The law surrounding depression and suicide

The recent death of Bollywood actor Sushant Singh Rajput, who allegedly committed suicide on 14th June 2020, has left the country in shock and has once again started the discussion on the much-subsided topic of the importance of mental health. As per sources, the actor was battling depression. This article focuses on the law surrounding mental illness and suicide.

As compared to earlier times, the rate of suicidal deaths are increasing every year in the country and majority of suicides are being committed by the youth of the country. Depression is a leading cause for the commission of suicide. In recent years the number of patients suffering from depression has also increased resulting in an increase in suicidal deaths. In India, an attempt to commit suicide was a punishable offence under Indian Penal Code, 1860 however the Mental Healthcare Act 2017 stresses the aspect of mental illness behind the commission or an attempt to commit suicide and raises the presumption of severe stress in case of attempt to commit suicide.

In 1946 the Constitution of the World Health organization (WHO) recognized that the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition. Later, the International Covenant on Economic, Social and Cultural Rights, by Article 12 stated that the States Parties to the present Covenant recognize the right of everyone to the enjoyment of the highest attainable standard of physical and mental health. Not only physical but mental health has also been given importance at international level.

I. Depression is a mental illness:

Mental illness is present at the time of suicide 27% to more than 90% of the time.[1] Half of all people who die by suicide may have major depressive disorder; having this or one of the other mood disorders such as bipolar disorder increases the risk of suicide 20-fold.[2]

Dr. Ranna Parekh in her article on depression defines depression as 'Depression (major depressive disorder) is a common and serious medical illness that negatively affects how you feel, the way you think and how you act. Depression causes feelings of sadness and/or a loss of interest in activities once enjoyed. It can lead to a variety of emotional and physical problems and can decrease a person’s ability to function at work and at home.'[3] Depression is a mental illness however it also has an adverse effect on the physical and emotional health of a person.

Mental illness is defined in section 2(s) of Mental Healthcare Act 2017 - 'mental illness' means a substantial disorder of thinking, mood, perception, orientation or memory that grossly impairs judgment, behaviour, capacity to recognise reality or ability to meet the ordinary demands of life, mental conditions associated with the abuse of alcohol and drugs, but does not include mental retardation which is a condition of arrested or incomplete development of mind of a person, specially characterised by subnormality of intelligence.[4]

The understanding of depression as a mental illness is not yet much developed in India. Depression is understood as being emotionally sensitive rather than being mentally ill. The emotional and physical effect that depression has on a person is not yet understood widely in our country. Due to lack of understanding of depression as a mental illness many people do not seek medical help as they think they are not suffering from any disease. Little do they know that depression is a serious medical illness which might even cause a person to take his own life. Depression leads to a loss of interest in life which may cause a person to commit suicide.

II. Suicide

Every year close to 800,000 people take their own life and there are many more people who attempt suicide. Every suicide is a tragedy that affects families, communities and entire countries and has long-lasting effects on the people left behind. Suicide occurs throughout the lifespan and was the second leading cause of death among 15-29 year-olds globally in 2016.[5]

Suicide is the act of intentionally causing one's own death.[6] Mental disorders, including depression, bipolar disorder, autism, schizophrenia, personality disorders, anxiety disorders, and substance abuse including alcoholism and the use of benzodiazepines are risk factors.[7] Some suicides are impulsive acts due to stress, such as from financial difficulties, relationship problems such as breakups, or bullying.[8] Approximately 1.5% of people die by suicide.[9]

Commenting on the reasons for committing suicide the Andhra High Court observed 'There may be so many reasons for committing suicide. It may be an act of a sickly person, committed in a of state delirium. It may be a self-centered phenomenon, arising out of aberrations in individual behaviour. It can be the result of a social mala adjustment. After all a man's mental stability is conditioned by the changing developments around him and the social millieu is destined to leave its impact on man especially when he has to struggle for his survival. It may be committed due to some of the proximate problems prior to suicide family dissensions, incurable ailments and guilt complex. There may be many who are prone to egoistic tendencies and they cherish their individualism as sacrosanct, the fell dejected. Their will to live and struggle to survive wane quickly. High individualism may lead to suicide. Sometimes a person kills himself an a gesture of sacrifice. "Sati" in India had 'Harakiri' in Japan are well Known. In primitive societies, men of old age embraced death so that they were not a burden to society. In case there is nothing to look forward to with hope and nothing to look back with satisfaction. If the society imposes regulation on individuals and when these check valves weaken, the individuals become nameless and anonymous entities and let themselves go without restraint only to land in the pit of dejection and depression. Sometime fatalism leads to suicide when there is no escape from discipline and regimentation people may resort to suicide. Many problems like poverty, deprivation, disappointment and several social mal-adjustments are sought to be solved by suicide.'[10]

