Criminal Prosecution of Suicide Attempt Survivors in Ghana

Abstract

Recently, there have been calls for the decriminalization (or depenalization) of nonfatal suicidal behavior (attempted suicide) in Ghana, India, Uganda, and other societies that currently criminalize nonfatal suicidal behavior. Despite this, there is a dearth of systematic studies that examine the extent, nature, and characteristics of attempted suicide prosecutions in countries that currently criminalize nonfatal suicidal behavior. The current study, therefore, explores the phenomenon of criminal prosecution and punishment for suicide attempters in Ghana, one among several countries where nonfatal suicidal behavior is a crime. Drawing from data extracted from local Ghanaian print and electronic news media articles, the study examines the sociodemographic characteristics of suicide attempt survivors, the patterns of nonfatal suicidal behavior, as well as the criminal justice outcomes of the criminal prosecutions. The findings indicate that the majority of defendants pled guilty to or were found guilty of the charge and sentenced to penalties ranging from monetary fines to incarceration. The results are discussed with regard to their implications for reducing nonfatal suicidal behavior in Ghana.

Keywords

suicide attempted suicide nonfatal suicidal behavior decriminalization Ghana

Introduction

Several countries and jurisdictions around the world have repealed their laws or statutes criminalizing nonfatal suicidal behavior (i.e., attempted suicide; Fay, 1994; Hoffman & Webb, 1981; Lester, 1992, 1993, 2002; Neelman, 1996; Vassilas, Morgan, Owen, & Tadros, 2007). Yet, in a handful of others, nonfatal suicidal behavior constitutes a crime (Adinkrah, 2011a, 2011b, 2012; Latha & Geetha, 2004; Musoni, 2011; Schlebusch & Burrows, 2009; Wendo, 2007; Yadwad & Gouda, 2005). In some of these jurisdictions, persons who engage in nonfatal suicidal acts are promptly apprehended by law enforcement personnel and vigorously prosecuted in criminal courts. If convicted, they are subjected to draconian penalties, including monetary fines and incarceration. The West African country of Ghana provides an example of one such society where nonfatal suicidal behavior constitutes a prosecutable offense (Ghana Criminal Code, 1960). Here, persons who survive suicide attempts are zealously prosecuted in criminal courts. Kenya, Malawi, Nigeria, Rwanda, Tanzania, and Uganda are among other African countries that currently criminalize nonfatal suicidal behavior (Kanjo, 2011). In Rwanda, for example, a person who engages in nonfatal suicidal behavior is liable, on conviction, to a 2- to 5-year prison sentence (Musoni, 2011). In Uganda, nonfatal suicidal behavior is a felony punishable by up to 2 years imprisonment (Wendo, 2007).

The criminalization of nonfatal suicidal behavior continues to be the subject of controversy and strident debate (Fay, 1994; Government of India, 2008; Kanjo, 2011; Latha & Geetha, 2004; Osei, 2011; Vandekerckhove, 1998; Yadwad & Gouda, 2005). Despite the often raucous and acrimonious nature of such debates, to date, the criminal prosecution of suicide attempters has been the focus of very little systematic study. Consequently, there is a dearth of information on the subject. The current study aimed to help fill the gap in the literature by investigating the extent, nature, and characteristics of attempted suicide cases that were prosecuted in Ghanaian criminal courts during 2000 to 2011. Among other things, the study explored the types of criminal charges preferred against defendants in suicide attempt prosecutions and the nature of criminal justice outcomes, such as the frequency of convictions obtained and the types of sentences imposed on convicted offenders. Other issues explored in the article include (a) the sociodemographic characteristics of the defendants (age, sex, employment status), (b) the modus operandi or suicide method, and (c) the spatial and temporal aspects of the offense. Case summaries of actual suicide prosecutions are proffered in the text to illustrate the prosecution, conviction, and punishment of persons who were charged and prosecuted under the country’s suicide law. The article concludes by arguing that criminal prosecution of nonfatal suicidal behavior and the concomitant fear of imminent incarceration for the offense is counterproductive and only serves to exacerbate suicidal persons’ state of mind and heighten their risk of death and disability. In this article, the phrase suicide attempt survivor is used to refer to a person who deliberately took a potentially lethal action designed to bring about his or her own demise but was unsuccessful.

Epidemiological Aspects of Nonfatal Suicidal Behavior

To properly contextualize a discussion of criminal prosecution and punishment of suicide attempt survivors, this section of the article provides a brief overview of the extant literature on nonfatal suicidal behavior. According to current estimates, about 1 million people across the globe commit suicide annually (World Health Organization [WHO], 2012). According to the WHO’s data projections, by the year 2020, this figure will reach 1.53 million (WHO, 2012). In addition, each year, millions of people around the world make abortive attempts to end their own lives (WHO, 2012 ). The WHO estimates that worldwide “suicide attempts are up to 20 times more frequent than completed suicide” (WHO, 2012). In Canada, it is estimated that there are 100 nonfatal suicidal acts for every fatal suicidal act that occurs each year (Silverman, 2009). In Australia and New Zealand, there are 50 suicide attempts by females and 10 by males for every fatal suicidal act (Pirkis, Beautrais, & Durkee, 2009). Schlebusch and Burrows (2009) reported that in the Republic of South Africa, nonfatal suicidal acts outnumber fatal suicidal acts by a ratio of 20 to 1. In the United States, it is estimated that between 600,000 and 1.8 million people survive suicide attempts each year (Silverman, 2009).

