Criminalization of Suicide and Suicide Rates in the World

Background: In the last half of the 20th century, many countries have already abolished anti-suicide laws; however, more than 20 countries still adopt them. This paper is the first to systematically explore the association between criminalization of suicide and national suicide rates in 174 countries/regions to examine the deterring effects of the anti-suicide laws. Methods: In 2012, 23 countries were identified to carry anti-suicide laws. A Negative Binominal Model was adopted to explore the association between national suicide rates and criminalization of suicide in the world in 2012, having controlled for the Human Development Index (“HDI”), size of Muslim population, and the national unemployment rate. Stratified analyses based on sex, size of the Muslim population and the HDI were performed to explore whether the anti-suicide laws had differential impact on different subgroups. Findings: Strong association was found in females (β estimate=0.51, P<0·0001) connecting criminalization of suicide and higher national suicide rates (β estimate= 0.36, P<0·001). Women in non-Muslim countries and countries with lower HDI were particularly affected by the anti-suicide laws. Suicide rates in men in lower HDI countries with anti-suicide laws were also found to have higher suicide rates compared to the countries without those laws. Nonetheless, negative impact of such laws on suicide rates was not found in Muslim countries and higher HDI countries. Interpretation: Paradoxically, laws penalizing suicide increased national suicide rates. The non-supportive patriarchal culture with the anti-suicide laws may render women vulnerable to suicidality. Instead of criminalizing suicide, a better way of suicide prevention is to emphasize on providing good mental health care and adjusting the socio-economic-cultural conditions that contribute to suicide. Funding Statement: Taiwan Ministry of Science and Technology, Taiwan National Health Research Institutes, and the Li Ka Shing Foundation. Declaration of Interests: None for all the authors. Ethics Approval Statement: Missing.