Mentally ill persons may not exhibit symptoms of their illness in some cases but the mentally depressed persons are choosing their own ways to commit suicide. Their disordered mind is searching its own fruitful ways. According to them the horrible sound of the train is a sweet melody and the flame of the fire may be an inspiration.[11]

Not only abetment to suicide but attempt to commit suicide was also a punishable offence under Indian Penal Code.

III. Law Surrounding mental illness and suicide

3.1 View of Supreme Court and High Courts on law of suicide (section 309)

Abetment to commit suicide is a punishable offence under section 306 of Indian Penal Code (IPC). In addition to this, attempt to commit suicide was also a punishable offence under section 309 of IPC before 2014. Section 309 of IPC reads as under:

'309. Attempt to commit suicide - Whoever attempts to commit suicide and does any act towards the commission of such offence, shall he punished with simple imprisonment for a term which may extend to one year or with fine, or with both.'

Hon’ble Mr. Justice R.Basant of Kerela High Court had observed 'Whether Section 309 I.P.C. can at all be an offence has been the subject matter of discussion by the Constitutional Courts on many occasions. In theology, in morality and in law, suicide has always been reckoned as impermissible whatever be the justification for such perception. The law does not, of course, make commission of suicide punishable. Commission of suicide is not made punishable not because the commission of suicide is not culpable, but because the person culpably responsible would have departed from this world before he can face any indictment.'[12]

The Law Commission in its Forty Second Report had examined whether attempt to commit suicide be retained as a penal offence. The Commission referred to the Dharma Sastras which legitimized the practice of taking one’s life in certain situations and also referred to the provisions of Suicide Act, 1961 in Britain which decriminalized the offence of attempt to commit suicide. After examining these views, the Commission recommended that section 309 is harsh and unjustifiable and it should be repealed.[13]

Hon’ble Mr. Justice Rajinder Sachar commented on the punishment for attempt to suicide as 'It is ironic that Section 309 Indian Penal Code still continues to be on our Penal Code. The result is that a young boy driven to such frustration so as to seek one's own life would have escaped human punishment if he had succeeded but is to be bounded by the police, because attempt has failed. Strange paradox that in the age of votaries of Euthanasia, suicide should be criminally punishable. Instead of the society hanging its head in shame that there should be such social strains that a young man (the hope of tomorrow, should be driven to suicide compounds its inadequacy by treating the boy as a criminal. Instead of sending the young boy to psychiatric clinic it gleefully sends him to mingle with criminals, as if trying its best to see that in future he does fall foul of the punitive sections of the Penal Code. The continuance of Section 309 Indian Penal Code is an anachronism unworthy of a humane society like ours. Medical clinics for such social misfits certainly but police and prison never. The very idea is revolting.'[14]

With regards to the constitutional validity of section 309 of IPC the Bombay High Court tested whether section 309 passed the test of Articles 14,19 and 21 of constitution. With respect to Article 19 and 21 the Court held 'The fundamental rights enumerated in Art. 19 are only extensions of the right to life and have no meaning without it. Essentially therefore we have to examine the precise contents of Art. 21….There is nothing unnatural about the desire to die and hence with the right to die. Whatever the circumstances which induce a person to end or terminate his or her life, the act of termination of life is the act of that individual. It is no less his than his act of living.'[15] With respect to Article 14 the Court held 'What may be considered suicide in one community may not be considered so in another community and the different acts, though suicidal, may be described differently in different circumstances and at different times in the same community as we have seen earlier. While some suicides are eulogised, others are condemned. That is why perhaps wisely no attempts has been made by the legislature to define either. But the difficulty in providing a plausible definition cannot certainly be pressed in favour of the validity of the provision particularly when it is penal. The want of plausible definition and even of guidelines to distinguish the felonious from the non-felonious act itself therefore makes the provisions of S. 309 arbitrary and violative of Art. 14. As is rightly said arbitrariness and equality are enemies of each other.'[16] The Bombay High Court in this case held Section 309 of IPC to be unconstitutional.

