Perceptions of the decriminalisation of suicidal attempts among mental health service users in Ghana: a qualitative...

Suicide remains a major global public health concern, with low- and middle-income countries (LMICs) disproportionately affected. In Ghana, attempted suicide had been criminalised under Section 57 (2) of the Criminal and Other Offences Act, 1960 (Act 29) until March 2023 when it was decriminalised. Despite this major reform, little is known about how mental health service users, the group most directly affected perceive the decriminalisation of attempted suicide and its potential impact on health-seeking behaviours. This study explored the perspectives of mental health service users on the decriminalisation of atempted suicide in Ghana, and anticipated effects on help-seeking behaviours.

A qualitative phenomenological design was employed. Thirty adult mental health service users with lived experience of suicidal ideation or attempts were purposively recruited from the Psychiatry department of the Korle-Bu Teaching Hospital, Accra. Data were collected through semi-structured, in-depth interviews and analyzed thematically using Braun and Clarke's six-phase approach.

Participants' perspectives revealed two key themes regarding perceptions of suicide: (1) perception of suicide as an escape route, a means of vindication, and a stress reaction and (2) perceptions about its criminality (suicidal attempt as a crime and suicide attempt not a crime). On the impact of decriminalisation of on health seeking behaviours, two key themes were developed. These were: (1) Positive Impact and (2) Negative impact. Their corresponding subthemes are discussed in the paper.

In this study, participants perceived suicide to be a escape from the challenges of life, a means of vindication, or a stress reaction. They further identified that decriminalisation had both positive and negative impacts on the health-seeking behaviours of service users. The findings point to the fact that decriminalization alone may not suffice in improving suicide prevention outcomes in Ghana. Complementary interventions such as stigma reduction campaigns, and community sensitization in terms of education are essential to maximize the benefits of the legal reform.