Zara's death most consistent with suicidal behaviour: Forensic psychiatrist

 

A consultant forensic psychiatrist told the Coroner’s Court in Kota Kinabalu today that the psychological autopsy into the death of Form One student Zara Qairina Mahathir concluded that the manner of death was most consistent with suicide.

Dr Chua Sze Hung, a forensic psychiatrist at Hospital Mesra Bukit Padang, Kota Kinabalu, when testifying before coroner Amir Shah Amir Hassan, said that the findings and conclusions of the psychological autopsy showed that the deceased had exhibited a predominance of suicide risk factors over protective factors at the time of the incident.

Chua, 43, said that the imbalance heightened vulnerability to suicidal behaviour.

“The convergence of predisposing and precipitating factors suggests that the final act was likely an act to end suffering, occurring during a state of overwhelming acute distress, impaired judgment and reduced access to normal protective mechanisms, rather than a meticulously planned termination,” he said.

The 67th witness said he had prepared, signed, and stamped an 84-page psychiatric report, dated Feb 2, on his assessment and findings of the case for the court.

He said the assessment reviewed multiple documents, including Zara’s diaries, her primary school report, the high school counselling report, a site visit to the hostel and class, as well as the post-mortem report by consultant forensic pathologist Dr Jessie Hiu.

Chua said information from interviews with Zara’s family members, school staff, and students of Sekolah Menengah Kebangsaan Agama Tun Datu Mustapha, Papar, was also used as a source of information in preparing the report.

SMKA Tun Datu Mustapha

“There is information suggestive of emotional dysregulation, intense anger, self-harming behaviour, unstable interpersonal relationships and fear of abandonment. However, it is insufficient to form a diagnosis of personality disorder retrospectively.

“While there is information suggestive of depressive symptoms. I do not believe that the deceased was suffering from a diagnosable severe mental illness before the alleged incident,” he said.

He said suicide is an intentional and self-harming act leading to death, adding that it is a complex phenomenon with multiple determinants and is not always linked to mental illness, as many suicide decedents were without known mental health conditions.

Chua also revealed that a study examining data on Malaysian school-going adolescents shows those aged 13 to 15 are at a higher risk of suicide attempts compared to other adolescent age groups, while students whose parents live apart show a higher likelihood of attempting suicide.

“In the case of the deceased, the risk factors (predisposing factors) include but were not limited to stressful life events, negative self-perceptions, perceived bullying, unsatisfactory academic achievement, history of substance (e-cigarette) use, anger/aggression (verbal), non-suicidal self-injury, parental separation, conflict with parent, social sensitivity, depressive symptoms, conduct issues and death wishes.

“The precipitating factors (direct factors) include a stressful life event (interrogation) and a sense of isolation. Other contributing circumstances include chronic insufficient sleep and disappointment from the Badar’s reminder,” he said.

Chua said it has to be underscored that several suicide risk factors existed before the deceased entered SMKA Tun Datu Mustapha, namely non-suicidal self-injury, parental separation or divorce, conflict with parents, social sensitivity, anger or aggression (verbal), history of e-cigarette use and death wishes.

The Sabah Attorney-General’s Chamber requested a psychiatric assessment of the deceased from the Health Ministry on Sept 17, 2025, to assist the court in fulfilling the objectives of the inquest.

A three-member team, consisting of Chua, together with child and adolescent psychiatrist Dr Nurulwafa Hussain and clinical psychologist Norhameza Ahmad Badruddin, was set up for the purpose.

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Chua said he has testified as an expert witness in homicide, drug trafficking, and sexual offence cases referred for assessment under Section 342 of the Criminal Procedure Code, and has also testified in the superior and subordinate courts in Peninsular Malaysia and Sabah, as well as in the syariah court.

Zara, 13, died at the Queen Elizabeth Hospital on July 17, 2025, a day after being found unconscious in a drain near her school dormitory at around 4am.

On Aug 13, 2025, the Attorney-General’s Chambers (AGC) ordered the inquest following a review of the police investigation report.

This was after the AGC on Aug 8, 2025, ordered the girl’s body exhumed to allow for a post-mortem to be conducted.

Proceedings continue this afternoon.

- Bernama