In the case of Chenna Jagadeeswar v. State of Andhra Pradesh (supra) the Andhra High Court upheld the validity of Section 309 of IPC and observed that 'From these Articles, it is seen that the right to life is not specifically mentioned. But, in a broader sense, unless a man is assured of physical existence there can be no other fundamental right and since the State exists for the common good of the citizens, no Constitution can ignore the right of the citizens to life though it may not be explicitly explained. In these circumstances, it is rather difficult to hold that the right to life impliedly guaranteed by the Constitution includes the right to die.'[17]

The Supreme Court tested the constitutional validity of section 309 in the case of P.Rathinam vs. Union of India and held that 'On the basis of what has been held and noted above, we state that section 309 of the Penal Code deserves to be effaced from the statute book to humanize our penal laws. It is a cruel and irrational provision, and it may result in punishing a person again (doubly) who has suffered agony and would be undergoing ignominy because of his failure to commit suicide. Then an act of suicide cannot be said to be against religion, 26 morality or public policy and an act of attempted suicide has no baneful effect on society. Further, suicide or attempt to commit it causes no harm to others, because of which State’s interference with the personal liberty of the persons concerned is not called for. We, therefore, hold that section 309 violates Article 21, and so, it is void. May it be said that the view taken by us would advance not only the cause of humanization, which is a need of the day, but of globalization also, as by effacing section 309, we would be attuning this part of criminal law to the global wavelength.'[18]

However, the decision of the Supreme Court in P.Rathinam case was overruled by a larger bench in the case of Smt. Gian Kaur v. State of Punjab where the Court held 'To give meaning and content to the word ‘life’ in Article 21, it has been construed as life with human dignity. Any aspect of life which makes it dignified may be read into it but not that which extinguishes it and is, therefore, inconsistent with the continued existence of life resulting in effacing the right itself. The ‘right to die’, if any, is inherently inconsistent with the ‘right to life’ as is ‘death with life.'[19] The Court upheld the constitutional validity of section 309 of IPC and observed that right to life does not include right to die.

3.2 210th Report of Law Commission of India:

210th report of Law Commission of India is titled 'Humanization and Decriminalization of Attempt to Suicide'. The report studies the statistics relating to suicidal deaths in India, the interpretation of section 306 and 309 of IPC as well as the problems that are faced due to criminalization of attempt to suicide.

The report highlights the following problems caused due to criminalization of attempt to suicide:

'1. Emergency treatment for those who have attempted suicide is not readily accessible as they are referred by local hospitals and doctors to tertiary centres as it is termed as Medico Legal case. The time lost in the golden hour will save many lives.

2. Those who attempt suicide are already distressed and in psychological pain and for them to face the ignominy of police interrogation causes increased distress, shame, guilt and further suicide attempt.

3. At the time of family turmoil dealing with police procedure adds to the woes of the family.

4. It also leads to a gross under-reporting of attempted suicide and the magnitude of the problem is not unknown. Unless one is aware of the nature of extent of the problem effective intervention is not possible.

5. As many attempted suicides are categorized in the guise of accidental poisoning etc. emotional and mental health support is not available to those who have attempted as they are unable to access the services.'[20]

The Law Commission report also mentioned that the President of the International Association for Suicide Prevention, France, has, vide his letter of 9 October 2007 addressed to Hon’ble Minister of Law and Justice, Government of India, strongly supported withdrawal of the status of attempted suicide as a punishable offence. The report states, 'He has stated that most countries in the world who have had laws criminalizing attempted suicide have withdrawn those laws in the second half of the twentieth century, justifying the withdrawal by the belief that attempting suicide is not a crime that should be punished but rather a desperate reaction to a difficult life situation by people who usually suffer from a mental disorder. These changes have indicated awareness that suicidal individuals need to be helped and imprisonment only makes their problem worse. One of the fears expressed when all countries in Europe and North America decriminalized attempted suicide was that suicide rates may increase. There are no indications whatsoever that there was an increase in suicides following decriminalization, and in many instances it is thought that suicide decreased since more suicidal individuals received the help they need… The International Association for Suicide Prevention wishes India to join the countries of the world, who have decriminalized attempted suicide in order to clearly communicate to suicidal individuals that they should seek help, rather than avoid admitting to their problems for fear of imprisonment'[21]