The research literature on nonfatal suicidal behavior, which is currently focused on countries in North America, Europe, Asia, Australia, and New Zealand, show that suicide attempt rates are higher among younger persons (age 15-44 years) than among older individuals, with attempted suicide risk decreasing with increasing age. Rates of nonfatal suicidal behavior are also higher among persons of lower socioeconomic background compared with people of higher socioeconomic status (Hawton & Catalan, 1982; Jiang & Cheng, 2009; Silverman, 2009; Pirkis et al., 2009; Rutz & Schmidtke, 2009).

In addition, in the majority of the countries where epidemiological data on suicidal behavior have been collected, rates of nonfatal suicidal behavior are higher for females than males. Australian, Canadian, New Zealand, and U.S. data indicate that females are more likely than males to engage in nonfatal suicidal behavior (Pirkis et al., 2009; Silverman, 2009). This is also the case for most European countries (Rutz & Schmidtke, 2009). In some countries including Egypt (Okasha & Lotaif, 1979), Finland (Rutz & Schmidtke, 2009), Ghana (Adinkrah, 2011a, 2011b, 2012), and Kenya (Arap Mengech & Dhadphale, 1984), the obverse situation is the case. In Ghana, Adinkrah (2011a, 2011b, 2012) observed, from a study of police-recorded data on suicidal behavior, that males greatly exceeded females in rates of fatal and nonfatal suicidal acts.

Regarding methods of attempted suicide, the extant literature indicates that male suicide attempters are more likely to use more decisively lethal methods than their female counterparts. For example, males are more likely to use self-inflicted gun shots, hanging, jumping, or drowning, whereas women are more likely to resort to ingestion of poisons, overdosing on over-the-counter drugs, and wrist cutting (Silverman, 2009; Rutz & Schmidtke, 2009).

Studies suggest that mental psychopathology or psychiatric illness constitutes a major precipitant for nonfatal suicidal behavior. For example, Rutz and Schmidtke (2009) concluded from their review of the European literature on nonfatal suicidal behavior that “up to 98 per cent of suicide attempters [met the] criteria for any psychiatric disorder” (p. 124), noting that “the mental disorders which suicide attempters predominantly suffered from include substance abuse, affective, and personality disorders” (pp. 124-125). In addition, in a 2003-2004 Australian and New Zealand survey, researchers observed that “the strongest correlate of making a suicide attempt was having a mental disorder—particularly a substance abuse or mood disorder, but also an anxiety disorder” (Pirkis et al., 2009, p. 128).

Extant research into the etiology of suicidal behavior has identified other risk factors. These include (a) childhood adversity, such as sexual abuse, severe physical abuse or neglect, or the death of a parent; (b) one or more stressful life events such as the death of a loved one, job loss, relationship termination (e.g., divorce, separation), financial bankruptcy, imminent criminal prosecution, and incarceration; (c) suffering from, or having recently been diagnosed with, a terminal illness; and (d) misuse or abuse of alcohol or drugs (Joiner, 2005, 2010).

The scholarly literature suggests that previous nonfatal suicidal behavior is a risk factor for lethal suicidal behavior (e.g., Hawton & Catalan, 1982; Silverman, 2009). This means that persons who survive nonfatal suicidal acts are more likely to attempt and complete a suicidal act. Indeed, it is estimated that one third of persons who engage in nonfatal suicidal behavior repeat the behavior within 1 year, and approximately 10% of persons who threaten or attempt an act of nonfatal suicidal behavior eventually kill themselves. The research literature suggests that adequate follow-up care with health care professionals, including treatment for psychiatric disorders, is necessary to prevent the repetition of suicidal behavior (Rutz & Schmidtke, 2009).

Nonfatal Suicidal Behavior and the Repeal of Antisuicide Legislation

This section of the article examines arguments regularly raised by those advocating decriminalization of attempted suicide as well as counterarguments proffered by those in favor of retaining criminalization or penalization of attempted suicide.

Proponents of decriminalization of nonfatal suicidal behavior argue that criminal prosecution and the imposition of custodial and financial penalties on those convicted of nonfatal suicidal behavior constitute cruel and unusual punishment and an affront to human dignity (Hoffman & Webb, 1981; Osei, 2011; Yadwad & Gouda, 2005). They argue that suicidal behavior is typically an impulsive act, a plea for help, or a symptom of psychiatric illness. Penal sanctions, therefore, cannot be expected to have the deterrent effect that is envisioned. Those arguing for decriminalization also contend that persons who engage in suicidal behavior are likely more in need of psychiatric care than penal sanctions (Hoffman & Webb, 1981; Kanjo, 2011; Osei, 2011; Yadwad & Gouda, 2005). Advocates of decriminalization further argue that criminalization of nonfatal suicidal acts may cause the problem of suicide to go underground, making it even more difficult for suicidal persons to receive necessary assistance (Wendo, 2007).

