Whenever there are discussions on human rights, how many people are advocating for the human right to suicide prevention?
Every day, people in a suicidal crisis need immediate, compassionate and effective help. Those of us working on telephone crisis lines and online services worldwide know this. We receive their calls and contacts. We know immediate response changes situations and saves lives.
How many of us, though, have joined the dots to see that providing immediate crisis support is upholding a human right? Do we acknowledge crisis support as an essential emergency service that should be available to all?
In 1966, the UN Human Rights Committee affirmed “the right of everyone to the enjoyment of the highest attainable standard of physical and mental health” in Article 12 of the International Covenant on Economic Social and Cultural Rights. In 2019, it upheld the right of individuals to be free from acts or omissions that may be expected to cause unnatural or premature death.
The Human Rights Committee then explicitly mentioned suicide prevention: “… States should take adequate measures, without violating their other Covenant obligations, to prevent suicides, especially among individuals in particularly vulnerable situations.”
So, the right to suicide prevention could be expressed as the right to be protected from the factors in one’s life — and that affect one’s mental health and well-being — that could foster suicidal thoughts and lead to a person’s premature and preventable death by suicide.
How can the right to prevent suicide be addressed? How does this translate into policies and what actions might be suited to a human rights approach so people are protected from suicide?
One country that has set an example is Japan, sadly because of the large numbers of people who have died by suicide in the past two decades, prompting national attention.
Japan’s national legislation has created the priority and policy mandate for resources and programs, known as countermeasures to suicide, which are required to be enacted at local levels. The suicide rate in Japan reduced from 24.9 to 15.3 per 100,000 in the space of a decade, though the number of youth dying by suicide is on the rise.
Nations with fewer resources are also embracing the human right to prevent suicide, including Indonesia. Last year, the nation passed national laws for the prevention of suicide. These laws will require government, public officials and society at large to act to prevent suicide. A national suicide prevention strategy is being adopted to inform this action.
The law and human rights are always closely interrelated. One key change that will uphold the human right to protection from suicide is the decriminalization of suicide and suicide attempts. In a study LifeLine International and the International Bar Association conducted last year, 25 countries were found to have laws to this effect in place and a further 27 countries were found to have ambiguous or confusing legal frameworks on suicide.
International studies covering more than 100 countries and over 20 years of statistical data have established that suicide rates are generally higher in those countries where suicide is criminalized and that when reductions in suicide occur, they occur less in those countries. In other words, whatever the intentions, laws that criminalize suicide do not prevent suicide. They are laws that frustrate the achievement of a human right to be free of suicide.
There is a humanitarian level of action required as well in the prevention of suicide. This is because human suffering is the foundation of a person’s despair and distress to such a degree that they find more reasons for dying than they can find for living. Mental health conditions may feature, creating symptoms that are unbearable. Socio-economic factors, including financial struggles, family relationship difficulties and experiences of personal violence and discrimination, also surround suicidal behavior.
The prevention of suicide must alleviate a person’s suffering. It seems reasonable then for every country to have in place a service response that is easy to reach and widely recognized in local communities, so a person experiencing a suicidal crisis is not left alone but is able to find human connection and support when they need it most. The design of national health systems should include such a service as an essential service, just as national health systems include ambulance and emergency services.
One countermeasure that seems reasonable for every country to have in place is a universal service response that is affordable, easy to use and widely known, so a person experiencing a suicidal crisis is not left alone but is able to find human connection and support when they need it most. The United States 988 service is built on this objective where people can call, chat or text with a trained crisis counselor. The concept is beyond just an easy-to-remember number, fostering parity between the corresponding response for a medical emergency, with 988, mobile crisis and crisis care as the sister system to 911, ambulance and emergency medical care.
As US states expand their 988 crisis care, one of the largest challenges is funding and ensuring people are aware that the service exists, making marketing a critical part of 988’s success.
For over 70 years, crisis support services for suicide prevention have been established in most countries and it is now estimated that they exist in 135 countries worldwide. They are known as helplines, hotlines, crisis lines or more recently as crisis chat, crisis text. These are crisis support services, an immediate form of crisis intervention, psychosocial support combined with a befriending interaction based on values of acceptance, compassion and empathy. They have names like Lifeline, Samaritans, Befrienders, Telephone Emergency Services and Emotional Support Services. There is even a global crisis support service for people on ships traversing the oceans, operated through Befrienders Worldwide.
Crisis support services form a basic, primary health service response for suicide prevention throughout the world. Some services are well-resourced and can respond to people quickly; other services are under-resourced and can’t meet the demand.
Ensuring that everyone has access to the support, care and resources they need to address mental health challenges and prevent suicide is linked to suicide prevention being a human right. Access to quality suicide prevention and crisis support services is critical in protecting individuals from harm and preserving their dignity and right to suicide prevention.
Earlier this year, the five organizations representing most of the world’s crisis support services issued a joint statement calling for these services to be regarded as essential in every country’s health system. This statement has been made because of the imperative of upholding every person’s right to be protected from death by suicide.
Governments, organizations and communities have a responsibility to promote and safeguard mental health, offer resources such as counseling, helplines and emergency services and work to reduce the stigma surrounding suicide prevention. Ensuring that suicide prevention is part of the broader conversation about human rights helps reinforce the need for compassion, support and understanding for those struggling with suicidal thoughts.
