Consultant forensic psychiatrist Dr Chua Sze Hung, 43, said the victim exhibited more suicide risk factors than protective factors at the time of the incident, according to a Malay daily.
PETALING JAYA: The death of 13-year-old Zara Qairina Mahathir is “most consistent with suicide”, a forensic psychiatric expert told the Coroner’s Court today, citing findings from a psychological autopsy.
Consultant forensic psychiatrist Dr Chua Sze Hung, 43, said the victim exhibited more suicide risk factors than protective factors at the time of the incident, according to a Malay daily.
The 67th witness said he had prepared, signed and sealed an 84-page psychiatric report dated Feb 2 for the court, focusing on the likelihood of suicide and the circumstances surrounding the teenager’s mental state.
He said materials reviewed included Zara Qairina’s diary, the scene of the incident, the post-mortem report by consultant forensic pathologist Dr Jessie Hiu, counselling records, visits to her hostel and dormitory, as well as interviews with family members and staff of Sekolah Menengah Kebangsaan Agama (SMKA) Tun Datu Mustapha and her former primary school.
“There was information indicating emotional disturbance, intense anger, self-harming behaviour, unstable interpersonal relationships and fear of abandonment. However, this was insufficient to establish a retrospective diagnosis of a personality disorder.
“Although there were indicators of depressive symptoms, I do not believe the deceased suffered from a severe diagnosable mental illness prior to the incident.
“The convergence of predisposing and precipitating factors suggests the final act was most likely an attempt to end her suffering, occurring during a state of acute and overwhelming stress, impaired judgement, and reduced access to normal protective mechanisms, rather than a carefully planned act,” he said while reading his witness statement before Coroner Amir Shah Amir Hassan.
Dr Chua added that suicide remains one of the leading causes of death among older adolescents, noting that nearly three in five youth suicide cases had no prior documented mental health diagnosis.
He said studies showed Malaysian adolescents aged 13 to 15 faced a higher risk of suicide attempts compared with other age groups, with those from separated families also exhibiting a higher likelihood.
“In this case, predisposing risk factors included, but were not limited to, stressful life events, negative self-perception, perceived bullying, unsatisfactory academic performance, substance use history, anger or verbal aggression, non-suicidal self-injury (NSSI), parental separation, parent-child conflict, social sensitivity, depressive symptoms, behavioural issues and a desire to die.
“Precipitating factors included stressful events (interrogation) and feelings of isolation. Other contributing conditions included chronic sleep deprivation and distress linked to disciplinary reminders by wardens,” he said.
Dr Chua also added that several suicide risk factors were present even before the victim enrolled at SMKA Tun Datu Mustapha.
On Sept 17, the Sabah Attorney-General’s Chambers applied to the Health Ministry to conduct a psychiatric evaluation to assist the inquest into Zara Qairina’s death.
A three-member team comprising Dr Chua, child and adolescent psychiatrist Dr Nurulwafa Hussain, and clinical psychologist Norhameza Ahmad Badruddin was appointed by the Health director-general on Sept 19, 2025, to carry out the assessment using a psychological autopsy approach.
Dr Chua told the court he had previously testified as an expert witness in cases involving murder, drug trafficking and sexual offences under Section 342 of the Criminal Procedure Code in the High Court, Sessions Court and Syariah Courts nationwide.
Zara Qairina was found unconscious on the ground floor of her school hostel and was pronounced dead on July 17, 2025, at Queen Elizabeth Hospital.