There are four arguments that are commonly raised in opposition to decriminalization (Kanjo, 2011; Latha & Geetha, 2004; Yadwad & Gouda, 2005). First, it is argued that there is universal condemnation of suicide because of the sanctity of human life; prohibition of attempted suicide and the application of penal sanctions against it are, therefore, legally and morally justified. Related to the aforementioned point, it is argued that every government has a moral obligation to prevent suicidal death among its people. This is accomplished by legislation that criminalizes suicidal behavior. Second is a utilitarian argument that every human being has material value that is lost when their life is extinguished. Because governments and communities invest resources in their citizens by providing them with education and other social services and skills, a person who deliberately ends his or her life has prematurely terminated the ability of the state to reap dividends from their investment (Kanjo, 2011). Third, those opposed to the repeal of antisuicide legislation argue that relatives are deprived of the loved one who takes his or her own life through suicide, and so should be discouraged through penalties (Yadwad & Gouda, 2005). Fourth, it is argued that criminal prosecution and legal sanctioning of nonfatal suicidal behavior generally acts as a deterrent against potential suicides (Latha & Geetha, 2004). Opponents of decriminalization contend that people make rational decisions to engage in a suicidal behavior by weighing the potential benefits and consequences of their actions, and so fear of criminal apprehension and punishment serves to deter such behavior. Repealing or abrogating current antisuicide legislation would, therefore, encourage suicidal behavior and lead to a rise in suicide rates (Wendo, 2007).

Research on the deterrent impact of antisuicide legislation has yielded mixed results. Lester (1992) compared suicide rates in Canada in the 10-year periods before and after decriminalization of suicide, and found no increase in the rate of suicide following decriminalization. In another study, Lester (1993) compared suicide rates in New Zealand in the 10-year periods before and after decriminalization, and found no increase in the country’s suicide rate following decriminalization. In a third study, Lester (2002) compared the suicide rates in seven countries (Canada, England and Wales, Finland, Hong Kong, Ireland, New Zealand, and Sweden) 5 years prior to decriminalization and 5 years following decriminalization, and found an increase in the suicide rates for the period following the abrogation of criminalization of suicide in all seven countries.

Legal and Social Responses to Suicidal Behavior in Ghana

According to the Ghana Criminal Code (1960, Act 29), nonfatal suicidal behavior is a crime. Section 57 of the code stipulates that “whoever attempts to commit suicide shall be guilty of a misdemeanor.” Consequently, persons who engage in nonfatal suicidal behavior in Ghana are subject to criminal apprehension and prosecution, and on conviction, receive criminal penalties.

In addition to the strong legal stance against suicidal behavior, a strong social stigma has surrounded suicidal behavior in Ghana, past and present. Among the Ashanti ethnic group for instance, in former times, a person who died by suicide was presumed to have committed some abomination and the suicidal act was interpreted as an attempt to evade punishment. For this reason, the corpse of the suicide decedent was tried, invariably convicted of an offense, and decapitated, as punishment (Busia, 1968; Rattray, 1969). Sandra Greene (2002) observed that among the 19th century Anlo Ewes of Ghana, people who committed suicide were buried in special cemeteries due to the perceived reprehensibility of the suicidal act. Today, decapitation of the suicide’s corporeal body has ceased, as have other denigrating forms of interment of the suicide’s body. Yet, suicide continues to be viewed with great repugnance. Among all ethnic groups in the country, suicide is considered a “bad death,” an ignominious act for which all efforts must be made to prevent its recurrence. In some ethnic groups, such as the Akans of Southern Ghana, physical contact with the suicide’s body must be avoided at all costs. In addition, in most communities in Ghana, people who die by suicide are perfunctorily and hurriedly buried in cheap wooden caskets, devoid of the proper customary funerary rituals, and decorum accorded those who die “good deaths.” In every ethnic community, the bereavement process for the suicide is either truncated or nonexistent. Furthermore, suicidal death brings dishonor onto the entire lineage in which a suicide has occurred. People are reluctant to marry from a lineage that has suffered a suicide death, fearing that an offspring from such a conjugal union would be destined to commit suicide in the future (Adinkrah, 2012).

Although a number of academic studies focusing on suicide ideation in Ghana have been published in recent years (Eshun, 2006; Hjelmeland et al., 2008), currently, epidemiological studies of suicidal behavior in Ghana are sparse (Adinkrah, 2011a, 2011b, 2012). In recent years, calls for the decriminalization of nonfatal suicidal behavior have mounted, as has coverage of suicidal behavior in the Ghanaian mass media (Anti-Suicide Body Advocates Reform of Criminal Code, 2010; Antwi-Otoo, 2011). Despite this, anecdotal evidence obtained from informal discussion with a random sample of Ghanaians suggests that there is significant opposition to the decriminalization of nonfatal suicidal behavior.

Method and Data Sources

Data on suicidal behavior in Ghana are scarce (Adinkrah, 2011a, 2011b, 2012). At present, no agency or organization in the country is charged with the responsibility of compiling suicide data or maintaining a suicide registry. Suicide data currently compiled by the police are limited (Adinkrah, 2011a, 2011b, 2012). For this research, then, various media records (i.e., newspaper, Internet sources) spanning 2000 to 2011 were perused for cases dealing with the prosecution of individuals charged with nonfatal suicidal behavior. In Ghana, due to the criminal status of suicidal behavior, the strong social taboo against the behavior, and the relative infrequency of deliberate acts of self-harm, suicide cases are considered particularly newsworthy (Adinkrah, 2012; Avevor, 2007). Consequently, they receive extensive coverage in the electronic and print media. Hence, various media sources are a viable data source on reported cases of suicidal behavior. A content analysis was conducted of each case identified, looking for the sex, age, and occupational status of the survivor, the modus operandi of the suicide attempt, and the dispositional outcome of the prosecution.