The Commission recommended repeal of Section 309 of IPC as follows:

'5.3 Section 309 of the Indian Penal Code provides double punishment for a person who has already got fed up with his own life and desires to end it. Section 309 is also a stumbling block in prevention of suicides and improving the access of medical care to those who have attempted suicide. It is unreasonable to inflict punishment upon a person who on account of family discord, destitution, loss of a dear relation or other cause of a like nature overcomes the instinct of self-preservation and decides to take his own life. In such a case, the unfortunate person deserves sympathy, counselling and appropriate treatment, and certainly not the prison.

5.4 Section 309 needs to be effaced from the statute book because the provision is inhuman, irrespective of whether it is constitutional or unconstitutional. The repeal of the anachronistic law contained in section 309 of the Indian Penal Code would save many lives and relieve the distressed of his suffering.

5.5 The Commission is of the view that while assisting or encouraging another person to (attempt to) commit suicide must not go unpunished, the offence of attempt to commit suicide under section 309 needs to be omitted from the Indian Penal Code.'[22]

3.3 De-criminalization of attempt to suicide:

On the basis of the recommendation of Law Commission in its 210th report, in December 2014 the Rajya Sabha after claiming support of 18 states and 4 Union Territories decided to repeal Section 309 from the Indian Penal Code.

While attempt to commit suicide is decriminalized, abetment to commit suicide still remains punishable under section 306 of IPC.

3.4 Law relating to mental illness:

Mental Healthcare Act 2017 was enacted to provide for mental healthcare and services for persons with mental illness and to protect, promote and fulfil the rights of such persons during delivery of mental healthcare and services and for matters connected therewith or incidental thereto. The Act defines mental illness. The Act provides that a patient of mental illness may nominate a representative of his choice who shall consider the current and past wishes, the life history, values, cultural background and the best interests of the person with mental illness; provide support to the person with mental illness in making treatment decisions; be involved in discharge planning and perform such other duties as are specified under the Act.[23]

The Act also provides various rights of persons with mental illness such as:

(1) Right to access mental healthcare[24]

(2) Right to community living[25]

(3) Right to protection from cruel, inhuman and degrading treatment[26]

(4) Right to equality and non- discrimination[27]

(5) Right to information[28]

(6) Right to confidentiality[29]

(7) Restriction on release of information in respect of mental illness[30]

(8) Right to access medical records[31]

(9) Right to personal contacts and communication[32]

(10) Right to legal aid[33]

(11) Right to make complaints about deficiencies in provision of services[34]

The Act also casts a duty upon the Government to plan, design and implement programmes for the promotion of mental health and prevention of mental illness in the country and, in particular, plan, design and implement public health programmes to reduce suicides and attempted suicides in the country.[35] The Act also imposes a duty on the Government to create awareness about mental health and illness and reduce stigma associated with mental illness.[36]

The Act also provides for the establishment of an authority to deal with applications and complaints by persons with mental illness.

3.5 Presumption in case of attempt to commit suicide:

Section 115 of the Act provides a presumption in case of attempt to commit suicide as follows:

'(1) Notwithstanding anything contained in section 309 of the Indian Penal Code any person who attempts to commit suicide shall be presumed, unless proved otherwise, to have severe stress and shall not be tried and punished under the said Code.

(2) The appropriate Government shall have a duty to provide care, treatment and rehabilitation to a person, having severe stress and who attempted to commit suicide, to reduce the risk of recurrence of attempt to commit suicide.'[37]

It is the duty of the Government to provide adequate facilities and treatment to the person who attempts to commit suicide in order to rehabilitate him.

IV. CONCLUSION

The attempt to commit suicide is no longer an offence but a provision is made in the Mental Healthcare Act to presume that the person attempting suicide is under severe stress and casts a duty upon the Government to provide care, treatment and rehabilitation to a person, having severe stress and who attempted to commit suicide, to reduce the risk of recurrence of attempt to commit suicide. The abetment to commit suicide continues to remain an offence under IPC.

