What if suicide prevention were removed from the mandate of mental health care?

When Robin Williams committed suicide, many people responded with the "Genie, you're free" scene from Aladdin. This response received a lot of criticism, some of which argued that suicide isn't freedom.

It occurred to me that the problem with this statement is it's clearly unknowable.  The author has no way of knowing with the amount of certainty they claim that you don't find freedom or peace after death.

And, because of this, their anti-suicide message has no credibility in the eyes of those considering suicide.  They're quite clearly just saying stuff to perpetuate the message of Suicide Is Bad.  So a person considering suicide isn't going to listen to them, because they're obviously just going to unquestioningly say Suicide Is Bad regardless of the truth of the matter.  (And if suicide is in fact Bad, you'd think they could come up with something substantiated to support that position.)

Then it occurred to me that this might be the symptom of a broader problem in mental health care and emergency response.

If I were suicidal, I would never even consider seeking medical attention, because I feel like they'd just want to stop me from committing suicide.  They'd restrain me in a mental ward somewhere and declare the job done, or monitor me for the rest of my life and never leave me a moment's peace.  Sounds like hell!

But what if health care as a whole recognized a person's right to end their life? Your body, your choice!  They don't prevent, persuade, coerce or manipulate you into not committing suicide.  It's considered a perfectly valid choice.

However, since it is also a drastic - and irreversible - choice, they strongly urge you to try less drastic approaches first.  Take a pill, talk to a doctor - the mental health equivalent of rebooting your computer and maybe reinstalling the OS rather than going straight to throwing it out the window. If it hurts, the doctor will give you something to try to stop it from hurting.  If you're feeling nothing, the doctor will give you something to try to make you feel again.  If your fish are dead, the doctor will try to resuscitate them.  If it doesn't work, you're no worse off than you were before and you can always kill yourself later!

Some people will argue "But when I was suicidal, I didn't actually want to kill myself.  I wanted to stop wanting to kill myself."  That's fine, a person could still go to the doctor and say "I have suicidal feelings and I don't like them! Can you help me make them stop?" But if the patient feels their suicidal feelings are valid, the doctor won't force them to do anything about it.

Analogy: if you've never gotten pregnant and you want to have children, you can go to the doctor and request assistance with conceiving.  But if you've never been pregnant and you're okay with that, they don't force fertility treatment on you.

And some people will argue "When I wanted to kill myself, it was just the depression talking. Once I received help, I came to realize that I didn't want to kill myself."  If that's the case, this approach will still achieve the same results.  The hurting/sadness/feeling nothing/dead fish will be treated, the patient will come to the realization they didn't actually want to kill themselves, and life would proceed as usual.

But if you want something right this moment and someone tells you "I'm going to take you to a doctor who will make you not want the thing you want," that would feel like they're going to brainwash you.  And if the doctor's mandate is to do everything in their power to prevent you from achieving what you want, you'd probably actively avoid them, perhaps even going as far as to deceive people about your condition and situation so they don't brainwash/restrain/monitor you in a way that would make it impossible to achieve your goal.

Building on the fertility treatment analogy above: suppose you tell a loved one that you want to have children, and they respond by taking you to a doctor who will make you not want children.  Or, based on the information you have absorbed from media/culture/society, you believe that a doctor would respond by taking all measures to prevent you from having children, up to and including forcibly sterilizing you. 

Or the inverse: suppose you don't want to have children, and a loved one responds by taking you to a doctor who will make you want to have children. And the information you have received throughout your life leads you to believe that the doctor would go as far as forcibly impregnating you.

Would this make you feel safe seeking medical treatment?  Or would it make you want to avoid it at all costs?

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Removing the suicide prevention mandate might also help reduce the criminalization of mental health patients. 

There was recently a series in the Toronto Star about how people are failing police checks they need for employment because they are known to police (even though they were never found guilty and in some cases never arrested or charged).  And some of them are known to police because police attended a mental health call.  The police were called because the person was considered a threat to themselves, and in the messed up system of disclosure for background checks there's no differentiation between being a threat to oneself and a threat to others.

If health care professionals were not mandated to prevent suicide, there'd be no such thing as involving the police because someone is a threat to themselves.  Killing yourself would be considered your own decision to make, even if it's ill-advised, so there'd be no reason to forcibly stop you.

Analogy: if someone wants risky ill-advised elective surgery and they're proactively trying to get this surgery, this isn't considered a reason for police intervention.  Even if getting the surgery would harm them, that's between them and their doctors. 

Since there's no police involvement, people won't have police records dogging them just because they were once suicidal, so they'd have the full range of employment and travel options still available to them. Surely this would make for a better recovery than being shut out of jobs where they can do good just because they were once suicidal!

Yes, this aspect could also be addressed by police only disclosing appropriate and pertinent information in background checks, but I feel like the medical profession could be more easily persuaded to make helpful decisions than the police.