A review of the scholarly literature reveals that the use of newspaper-based case reports in studies of suicidal behavior is not new (see, for example, Khan & Reza, 2000; Liem & Koenraadt, 2007; Malphurs & Cohen, 2002). Indeed, using such data sources is deemed particularly necessary in developing countries where officially collated data and other primary sources of information are virtually nonexistent (Adinkrah, 2011a; Khan & Reza, 2000). As previously noted, in Ghana, there are currently no private or governmental agencies that compile or maintain a registry of suicidal behavior. It must be added, however, that newspaper-based suicide data have a high degree of reliability given the relatively limited number of suicide cases in the country and the curiosity that such cases engender in the populace. These factors conjoin to make suicide incidents newsworthy, engendering the various presses to send reporters to cover the stories and publish information about suicides.

Results

The research identified 20 cases of criminal prosecution of suicide attempt survivors from 2001 to 2011. In one case, there were 2 defendants, bringing to 21, the total number of persons charged with nonfatal suicidal behavior or what is described in Ghana as “attempted suicide,” during the study period. A total of 17 (81.0%) of the 21 defendants were male, whereas 4 (19.0%) were female. The defendants ranged in age from 16 to 52 years with a mean age of 30.2 years and a median age of 24 years.

The majority of persons prosecuted for attempted suicide were of lower socioeconomic background. Six (28.6%) were unemployed at the time of the crime, three (14.3%) were peasant farmers, two (9.5%) were students, two (9.5%) were semiskilled artisans (mason, brick-maker), two (9.5%) were taxi drivers, one was a fisherman, one was a teacher, and one was a laborer.

Regarding the suicide method, 10 (47.6%) of the 21 defendants used hanging, 4 suicidal (19%) acts involved self-inflicted stabbing, and another 4 (19%) involved drinking a poisonous chemical, usually an agrochemical called dichlorodiphenyltrichloroethane (DDT).

Concerning the spatial aspects of suicide attempts, the data show that 10 (47.5%) occurred in the defendants’ home. Another 7 (33.3%) occurred in police jail cells where the defendants were being held in preventive detention for having committed some other crime. In addition, 3 (14.3%) occurred in some remote location away from home, and 1 occurred in a courtroom.

With regard to the motivation behind attempted suicides, the data show that fear or shame regarding imminent prosecution for a criminal offense constituted the most common motive for attempted suicide. In 7 (33.3%) of the 21 cases, the defendants had been apprehended for varied criminal offenses, including armed robbery and larceny, and had been placed in police jail cells to await further criminal justice processing. The shame and stigma associated with imminent public disclosure of their crimes, failure to obtain bail, the jail experience, or imminent sentencing following conviction triggered or fueled the defendants’ decision to attempt suicide.

Other motivations for suicide attempts included intrafamilial disharmony or discord. Two (9.5%) men engaged in nonfatal suicidal behavior when they discovered or suspected their wives’ infidelity; two (9.5%) other men attempted suicide because of the termination of an intimate relationship by their partners. Three women tried to kill themselves after their boyfriends terminated their relationships. One woman tried to kill herself when her boyfriend denied responsibility for her pregnancy. Two male defendants were motivated by financial difficulties; one carpenter could not raise money to establish his own workshop, whereas the other had been bedeviled by chronic unemployment and financial debts.

Regarding criminal justice processing, the data show that persons who attempted suicide were swiftly apprehended by police once a case of attempted suicide was lodged with the law enforcement authorities (e.g., “Student Jailed for Attempted Suicide,” 2005; “Suicide Man Jailed,” 2011). The defendants were put in police cells, denied bail, and transported to the next sitting of the local criminal court to face charges. In a few cases, the defendants were referred to a psychiatric hospital for evaluation. However, the shortage of psychiatric resources and personnel made such referrals unlikely for defendants facing charges of attempted suicide in rural areas. The defendants invariably represented themselves in court and pled guilty to the charges preferred against them. Dispositional outcomes in cases where a psychiatric referral occurred were not available.

Regarding dispositional outcomes, five (23.8%) of the defendants received custodial sentences, ranging from 3 to 36 months. Of the five, three (14.3%) defendants were each sentenced to 24 months imprisonment. One defendant was asked to pay financial penalties worth roughly US$1,000. One defendant received a 2-year probationary sentence. Two (9.5%) convicted defendants were referred to the psychiatric authorities for evaluation, counseling, and treatment. One convicted defendant was cautioned and discharged by the court. Information regarding the dispositional outcome was unavailable for eight cases.

Below, a summary of each case is provided. The case summaries are designed to further illuminate the phenomenon of criminal prosecution and punishment for suicide attempters by providing specific details and the social context for each case. They provide information about the sociodemographic characteristics of the suicide attempter, the temporal and spatial aspects of the suicide, suicide method and motive, and, where available, the judicial disposition of the case. The case examples are grouped under the following themes: (a) recent incarceration or having to appear in court for an offense; (b) difficulties in relationships with a spouse, boyfriend, or girlfriend; (c) employment problems and financial hardship; and (d) miscellaneous cases.

