may inadvertently encourage individuals ensnared by the deafening silence of despair, to resort to more lethal means of ending their lives, rather than surviving their attempt only to face the reality of legal repercussions and societal stigma. Critically, the undergirding reason for this move is an embodiment of the commitment to upholding fundamental human rights, including the rights to self-determination, life, freedom from discrimination, liberty, as well as access to essential healthcare services and support.19 Moreover, the discourse surrounding suicide should pivot away from vilification and toward fostering a rehabilitative framework underpinned by new regulations and institutional structures. This approach aims to empower individuals at risk of suicide to seek professional help and alleviate their distress, extending a beacon of redemption and for them to find solace in support.

D. LEGAL ANALYSIS

1. Call for Amendment

Specifically, S.309 of the PC delineates penalties for individuals who attempt suicide, including imprisonment for up to one year, a monetary fine, or both. Within this context, it is to be noted that the preparatory stages of suicide, such as composing a suicide note or preparing a noose, do not constitute a criminal offence. It is only if an individual is in the act of hanging themselves and the attempt fails due to a snapped rope that they may be found guilty under S.309 of the PC.

Within the legal realm, the evaluation of criminal responsibility and fitness to stand trial assumes paramount importance when an individual faces criminal charges for attempting suicide, given the fact that a suicidal act is often associated with mental incapacity or psychiatric disorder. For instance, under S. 342 of the Criminal Procedure Code, individuals charged under S. 309 may be subject to psychiatric evaluations to determine their fitness to stand trial. Subsequently, their criminal liabilities are examined under S. 84 of the Penal Code to assess the presence of “unsoundness of mind”, as it is not wrongful for a person who, at the time of committing the offence, is incapable of comprehending that their actions contravene the law. However, the decision to order such evaluations rests with the presiding Magistrate. The assessment outcomes are then presented to the court in the form of a report, which may lead to sentencing, acquittal, or confinement in a government forensic hospital if the individual is deemed unfit to assume criminal responsibility or stand trial.

On this basis, the ambiguity of the interpretation and its procedural aspects cast doubt on the efficacy of statutory provisions for facilitating essential mental health support and evaluation for individuals who attempt suicide under S. 22 of the Mental Health Act 2001. Furthermore, lengthy legal proceedings and evaluation processes can significantly impede timely treatment for psychiatric suicide attempters, neglecting the purpose of providing prompt mental health care to the patients and aggravating their risk of suicidal behaviour in future.

Within the scope of the impugned law, according to Jha, approximately only 11% of individuals identified as suicide attempters faced prosecution from 2014 to 2018, indicating a low incidence of criminal charges and prosecution rates under this statute.22 In these circumstances, several nations, including Sri Lanka and Singapore, which adopted provisions akin to the Indian PC, have repealed the anachronistic laws pondering its impact on the nation’s social, moral and political perspectives. Prior to this legislative reform, Malaysia stood alongside Myanmar and Brunei as one of the few Southeast Asian countries that still criminalised attempted suicide. Consequently, the Malaysian government has faced mounting pressure to reconsider its position before abrogating the outdated provision relating to the suicide criminalisation laws.

2. Trend of Sentencing Before Amendment

There are also case precedents that demonstrate the inadequacy and ineffectiveness of S. 309 of the PC in dealing with attempted suicide arising from mental health conditions in Malaysia, particularly in circumstances where it was attached to some graver criminal offence. In Jacob Tiang Lee Yee v Public Prosecutor [2016] 12 MLJ 72, it can be observed that the court failed to justify that the prosecution was incapable of establishing a prima facie case under S.309 of the PC, leaving out its constituting elements and only addressing the ingredients of other charges under S.302 and S.307 of the PC. The prosecution also did not provide any explanation for not appealing against the decision. According to research, increasingly, S.309 of the PC is typically not reported when it is the only provision involved.

The judicial indifference to the mental states of the suicide attempter can also be shown in some unreported cases where, in April 2017, the Magistrate in his obiter dicta stated that “No matter how much pressure you are facing, suicide is not a solution, now you’re out of the hospital, you must be charged in court anyway. You must know that attempting suicide is a crime,” and fined the 24-year-old Chinese woman with RM2,000.25 In a separate incident, the prosecution contended that the man’s attempt to jump from the balcony of a flat had caused inconvenience to numerous parties, and fined the man amounting to RM 3,000 and a three month jail sentence upon failure to pay the fine.26

However, it is intriguing to note that, with only a slim prospect for progress, there has been a shift in attitude from the judiciary. In PP. Musdar Rusli [2017] 7 CLJ 703, the Court of Appeal reversed the High Court’s decision, which meted out that the previous judgement where the respondent was guilty only of the lesser offence of culpable homicide not amounting to murder punishable under S.304 of the PC was an outright travesty of justice, as it would recognise an attempt to commit suicide immediately after the heinous murder act as a valid defence to infer that there is no mens rea to kill the victim. Consequently, the previous punishment was quashed and substituted with a conviction for murder punishable under S.302 of the PC, resulting in the respondent being sentenced to death.

