Mental Health Coalition – Sierra Leone

The WHO estimates Sierra Leone’s suicide rate at 9.7 per 100,000 people, which is higher than the sub-Saharan average of 7.5. This equates to 733.0 every year in Sierra Leone, with 50 attempts for each committed suicide. Suicide attempts are common among psychiatric patients, accounting for 15-50%. Sierra Leone has an age-adjusted death rate of 11.25 per 100,000 people, ranking it 56th in the world. The root causes for suicidal in Sierra Leone are multi-fold, but they include limited mental health infrastructure and service delivery, a law that criminalizes suicide, stigma, and compounded trauma from years of war, the Ebola epidemic, natural disaster related casualties, and the COVID-19 pandemic. 

Sierra Leone is one of the countries that still criminalizes attempted suicide under the common law, which is enforced per section 74 of Courts Act No.31 of 1965. In Sierra Leone someone as young as 14 years old can be prosecuted. In 2020, a 42-year-old man was remanded to prison for 42 months for attempted suicide in a case of extreme injustice where a person that required urgent help was locked away. 

The stigma attached to suicide, along with the fear of legal consequences, discourages many from seeking the help they urgently need. Mental health conditions, often tied to suicidal behavior, remain heavily misunderstood and stigmatized. For individuals who survive suicide attempts, the possibility of arrest and prosecution worsens their mental health struggles, fueling a harmful cycle that isolates already vulnerable people even further. The man who climb the cotton tree, those taken by kush (harmful drug), school going children, those in universities and many unreported cases are all part of individuals cry for help – even though not on their behalf (as some of them had already gone), but the many more who might be struggling with similar issues as I was at age 14.

A campaign to decriminalize suicide has started, led by the Mental Health Coalition Sierra Leone and other partners – even though it is not reflected in the newly developed mental health bill. Key stakeholders, including Members of Parliament and government officials are being engaged with the aim of either influencing the mental health bill to cater for suicide prevention and decriminalization or tabling a new bill to decriminalize suicide.

Dr. Alie Wurie, 1^st appointed Director of Non – Communicable Diseases and Mental Health at the Ministry of Health urged Sierra Leoneans to be more open about mental health issues and do everything in their power to fight stigma against people affected. “At some point in our lives, mental health issues will almost certainly affect us directly or someone we love, yet they are rarely talked about. We need to change this! We must encourage those struggling with mental illness to come forward for help, and offer our support.” (WHO Report on Depression 07 April 2017)

At a global level, United for Global mental health is launching a new report on decriminalizing suicide researched together with Trust Law, Thomson Reuters Foundation’s global pro bono legal program. This report will be launched and available on their website this World Suicide Prevention Day on September 10. It contains country profiles of 25 countries that still criminalize suicide, detailing legal frameworks, penalties, how to change the law, and ongoing reform efforts. 

We can learn from countries like Malaysia, Ghana, and Pakistan, which have decriminalized suicide in recent years. Punishing individuals for attempting suicide does nothing to address the underlying causes and offers no real prevention. Instead, it pushes those who are suffering further away from the help they need, making access to care even more difficult.

Decriminalizing suicide goes beyond a legal reform; it is a moral obligation. On this World Suicide Prevention Day, we must acknowledge the dignity of those battling suicidal thoughts and extend to them the compassion and care they deserve. Decriminalizing suicide in Sierra Leone is essential for breaking the cycle of stigma, ensuring more compassionate support for mental health, and protecting vulnerable lives through increased access to care.

Joshua A Duncan – Mental Health Coalition – Sierra Leone