Case Examples

Case 1

In November 2000, a 20-year-old man was convicted in a trial court for physically assaulting another man. Following his conviction, the man reportedly told his mother, who was in the court audience, to “take care of my brother because I am leaving this world.” Then, running at top speed across the courtroom, he slammed his head against the wall. He was rendered unconscious and was rushed to the local hospital for medical treatment. Two weeks later, following his recovery, he appeared in the same courtroom, charged with attempted suicide. He was convicted and sentenced to 2 years imprisonment for the attempted suicide conviction and additionally fined the equivalent of US$200 for the physical assault charge for which he had originally been tried and convicted in the courtroom (“Man Jailed for Attempted Suicide in Court,” 2000).

Case 2

In August 2005, a 20-year-old student was sentenced to 2 years imprisonment for attempting to commit suicide while in the police custody. While in jail awaiting prosecution for a charge of stealing the equivalent of US$100, he poured and smeared feces obtained from his cell on his whole body and on the floor of the jail cell. In addition, he attempted to sever his penis with the serrated edge of a piece of plastic metal (“Student Jailed for Attempted Suicide,” 2005).

Case 3

In this case, a 30-year-old, unemployed man was arrested by police for stealing three goats. While in pretrial detention, he tied the police-issued blanket to the ceiling fan in the cell and attempted to hang himself. The on-duty police officer, alerted by unusual noises coming from the cell, went to investigate and found the defendant hanging by his neck. The defendant was rushed to the local hospital and treated for his physical injuries. In court, he pled guilty to larceny of three goats and attempted suicide. He was to reappear in court later for sentencing. The final disposition of the case was unavailable at the time of the research (“Man Remanded for Stealing Goats,” 2008).

Case 4

In this case, a crime suspect languishing in a police jail cell tore a piece of his blanket and used it as a rope to attempt to hang himself in the cell. The facts of the case indicate that the 23-year-old taxi driver’s original charge was larceny of sheep. He was accused of stealing six sheep belonging to his neighbor. He abandoned the process of loading the sheep into the taxi when someone raised an alarm about the theft. He drove the taxi off but was later apprehended by police and thrown into a jail cell. Hearing unusual noises emanating from the jail cell, police personnel went to investigate, found him hanging himself, then rushed to untie the noose and rescue him. He was taken to the local hospital for treatment. Following his discharge from the hospital, he was criminally charged with attempted suicide and brought before the courts. He pled guilty and was sentenced to 36 months imprisonment (“Driver Jailed for Stealing and Attempting Suicide,” 2003).

Case 5

In this case, two men were found guilty of attempting to kill themselves in their jail cells. One of the men, a 21-year-old, was unemployed. The other, a 24-year-old, was employed as a taxi driver. Both were convicted of the charges and given custodial and financial penalties. According to the facts of the case, the two men stole a sheep and a goat and were caught while loading the animals into the 24-year-old defendant’s taxi. Their plan was to transport the animals to another part of the city to sell them, but they were apprehended and handed over to the police. While in police cells, the men tied their shirts to the rafters of the ceiling and tried to hang themselves. Neither was successful. In court, they were convicted of larceny of sheep and goat and attempted suicide. For the suicide charges, they each received a custodial sentence of 12 months in hard labor and fined the equivalent of US$300. In default of the payment of the fine, they were each to serve an additional 6 months in prison. Passing sentence, the judge chastised the defendants, stating that they had no right to try to terminate their lives. She noted,

Your individual lives value more than the offense you have allegedly committed. Every human life lost cannot be replaced and as such, an attempt to take one’s own life just to find trouble for the police is a grievous offense which should not go unpunished. (“Two Attempt Suicide in Police Custody,” 2009)

Case 6

In this case, an 18-year-old male, brick-maker attempted to commit suicide in a jail cell. The day preceding the suicide attempt, the man had been arrested and detained by police for stealing a live goat valued at about US$30. A police officer on duty discovered the defendant in an unconscious state, lying in a pool of blood. On inspection, he discovered that the accused had stealthily and repeatedly hit his forehead against a protruding nail that had been used by police to secure the cell door, with the intention of killing himself. The accused was rushed to the hospital, revived, and treated. On discharge from the hospital, he was rearrested and charged with attempted suicide, in addition to the original charge of larceny of a goat. When queried about his motive for the suicide attempt, the accused indicated that “he intended to take his life because he felt too lonely at the cells since his relatives ignored him.” He pled guilty to both charges and was fined the equivalent of US$600. In addition, he was given a 2-year probationary sentence with the proviso that he not commit another criminal act. In default, he was to serve a 12-month prison term. As part of the conditions of probation, he was mandated by the court to report to the local police station every month (“Court Bonds Teenager for Suicide Attempt,” 2006).

Case 7

On November 9, 2005, a 52-year-old male farmer was sentenced to a 3-year prison term, with hard labor, for attempting to commit suicide. He had previously pled guilty to the charge of attempted suicide. Two years earlier, the man had fatally stabbed his wife over suspicion that she had been sexually unfaithful to him. Realizing that the wife was on the verge of death, he drank the agrochemical DDT in a bid to kill himself. He was rescued and sent to a hospital where he was saved. Murder charges were still pending against him (“Man Jailed for Attempted Suicide after Stabbing Wife,” 2005).