3. Scope of Amendment

The Criminal Procedure Code (Amendment) (No. 2) Bill 2023 aimed to amend certain provisions of the PC concerning suicide. In light of the slew of legal reforms, S.305 and S.306 of the PC, which address aiding and abetting suicide, will remain intact as criminal offences. However, their scope is broadened to include “attempted suicide” in addition to mere “suicide” prior to the amendment. Following the amendment, a “person who lacks mental capacity” under S.305 of the PC refers to individuals classified as insane, idiotic, delirious, or intoxicated. Also, the potential imposition of the death penalty as a punishment under this provision has been eliminated, yet penalties of imprisonment for up to 20 years and fines persist. Primarily, the amendment abolishes S.309 of the PC, thereby aiming to decriminalise suicide as an offence in Malaysia.

Furthermore, the introduction of the Mental Health (Amendment) Bill 2023 entails the expansion of the role of crisis intervention officers and their powers under S. 11, encompassing officers from entities such as the Malaysian Maritime Enforcement Agency, Fire Department, Auxiliary Fire Department, and the Malaysia Civil Defence Force, as an addition to the previously designated posts of only police and social welfare officers before the amendment. These officers are now empowered to enter any premises as necessary or forcibly to apprehend mentally disordered persons and suicide attempters. Subsequently, such individuals must be promptly transferred to a public or private psychiatric hospital for evaluation within twenty four hours of the apprehension. Consequently, this effectively rectifies the discretionary authority of the Magistrates to order psychiatric assessments and medical assistance for suicide attempters under S. 342 of the Criminal Procedure Code.

In addition, the expansive definition of “mentally disordered person” within this context remains consistent with the previous S. 2 of the Mental Health Act 2001, read in conjunction with its S. 11, encompassing individuals with any form of mental illness, psychiatric disorder, mental disability, or incomplete mental development, which are capable of posing a risk to themselves, others, or property.

4. Comparison of Jurisdictions

A comparison of strengths and weaknesses in relation to the model or frameworks from other Common Law countries that decriminalised suicide, from both legal and policy perspectives, requires thorough examination, analysis, and evaluation to determine its suitability for enhancement before it can be proposed for adoption or referral for legal implementation in Malaysia. The authors then delve into the discussion of the implications in terms of the efficacy and sustainability of implementing suicide decriminalisation across different jurisdictions.

(a) India

Prior to the repeal of the outdated provision in S.309 of the Indian Penal Code, there have been numerous court judgments pronounced this provision as incompatible with societal values, being irrational and inhumane, and thereby should be null and void as it violates the “right to life” enshrined under Article 21 of the Indian Constitution. Following this, in India, the decriminalisation of suicide attempts was effectuated through the Mental Healthcare Act 2017 (“MHCA 2017”). The primary objective of this legislation is to establish and offer mental healthcare services for individuals grappling with mental disorders, while also safeguarding, promoting, and fulfilling their rights throughout the treatment processes, among other ancillary matters.

In this sense, mental illness is defined by S. 2(1)(s) of the MHCA 2017 as “a substantial disorder of thinking, mood, perception, orientation or memory that grossly impairs judgement, behaviour, capacity to recognise reality or ability to meet the ordinary demands of life, mental conditions associated with the abuse of alcohol and drugs.” Besides, S. 115 of the MHCA 2017 stipulates that any individual attempting suicide shall, unless proven otherwise, be assumed to be experiencing severe stress. Consequently, they shall not face prosecution under the Act. The responsibility lies with the relevant government authorities to ensure that appropriate care, treatment, and rehabilitation are provided to mitigate the risk of future suicide attempts.

It is noteworthy in India that individuals who attempt suicide are categorised under the umbrella term of “mental illness,” while the phrase “severe stress” is employed to mitigate the stigma associated with the term “mental illness” for those who die by suicide or attempt suicide. Similarly, in Malaysia, though the definition of a mentally disordered person, as outlined in S. 11 of the Mental Health (Amendment) Bill 2023, appears not to encompass suicide attempters explicitly, it can be inferred that a suicide attempter may be considered a psychiatric patient implicitly under the Mental Health Act 2001.

