Decriminalization of suicide deprives survivors of psychiatric help

Bengaluru: Young, hardworking, intelligent, and pursuing a PhD, she should have been on the path to success. But her envious fellow male researchers started targeting her. The woman, in her mid-twenties, confused and unable to handle the constant harassment, attempted suicide five times in the past two years. She is now taking psychiatric help at MS Ramaiah Hospital to overcome her fear and depression - a bit late, as she wasn't counselled each of the four times she survived.
Nursing homes where she was admitted stabilized her physical condition but never addressed her core problem of depression given that the process to decriminalize suicide has been set in motion.
In December 2014, the Centre decided to decriminalize suicide by deleting Section 309 of the IPC and started the legal process to do so. The decision was hailed as a great move by many activists and psychiatrists. Section 309 prescribes one year punishment to those who attempt suicide and a psychiatrist's evaluation played a key role in the prosecution of the survivor. But sources in the city police said given that the scrapping of Section 309 is a matter of time, they have stopped registering cases against the survivors.
Now that no cases are booked against the person who attempts suicide most of the time, counselling and psychiatric therapy is not given to the survivors as psychiatric evaluation for pursuing prosecution is not necessary. The result: in the absence of psychiatric help, most survivors sink further into depression, a condition where another attempt at suicide is eminently possible.
"We needed to decriminalize suicides to do away with punishment and imprisonment but not to keep psychiatrists away from the scene. Earlier, we would counsel the survivor and boost self-esteem, self-confidence and help the person overcome depression. Based on the psychiatrist's note, police would take cognizance of the case. This is now missing and setting a bad trend," says Dr Vaijayanthi Subramanian, psychiatrist at MS Ramaiah Hospital.
The problem is acute, especially in neighbourhood private nursing homes and smaller hospitals where suicide survivors are rushed. For the past year, most private nursing homes have not renewed contracts with psychiatrists whom they so far required in treating suicide survivors' cases for legal clearances. "There is a stigma involved in taking psychiatric help. If the law does not mandate it, middle and upper middle class families hardly come out seeking help," she adds.
Agreeing with her, Dr Mahesh Gowda, psychiatrist and founder of Spandana, said, "Decriminalization of suicide is one of the most debatable issues. Though the objective was to bail out survivors from criminal interrogation and psychological trauma during trial, it has, sadly, deprived them of psychiatric help too. Suicides should not be seen as an alternative to get justice, as we now see in the recent suicide attempts by government officers. The glorification of suicide will only lead to a rise in the number of such attempts. There should be a deterrent, and not spur suicides," says Dr Gowda, who is also president of the Indian Psychiatric Society, Karnataka chapter.
Dr Gowda said he sees a minimum of 10 cases of suicide survivors every month.
Help in Victoria Hospital
The scene is not the same in the government-run Victoria Hospital's burns ward, which gets a large number of suicide attempt cases. "Post decriminalization of suicides, there is no penalty clause. But we consider each such case a medico-legal case. In-house psychiatrists and women activists from NGOs constantly counsel the survivors. Of 180-200 burns cases we see every month, over 60% are suicide attempts. Cases are booked as they are usually linked to domestic violence or other such matters," says Dr Ramesha KT, HoD of the burns ward.
Family needs counselling too
A suicide attempt is a culmination of many aspects, and hence counselling is a must not just for the suicide survivor but also for the entire family, points out Dr Bhupendra Chaudhry, consultant psychiatrist at Manipal Hospitals."When such cases come in, we ensure the patient and family meet up with a psychiatrist. Most of the corporate hospitals practise this. Suicide attempts are not singular, survivors try more than once to end life with the same helplessness and manipulation. Unless they are treated at the right time, such cases will only increase," he says.