Case 8

In October 2009, a 21-year-old mason was rescued from his attempt to kill himself in his home. He was found hanging by the neck from the ceiling of his bathroom. In court, he pled guilty to the charge of attempted suicide. Regarding his motive, he indicated that he wanted to kill himself because his girlfriend had deserted him for another man. The presiding judge deferred sentence, referring the convicted man for psychiatric evaluation and possible treatment. The final disposition of the case was unavailable at the time of the research (“Jilted Lover Attempts Suicide,” 2009).

Case 9

In this case, a 47-year-old male high school teacher pled guilty to charges of unlawfully causing harm and attempting to commit suicide. According to the police, the defendant and his wife were having conflicts over the wife’s son from a previous marriage. The defendant had attempted to evict his stepson from the house, asking the wife to seek alternative living arrangements for him, and threatening to kill her and then himself if the stepson ever showed up at his house again. Thinking that her husband was merely joking, she allowed the boy to remain in the house. The boy’s continued presence in the house sparked another quarrel between the couple, escalating into a violent confrontation in which the husband stabbed his wife with a knife. Believing that his wife was dying, he hurriedly wrote a suicide note in which he placed blame for his death on his wife. He then drank a poisonous concoction. He was, however, rushed to a local hospital in time for treatment. During his criminal trial, he pled guilty to the two charges and was granted the equivalent of US$5,000 bail pending sentencing. The final disposition of the case was not available at the time of the research (“Teacher in Court for Attempted Suicide,” 2004).

Case 10

In this case, a 35-year-old unemployed woman who became despondent after discovering her boyfriend living with another woman attempted to kill herself. When her suicide attempt failed, she was brought before a criminal court and charged with attempted suicide. According to the facts of the case, the woman had lived in a cohabiting relationship with her boyfriend for 7 years. During that period, the couple had three children. The man informed her that they were being evicted from the apartment where they resided and suggested that she and the children should go and live with her parents until such time that he was able to find an alternative accommodation for the entire family. She complied and left with the children. For 7 months, the man failed to visit her and the children. He also did not remit them financially during their separation. Soon after, she returned to find her boyfriend living with another woman in the same abode. The following day, while the boyfriend and his new girlfriend were at work, she broke down the door, entered the room, and used a rope to make a noose to hang herself in the bedroom. Other residents in the apartment complex heard her screams and came to her rescue. She was arrested by police and charged with attempted suicide. In her statement to police, she indicated that her husband had abandoned her and the children financially and she was indebted to several people, and so had decided to end her suffering by taking her life. Information concerning the outcome of this case was not available at the time of the research (“Woman Charged With Attempted Suicide,” 2008).

Case 11

In this case, a 30-year-old woman who had been charged with the offense of attempting to commit suicide was referred by the trial judge to a psychiatric hospital for psychological evaluation. The woman attributed her suicidal behavior to “frustration.” Some weeks prior to the defendant’s suicide attempt, she was residing in Accra, Ghana’s capital city, with her husband. Following a misunderstanding, the husband sent her away to her hometown with plans to divorce her. A few weeks later, during the divorce proceedings, the defendant asked to be excused. She was later found in a remote location in the bush attempting to hang herself with a rope. She was arrested and handed over to police. While in police custody, she started to behave abnormally, thereby prompting the psychiatric referral. She blamed her suicidal behavior on frustration. The dispositional outcome of this case was not available at the time of the research (“Court Refers Woman to Psychiatric Hospital for Examination,” 2007).

Case 12

In this case, a 21-year-old pregnant woman attempted to kill herself by drinking DDT. She was rushed to the hospital, treated, and discharged. One day later, she attempted to commit suicide again by drinking the same chemical. This time, she was arrested by police following her discharge from the hospital, put before a criminal court, and prosecuted for attempted suicide. The woman, a single mother with a 5-year-old child, was in an intimate relationship with a taxi driver. Having recently discovered that she was pregnant, she informed her partner who denied responsibility for the pregnancy. In response, she drank the pesticide with the aim of terminating her life. Following her conviction for attempted suicide, the court deferred sentence and referred her to the Department of Social Welfare for counseling. The court’s decision to postpone sentencing and refer her to counseling followed clemency pleas from friends of the court (“Pregnant Woman Arrested for Attempted Suicide,” 2004).

Case 13

In this case, a 31-year-old man was arrested by police for attempting to kill himself by hanging. In his statement to police, following his arrest, he indicated that he “was tired of life as he was fed up with living with an unfaithful wife.” At the time of the suicide attempt, the man had been living with his wife in a major Ghanaian city. He claimed he suspected that his wife was involved in sexual affairs with other men. On the evening of the suicide attempt, he returned home from work to find that his wife was not at home. Presuming that she was with another man, he decided to hang himself with a rope in his bedroom. When his wife arrived home and found him attempting to hang himself, she raised an alarm that brought neighbors onto the scene who brought him down. He was taken to the police station, charged with attempted suicide, and arraigned for trial. With his prosecution imminent, he changed his story, stating that his purported suicide attempt was a ruse and that he only intended to see how his wife would respond to a suicide attempt. Information on trial and case disposition was not available at the time of the research (“Man Charged with Attempted Suicide,” 2007).