In India, meticulous medico-legal protocols govern the management of individuals who have attempted suicide, encompassing assessment and triage in emergency settings, discharge planning, and subsequent follow-up care coordinated among medical, surgical, and psychiatric teams in accordance with established guidelines. On top of that, mental health professionals and medical practitioners are mandated to continuously update their knowledge regarding the protocols, procedures, and management strategies pertaining to individuals who attempt suicide, as delineated in the MHCA 2017.

In contrast, from a legal standpoint in Malaysia, there is a dearth of explicit guidelines or frameworks outlining the process for delivering mental health services and post-discharge protocols tailored to individuals who have attempted suicide. Moreover, the absence of surveillance systems compounds the challenge of ensuring continuity of care to prevent future suicide attempts.

(b) United Kingdom

In the context of the United Kingdom, S.1 of the Suicide Act 1961 (“SA 1961”) was enacted on 3 August 1961 with the aim of decriminalising suicide attempts as an offence in England and Wales. However, the abolition of the suicide offence led to the establishment of a new offence under S. 2(1) of the SA 1961. This provision stipulates that “aiding, abetting, or procuring suicide of another person”, commonly known as assisted suicide, is punishable by imprisonment for up to 14 years. In addition, such acts are treated as manslaughter under the Homicide Act 1957. Furthermore, in England, the Mental Health Act 1983 (“MHA 1983”) serves as the principal statute governing the assessment, treatment, and rights of individuals with mental health issues. Notably, S. 136 of the MHA 1983 specifically addresses suicide prevention. This section empowers police officers, rather than mental health professionals, to remove individuals from public places and detain them in a safe location to prevent self-harm or protect others.

Interestingly, the inclusion of the crisis intervention officer role in the Malaysian Mental Health (Amendment) Bill 2023, which extends beyond police officers, is viewed as a positive advancement. This expansion recognises that rescuing individuals in crisis requires specialised training and expertise, thus enhancing the effectiveness of response efforts. In comparison, in England and Wales, it was frequently the police who primarily responded by repeatedly detaining individuals under S. 136 of the MHA 1983, exposing vulnerable persons to recurrent suicidal crises. Studies have indicated that such inconsistent responses from mental health services inadvertently exacerbated feelings of hopelessness, leading to further suicide attempts. Accordingly, there is a need to examine the systemic support and circumstances surrounding an individual’s detention to determine the appropriate measures for supporting them and preventing recurrent crises. This necessitates a multi-agency response, though multiple detentions by police officers have been closely associated with suicide prevention. Additionally, police forces in England and Wales have been preparing to implement extensive operational reforms mandated by the Policing and Crime Act 2017, aimed at providing varied services.

(c) Singapore

When it comes to our neighbouring country, Singapore, S.309 of the Penal Code 1871 was abolished through the enactment of the Criminal Law Reform Act 2019. Nevertheless, S.305 of the Singaporean Penal Code 1871 imposes severe penalties for individuals who incite suicide committed by minors or individuals lacking capacity, with the punishment of death sentence or life imprisonment or a maximum of 20 years incarceration and fines. Similar penalties are applicable to individuals who abet attempted suicide resulting in harm to any person during the attempt, but no death penalty is imposed in such cases. Rather, lighter penalties of up to 15 years imprisonment and fines are prescribed for those who abet attempted suicide by minors or individuals lacking capacity. Meanwhile, S.306 of the Singaporean Penal Code 1871 underwent the same amendment as Malaysia to be scrapped as a criminal offence.

Under the Mental Health (Care and Treatment) Act 2008, police officers in Singapore have the authority to apprehend and detain psychiatrically suicidal patients in the pursuit of their well-being or security, or to safeguard others. Such individuals may be subjected to institutionalised treatment for a duration spanning from a minimum of three days to a maximum of six months, as deemed necessary by a doctor’s assessment. However, only medical practitioners at the Institute of Mental Health (IMH) are permitted to formally apply under this Act and determine involuntary admission.

Comparatively, in Malaysia under the Mental Health Act 2001, individuals suspected of mental illness may be involuntarily admitted based on an application submitted to the medical director of an acute psychiatry unit by a relative, police officer, or social welfare officer after a personal examination lasting no more than five days prior to admission. Nonetheless, a shared challenge faced by both jurisdictions is that general hospital doctors are only permitted to refer patients to psychiatric hospitals for assessment based on good faith under common law, as involuntary hospitalisation can only be authorised by designated medical practitioners prescribed under the statute after conducting an assessment. At the same time, while both laws allow for the discharge of involuntary patients by designated medical practitioners at any time, they do not provide for independent review of detention provisions.

