Responding to Malaysia Decriminalising Suicide Attempts

By Puan Anita Abu Bakar, Founder & President of Mental Illness Awareness & Support Association

We applaud the government for decriminalising suicide attempts and for its efforts to make amendments to the Mental Health Act 2023. The Mental Health Act lacks the language of human rights and input from people with lived experience, resulting in a law that does not fully and rightly protect the rights and dignity of people with mental health conditions. Following the recent amendment to the Mental Health Act, we are concerned that people in crisis situations will continue to be forcibly detained and restrained in violation of their human rights and will not be supported with empathy, care, and compassion. These individuals are not criminals, but people who are in deep crisis and need help, treatment and support.

As a mental health organisation that advocates for a rights-based approach to the treatment, support, and recovery of those struggling with mental health challenges, we strongly urge that the rights of people in crisis must be respected. The crisis interventionist must be trained to assess the situation with care and compassion and to empathise with the needs of the individual by understanding the circumstances that lead the person to consider self-harm or suicide attempts. The officer handling the situation needs to understand that the goal is to help and support the person in crisis and keep them safe for now (term coined in the suicide intervention training), not to simply arrest them or detain them to a psychiatric hospital.

These long-standing misperceptions and actions do extreme harm, exacerbate the person in crisis, further weaken them, rob them of their recovery, and keep them silent. These people are unwell, whether they are struggling with suicidal thoughts that are extremely complex or struggling with mental health conditions that can be extremely debilitating and painful, especially if treatment, help and support are not offered, not to mention the prejudice that comes with it. 

There is specialised training available to help one know what can be done when it comes to suicide intervention, prevention, or suicide first aid. We strongly recommend that all potential crisis intervention officers undergo this training to better equip themselves so that they can handle suicide attempt crises with care and compassion. 

Continuous measures: 

  • Deep learning and public discourse in mental health must happen continuously in all settings to normalise tough topics and conversations and spur action and change. 
  • Education and information are key to advocating for mental health issues in Malaysia. Law enforcers, welfare officers, teachers, and even neighbours and families should be given information about mental health, the importance of mental health well-being, and the harmfulness of stigma. All of us should be equipped with the knowledge of how to support or help someone struggling with mental health issues or going through mental health conditions. It is not a taboo subject or something to be feared; it is something that could happen to anyone and affect our lives. 
  • There are so many trainings and seminars on mental health available now: Mental Health First Aid (MHFA), Applied Suicide Intervention Skills Training (ASIST), as well as other general talks and workshops on mental health-related topics. So, everyone can play a part in making Malaysia a better place for mental health peers by being inclusive and respectful. 
  • We must continuously strengthen, expand, and develop community support services. Recovery is in the community, and this must be provided to ensure effective recovery happens for everyone. It is not success if only some people are allowed to excel; everyone must be given the opportunity to thrive. 
  • We must invest in and prioritise mental health. With only 1+ percent of our health budget being invested in mental health every single year, it is surely inadequate to support recovery and preparedness for those needing help in the community, with the bulk of the funds still being given to the large four psychiatric hospitals housing the more severe mental health conditions, which only accounts for about 1% of those struggling, where 99% of those in the community with more common conditions are under-treated and underserved. 
  • We must leverage our primary care network, which can provide tremendous help to those struggling in the community with mental health issues, to prevent these from developing into mental health conditions. Educating our community on a healthier way of living means changing their lifestyle, including sleep habits and the importance of sleep, exercising, eating well, investing in hobbies, social connectedness, and learning effective coping mechanisms, including deep breathing exercises, relaxation techniques, and grounding, which can help tremendously when faced with stress, anxiety, and more. 
  • We should empower the community to help and implement task shifting, which can ease the burden of the health system, and to realise that not everyone who is struggling needs clinical intervention. Just by them talking to someone and knowing what to do and how to manage their challenges during difficult times, it can go a long way. At MIASA, through our own experience running our 24/7 crisis helpline manned by our crisis team, we see how just talking to someone can provide tremendous help and relief to a person in crisis. 

There is nothing shameful about talking about mental health or admitting to having a mental health condition, but we need a supportive and inclusive community to enable mental health peers to feel safe and accepted. All of us need to get out of our comfort zone and care about mental health; all of us need to seek the right and sound information on mental health; all of us need to be empathetic and compassionate, not judging or criticising. 

Ultimately, we must understand that mental health isn’t merely a healthcare issue; it is a social justice issue; hence, much work needs to be done with systemic change for things to improve and more positive recovery outcomes to be seen. Individuals with mental health conditions must be given the same opportunities and rights as everyone else, be it in employment, support for housing, spaces for recreational activities, or the liberty to live among the community (friends, families, and neighbours), given their rights, choices, and freedom to do so. 

We need to start now and intentionally build a generation that is truly inclusive and free from stigma, discrimination, injustices, and human rights violations and abuses.