Case 14

In this case, a 45-year-old fisherman attempted to commit suicide by hanging after his wife divorced him and left him with their children. On the day of the attempted suicide, the defendant tied one end of a rope to the ceiling in his room and tied the other end around his neck. The rope, however, became disengaged and he fell to the ground, amid screams for help. His screams attracted his children and neighbors who rescued him and sent him to the hospital for treatment for his injuries. The suicidal behavior was subsequently reported to the local police who arrested the defendant and charged him with the offense. He was convicted of the charge and placed on 1-year probation with the condition that he be of good behavior during the probationary sentence. In default of the probationary sentence, he would be imprisoned for 3 months. During sentencing, the judge offered advice to the defendant suggesting that he not give up easily on life, adding that “when one door gets shut, many get opened” (“Fisherman Bonded for Attempted Suicide,” 2008).

Case 15

In this case, a 37-year-old farmer was ordered by a circuit court to be held in jail pending sentencing for attempting to commit suicide. On the day of the suicide, the defendant and a friend had been laboring on a farm and returned around 4 p.m. Late that evening, the defendant grabbed a machete and started cutting his throat. He reached a point where he found the pain unbearable and screamed for help, attracting neighbors who conveyed him to the hospital for treatment. Following his discharge from the hospital, he was arrested by police and placed before the court. The defendant pled guilty to the charge of attempted suicide but could not offer any reason for his suicide attempt. He was remanded in court for sentencing. The final disposition of the case was unavailable at the time of the research (“Farmer Remanded for Attempted Suicide,” 2011).

Case 16

In this case, a 42-year-old male, armed robbery suspect who was being kept in pretrial detention, attempted to commit suicide by cutting his penis with the serrated edge of a mosquito repellent stand in his cell. When he could no longer withstand the pain, he screamed to attract the attention of the officers on duty. He was discovered lying in a pool of blood. He was rushed to the hospital, treated for his injuries, and charged with the offense of attempted suicide. When questioned about his motive for the crime, he said he was innocent of the armed robbery charge but nobody would believe him. He had also been despairing over the fact that neither family nor friends would bail him for the charge of armed robbery. Information regarding the final disposition of the case was not available at the time of the research (“Suspect Attempted Suicide by Cutting His Penis in Police Custody,” 2005).

Case 17

In this case, a 22-year-old woman’s attempt to commit suicide by hanging was foiled by her husband. She was subsequently arrested by police. According to the facts of the case, in the days leading to the suicide attempt, the woman accused her husband of being in a relationship with another woman. On the day of the suicide attempt, the defendant refused to prepare dinner for the husband. When she left the house, the husband stealthily followed her. When she was about to hang herself, the husband stepped in to prevent her. The incident was reported to the police who apprehended her and brought criminal charges against her. In court, she pled guilty to the charge of attempted suicide and was granted the equivalent of US$8,000 bail to reappear in court 1 week later for sentencing. Information on sentencing was not available (“Woman Before Court for Attempting Suicide,” 2004).

Case 18

In this case, a 16-year-old boy attempted to commit suicide. When neighbors discovered him bleeding profusely from the nose, he was rushed to the nearest hospital for medical treatment. So critical was his situation that he was later transferred to a major hospital in Accra for treatment. After receiving treatment, he confessed that his injuries were from an attempted suicide. He explained that he wanted to take his life because he was not being adequately cared for by his father whom he also accused of physical and psychological maltreatment. Police informed the general public that the 16-year-old boy would be arraigned before the courts following recovery from his injuries. Final disposition of the case was not available at the time of the research (“Teenager in Suicide Bid,” 2009).

Case 19

In this case, an unemployed carpenter attempted to commit suicide by drinking DDT. On the day of the attempted suicide, the man was rushed to the local hospital while “very weak and on the verge of dying.” The doctor on duty managed to resuscitate him after discovering he had drunk DDT. Following his recovery, the doctor made a referral to the local police. When asked by police why he drank the agrochemical, the defendant said he had wanted to take his own life because he could not raise money needed to open his own carpentry shop and was still financially dependent on his father. Yet, on his conviction for attempted suicide, the defendant asked that the court show leniency because he did not know what drove him to try to kill himself. He was cautioned and released by the presiding judge who ordered him to consult his church pastor for counseling (“Court Orders Accused to Consult his Pastor,” 2005).

Case 20

In May 2011, a 50-year-old man was convicted of attempted suicide and sentenced to a 3-month prison term. The man had inflicted multiple razor blade wounds on his neck in a bid to kill himself. The attempted suicide occurred in a remote forested area. He was rescued by a neighbor who heard his screams of pain and anguish. The suicidal man told the court that he wanted to end his life because he was ostracized by people in his residential community. Passing sentence on the defendant, the judge remarked, “It is only by good fortune that the injuries inflicted did not prove fatal. You won’t be lucky next time” (“Suicide Man Jailed,” 2011). The case garnered extensive media coverage and drew considerable public commentary from advocates of suicide decriminalization who suggested that the defendant needed psychiatric treatment rather than a custodial sentence (Osei, 2011).