(d) Hong Kong

In Hong Kong, the decriminalisation of suicide occurred in 1967. Subsequently, the establishment of the Centre for Suicide Research and Prevention (CSRP) served as a pivotal research and training hub. The CSRP facilitated linked data systems with clinical care providers to ensure seamless continuity of care for high-risk patients discharged from hospitals. On top of that, initiatives such as gatekeeper training, the development of local social service networks, and responsible media reporting through media engagement, among others, were implemented.

Various effective suicide prevention strategies have also been put in place by multiple agencies and community stakeholders in Hong Kong. These include measures such as refraining from renting holiday houses to single individuals, installing carbon monoxide detectors in each room, and imposing sale restrictions on items like charcoal, helium, and sodium nitrite, which are commonly used means of suicide.

In light of the foregoing discussion, it is prudent for Malaysia to adopt similar strategies tailored to the local circumstances with necessary modifications. This entails providing assistance and resources to individuals facing crises, including but not limited to ensuring accessibility to mental health services, enhancing the availability of mental health clinics, and establishing rehabilitation centres for individuals with suicidal tendencies.

5. Implications of Decriminalisation

Undeniably, research shows that the mean scores of nations that maintained attempted suicide as a criminal offence were lower than both the global average and those of 20 comparison nations that had decriminalised suicide over the course of 20 years. Nevertheless, it is important to recognise that the average annual percentage decrease in suicide rates was more significant for countries where attempted suicide was not considered a criminal act.

However, as of now, there exists no substantial and definitive evidence indicating that nations which criminalised attempted suicide consistently adumbrated lower suicide rates compared to the global average. Correspondingly and interestingly, the available evidence is also insufficient to conclude that decriminalisation leads to reductions or prevention of suicide rates having an effective deterrent effect.

Past research has yielded varied outcomes regarding the impact of decriminalisation across different countries. Anyhow, there is no conclusive assertion regarding whether criminalising suicide is advantageous or detrimental in reducing the overall suicide rate for the general populace. Thus, future investigations should persist in assessing the distinct effects of decriminalising attempted suicide while considering other pertinent factors, thereby bolstering the evidence base with sufficient and high-quality data to substantiate these findings.

Nonetheless, policy shifts should be regarded as the nascent step toward decriminalising suicide, which may contribute to a decline in overall suicide rates. This is because individuals at risk of suicide would likely be more inclined to seek assistance from their communities and mental health professionals, thus facilitating early interventions aimed at averting suicidal behaviour.

E. RECOMMENDATION AND CONCLUSION

It is in light of the foregoing discussion that the authors are of the firm opinion that it is imperative to refer to and incorporate various trends in respect of legal and policy-making concerning suicide from various countries into future consideration in navigating the viable pathways forward within Malaysia’s framework.

The authors echo the viewpoint that initiatives such as suicide prevention hotlines, mental health awareness programs, and endeavours to foster social connectedness are imperative. In this context, healthcare providers ought to establish a structured suicide screening protocol to detect individuals at risk and enhance risk assessment for suicide. Holistically, the authors would recommend collaboration across sectors involving different stakeholders and agencies, along with vigilant monitoring, surveillance, and responsible media reporting, which form the crucial components of suicide prevention strategies, aligning with the Malaysian National Mental Health Strategic Plan 2020-2025.

Although the authors admit that there are constraints in data quality within Malaysia, the authors’ humble view is that robust surveillance of both fatal and non-fatal suicidal behaviour is indispensable, which facilitates the identification of vulnerable populations and enables the customisation and targeting of interventions to mitigate suicidal behaviour and ideation effectively. Globally, obtaining accurate data on suicide and suicide attempts poses challenges, largely due to social stigma, resulting in many suicides being misclassified as undetermined deaths or accidents. It is hoped that the decriminalisation of suicide in Malaysia will lead to improved accuracy in suicide data collection.

Aligned with the WHO Mental Health Action Plan 2013–2030 and the United Nations Sustainable Development Goals, which aim to lower the suicide rate by thirty-three per cent by 2030 and promote mental health and well-being, Malaysia’s move to decriminalise suicide represents a significant milestone in its mental health and legal landscape. The authors acknowledge that the decision to abolish anti-suicide laws deserves commendation, and these advancements have been instrumental in reshaping societal attitudes toward suicide in this contemporary era.