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There was a gathering of villagers in front of the house of Purnima Ram. This 50 year old woman lived in the house with her two sons after her husband's death. A resident of a remote village in south India, Ram had depression, the BMJ was told by a rural doctor. "It was her third attempt, she attempted suicide two times before," said a villager, adding, "At last she could kill herself by consuming pesticide."
People such as Ram are looked on with pity but rarely can they find affordable mental health services to help with their disease. More importantly, those who attempt suicide are treated as criminals, according to section 309 of Indian penal code (IPC), which came into force in British India in 1860. 1 It says, "Whoever attempts to commit suicide and does any act towards the commission of such offence, shall be punished with simple imprisonment for a term which may extend to one year [or with fine, or with both]." 1
Decriminalisation
Suicide has long been decriminalised in developed nations such as the United Kingdom, and now activists and psychiatrists in India who have urged for decriminalisation have had their calls answered.
In an attempt to reform mental healthcare, in August the government introduced the Mental Healthcare Bill 2013 in parliament. 2 The bill, for the first time in India's history, will establish access to affordable and quality mental healthcare as a right for all and, at the same time, decriminalises suicide. 3
Section 124 of the bill says, "Notwithstanding anything contained in Section 309 of the IPC, any person who attempts suicide shall be presumed, unless proved otherwise, to be suffering from mental illness at the time of the bid and shall not be liable to punishment under the said sections." 3 The bill also mandates that "the appropriate Government shall have a duty to provide care, treatment and rehabilitation to a person, having mental illness and who attempted to commit suicide, to reduce the risk of recurrence of attempt to commit suicide." 3 Once parliament passes it, which is likely soon, and it is granted assent by the president of India, the bill will replace the Mental Health Act of 1987. 4
How many suicides?
The government's move...