With the increasing problems of mental health in the youth these days, it is essential that mental health education should also be made a part of the academic curriculum in schools and colleges and there should also be counsels appointed so that the students can talk and proper advice can be given to them. There should also be meetings of people suffering from mental illness such as depression so that they can talk out their feelings and when they listen to the problems or feelings of other patients they may get a sense of hope and might be cured.

There are also various helplines setup by NGOs and Government so that the people who have suicidal thoughts may call on those helplines and seek mental and emotional help rather than succumbing to their suicidal urge.

Mental illness and suicide go hand in hand and with the increase in suicidal deaths and mental illness patients it is essential that steps must be taken so as to prevent the people from falling prey to such evils.

REFERENCES:

[1] University of Manchester Centre for Mental Health and Risk, "The National Confidential Inquiry into Suicide and Homicide by People with Mental Illness", July 2012

https://web.archive.org/web/20120714134607/http://www.medicine.manchester.ac.uk/cmhr/centreforsuicideprevention/nci/reports/annual_report_2012.pdf

[2] Kutcher S, Chehil S (2012), Suicide Risk Management A Manual for Health Professionals (2nd ed.), pp. 30–33, ISBN 978-1-119-95311-1

[3] What is depression? Physician Review by Dr. Ranna Parekh, January 2017

URL: https://www.psychiatry.org/patients-families/depression/what-is-depression

[4] Section 2(s) of Mental Healthcare Act 2017

[5] "Suicide Fact sheet N°398', WHO, April 2016

URL: https://www.who.int/en/news-room/fact-sheets/detail/suicide

[6] Stedman's Medical Dictionary (28th ed.) 2006, ISBN 978-0-7817-3390-8

[7] Hawton K, van Heeringen K (April 2009), 'Suicide", Lancet. 373 (9672): 1372–81

URL:https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60372-X/fulltext

[8] Ibid.

[9] Fazel S, Runeson B, "Suicide", New England Journal of Medicine, January 2020, 382 (3): 266–74

URL: https://www.nejm.org/doi/10.1056/NEJMra1902944

[10] Chenna Jagadeeswar And Anr. vs State Of Andhra Pradesh, (1983) Crl. Law Journal 549

URL: https://indiankanoon.org/doc/66070774/

[11] Benoy vs. Aleyamma Kuriakose, 11th August 2010, Kerala State Consumer Disputes Redressal Commission

URL: https://indiankanoon.org/doc/194839039/

[12] Berin P.Varghese vs State Of Kerala, [1971] 27 S.T.C. 459

URL: https://indiankanoon.org/doc/1652338/

[13] Humanization and Decriminalization of Attempt to Suicide; Law Commission of India; Report No. 210; October 2008

URL: http://lawcommissionofindia.nic.in/reports/report210.pdf

[14] State vs Sanjay Kumar Bhatia, 1986 (10) DRJ 31

URL: https://indiankanoon.org/doc/1253283/

[15] Maruti Shripati Dubal vs State Of Maharashtra, (1986) 88 BOMLR 589

URL: https://indiankanoon.org/doc/490515/

[16] Supra

[17] Supra

[18] P.Rathinam vs Union Of India, 1994 SCC (3) 394

URL: https://indiankanoon.org/doc/542988/

[19] Smt. Gian Kaur vs The State Of Punjab, 1996 SCC (2) 648

URL: https://indiankanoon.org/doc/217501/

[20] Humanization and Decriminalization of Attempt to Suicide; Law Commission of India; Report No. 210; October 2008

URL: http://lawcommissionofindia.nic.in/reports/report210.pdf

[21] Supra

[22] Supra

[23] Section 17 of Mental Healthcare Act 2017.