Discussion and Conclusion

The current study has contributed to the growing literature on suicidal behavior. It has also contributed to the remediation of a knowledge gap concerning the criminal prosecution of suicide attempt survivors. A few of the results merit additional commentary. A notable finding from the study was that there was considerable disparity in the sentences imposed on convicted suicide attempt survivors. While some received custodial sentences of up to 3 years, some were required to pay monetary fines and others were simply bonded to be of good behavior.

The finding that a relatively large proportion of the prosecuted suicide attempt cases occurred during custodial incarceration in a police jail cell is consistent with the persistent finding in the literature that jail incarceration is a significant risk factor for suicidal behavior (Kerkhof & Blaauw, 2009; U.S. Department of Justice, 2010). In Ghana, as in many jurisdictions, jails are used to detain persons awaiting criminal trial or to provide short-term, temporary confinement for convicted offenders awaiting transfer to their assigned prisons. At present, physical conditions in most Ghanaian jails are harsh. Many are overcrowded and lack classification schemes designed to segregate different categories of offenders. Furthermore, pretrial detainees in police jail cells are allegedly often physically abused by police criminal investigators eager to extract inculpatory evidence. These conditions may serve as triggering factors for suicidal behavior. Therefore, improving the harsh conditions in jails could contribute to a reduction in jail suicides. The Ghanaian authorities must also take urgent steps to ensure the safety of inmates in these cells. Suicide prevention programs in Ghana should include measures to make police jail cells suicide proof. This is especially crucial considering that in some instances inmates used items found in the cells, such as nails and blankets, to attempt suicide. It is encouraging that some jurisdictions have already taken steps toward this end. In January 2010, it was reported that the La District Police had inspected its jail cells and taken steps to safeguard the security of the cells for inmates, including discarding items that could potentially be used to commit suicide (“Suicide Attempt Pushes Police to Search Cells,” 2010). The reforms had been prompted by an attempted suicide case in which an inmate tried to slash his throat with a piece of scrap metal that he had extracted from breaking the toilet seat in his jail cell. Other safety measures adopted at the same facility have included having a police officer check food brought by inmates’ relatives to the inmates to ensure that “nothing dangerous is smuggled into the cells to facilitate any diabolical act” (“Suicide Attempt Pushes Police to Search Cells,” 2010, p. 1). It is further recommended that to prevent jail suicides, new inmates be monitored closely, particularly during the first few hours or days of arrival. This is because research indicates that many suicides occur during the early periods of confinement (Mumola, 2005).

The present study shows that persons prosecuted for nonfatal suicidal behavior were driven to suicidal action by myriad factors, including unemployment, marital problems, interpersonal conflict, conviction or incarceration for criminal offenses, shame, romantic disappointments, and psychological illness. From this, one can surmise that the productive strategies for the Ghanaian authorities to pursue to prevent suicide include increasing employment opportunities for the jobless and establishing counseling centers and psychotherapeutic programs for the psychologically distressed and psychiatrically impaired. Criminal apprehensions and prosecutions and concomitant fear of imminent incarceration will only serve to exacerbate suicidal persons’ risk for depression, anxiety, and repetitive suicidal behavior (see, for example, “Man, 26, Commits Suicide After Two Failed Attempts,” 2010).

Does criminalization of attempted suicide have a deterrent impact on suicidal behavior in Ghanaian society? It cannot be determined what percentage of the suicide attempt survivors profiled in this study were aware that nonfatal suicidal behavior was a crime in Ghana prior to their arrest for a suicidal act and whether prior knowledge of the illegality of suicide attempts in Ghana would have served as a deterrent. It is worth noting that Ghana’s current antisuicide law was originally imposed as part of a penal code during the British colonial era (Seidman & Eyison, 1969). To date, there is no body of data that indicates the level of awareness among the wider population concerning the criminal status of nonfatal suicidal behavior. This author’s own informal survey of ordinary Ghanaian citizens, as well as information obtained from discussions with a Ghanaian clinical psychologist and suicide researcher, demonstrates that a large segment of the Ghanaian population is currently unaware of the criminal status of attempted suicide in the country. Thus, it can be conjectured that decriminalization of nonfatal suicidal behavior is unlikely to lead to burgeoning rates of fatal or nonfatal suicidal behavior.

Some limitations of the current research include questions concerning the availability and reliability of reported and recorded suicide data in Ghana. First, it is possible that not all attempted suicide cases are reported to the authorities and not all reported cases result in criminal prosecution. Family, friends, and neighbors, reluctant to see their loved ones prosecuted and sent to prison for suicidal behavior, may decide not to report nonfatal suicidal behavior. This is particularly the case with suicidal acts that did not result in such serious injuries as to warrant medical treatment at a hospital or clinic. Second, in some instances, law enforcement officials may have exercised discretion in the handling of suicide attempt survivors. Some suicide attempters may have simply been cautioned and released. Third, the media may not have reported all instances of the criminal prosecution of suicide attempters. Ghana has scores of circuit, magisterial, and traditional courts in various locations around the country, and some cases may not have received media coverage. Despite the limitations of the data, the study offers important insights about a heretofore unexplored subject.

Footnotes

Acknowledgements

The author is grateful to Dr. Carmen M. White of Central Michigan University and the three anonymous reviewers of this journal for their valuable comments on earlier drafts of the manuscript.

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

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