[24] Section 18 of Mental Healthcare Act 2017

[25] Section 19 of Mental Healthcare Act 2017

[26] Section 20 of Mental Healthcare Act 2017

[27] Section 21 of Mental Healthcare Act 2017

[28] Section 22 of Mental Healthcare Act 2017

[29] Section 23 of Mental Healthcare Act 2017

[30] Section 24 of Mental Healthcare Act 2017

[31] Section 25 of Mental Healthcare Act 2017

[32] Section 26 of Mental Healthcare Act 2017

[33] Section 27 of Mental Healthcare Act 2017

[34] Section 28 of Mental Healthcare Act 2017

[35] Section 29 of Mental Healthcare Act 2017

[36] Section 30 of Mental Healthcare Act 2017

[37] Section 115 of Mental Healthcare Act 2017

[1] University of Manchester Centre for Mental Health and Risk, "The National Confidential Inquiry into Suicide and Homicide by People with Mental Illness", July 2012

https://web.archive.org/web/20120714134607/http://www.medicine.manchester.ac.uk/cmhr/centreforsuicideprevention/nci/reports/annual_report_2012.pdf

[2] Kutcher S, Chehil S (2012), Suicide Risk Management A Manual for Health Professionals (2nd ed.), pp. 30–33, ISBN 978-1-119-95311-1

[3]What is depression? Physician Review by Dr. Ranna Parekh, January 2017

https://www.psychiatry.org/patients-families/depression/what-is-depression

[4] Section 2(s) of Mental Healthcare Act 2017

[5] "Suicide Fact sheet N°398', WHO, April 2016

URL: https://www.who.int/en/news-room/fact-sheets/detail/suicide

[6] Stedman's Medical Dictionary (28th ed.) 2006, ISBN 978-0-7817-3390-8

[7] Hawton K, van Heeringen K (April 2009), 'Suicide", Lancet. 373 (9672): 1372–81

URL: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60372-X/fulltext

[8] Ibid.

[9] Fazel S, Runeson B, "Suicide", New England Journal of Medicine, January 2020, 382 (3): 266–74

URL: https://www.nejm.org/doi/10.1056/NEJMra1902944

[10] Chenna Jagadeeswar And Anr. vs State Of Andhra Pradesh, (1983) Crl. Law Journal 549

URL: https://indiankanoon.org/doc/66070774/

[11] Benoy vs. Aleyamma Kuriakose, 11th August 2010, Kerala State Consumer Disputes Redressal Commission

URL: https://indiankanoon.org/doc/194839039/

[12] Berin P.Varghese vs State Of Kerala, [1971] 27 S.T.C. 459

URL: https://indiankanoon.org/doc/1652338/

[13] Humanization and Decriminalization of Attempt to Suicide; Law Commission of India; Report No. 210; October 2008

URL: http://lawcommissionofindia.nic.in/reports/report210.pdf

[14] State vs Sanjay Kumar Bhatia, 1986 (10) DRJ 31

URL: https://indiankanoon.org/doc/1253283/

[15] Maruti Shripati Dubal vs State Of Maharashtra, (1986) 88 BOMLR 589

URL: https://indiankanoon.org/doc/490515/

[16] Supra

[17] Supra

[18] P.Rathinam vs Union Of India, 1994 SCC (3) 394

URL: https://indiankanoon.org/doc/542988/

[19] Smt. Gian Kaur vs The State Of Punjab, 1996 SCC (2) 648

URL: https://indiankanoon.org/doc/217501/

[20] Humanization and Decriminalization of Attempt to Suicide; Law Commission of India; Report No. 210; October 2008

URL: http://lawcommissionofindia.nic.in/reports/report210.pdf

[21] Supra

[22] Supra

[23] Section 17 of Mental Healthcare Act 2017.

[24] Section 18 of Mental Healthcare Act 2017

[25] Section 19 of Mental Healthcare Act 2017

[26] Section 20 of Mental Healthcare Act 2017

[27] Section 21 of Mental Healthcare Act 2017

[28] Section 22 of Mental Healthcare Act 2017

[29] Section 23 of Mental Healthcare Act 2017

[30] Section 24 of Mental Healthcare Act 2017

[31] Section 25 of Mental Healthcare Act 2017

[32] Section 26 of Mental Healthcare Act 2017

[33] Section 27 of Mental Healthcare Act 2017

[34] Section 28 of Mental Healthcare Act 2017

[35] Section 29 of Mental Healthcare Act 2017

[36] Section 30 of Mental Healthcare Act 2017

[37] Section 115 of Mental Healthcare Act 2017