KOTA KINABALU: A forensic psychiatric consultant told the Coroner’s Court here that a psychological autopsy into the death of Zara Qairina Mahathir found that her death was most consistent with suicide.
Dr Chua Sze Hung, 43, of Mesra Bukit Padang Hospital in Kota Kinabalu, said this conclusion was based on his assessment that at the time of the incident, Zara Qairina had more risk factors than protective factors, reported Sinar Harian.
“This imbalance increases vulnerability to suicidal behaviour. The combination of predisposing and precipitating factors suggests that the final act was most likely an attempt to end suffering, occurring in a state of extreme acute stress, impaired judgement, and reduced access to normal protective mechanisms, rather than a carefully planned act to end life.
“Therefore, this psychological autopsy concludes that the manner of death is most consistent with suicide,” he said while reading his witness statement before Coroner Amir Shah Amir Hassan on Thursday (April 2).
He said the conclusions of Zara Qairina’s psychological autopsy also led to several key findings.
“I do not believe the deceased was physically pushed, as there is no credible evidence at the time of writing the report to support that.
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“There is information indicating emotional dysregulation, intense anger, self-injurious behaviour, unstable interpersonal relationships, and fear of abandonment. However, it is not sufficient to make a retrospective diagnosis of a personality disorder.
“Although there is information indicating symptoms of depression, I do not believe that the deceased suffered from a severe, diagnosable mental illness prior to the alleged incident,” he said.
Dr Chua said suicide is a deliberate act of self-harm that results in death.
“It is a complex phenomenon with multiple determining factors. It is inaccurate to attribute all suicides to diagnosable mental illness.
“Approximately one-fifth of lifetime suicide attempts occur without an apparent psychiatric disorder (Oquendo et al., 2024). More than half of suicide victims have no known mental health condition (Stone et al., 2018).
“One of the leading causes of death among adolescents is suicide (WHO, 2021). Nearly three out of five adolescents who die by suicide have no prior mental health diagnosis (Chaudhary et al., 2024).
“Studies in Malaysia show that adolescents aged 13 to 15 years have a higher risk of suicide attempts compared to other age groups. Students whose parents are separated also show a higher likelihood of suicide attempts (Liew et al., 2023),” he said.
He said that in Zara Qairina’s case, the risk factors included, but were not limited to, life stress, negative self-perception, a perception of being bullied, unsatisfactory academic achievement, a history of e-cigarette use, anger, verbal aggression, self-harming behaviour without suicidal intent, parental separation, conflict with parents, social sensitivity, depressive symptoms, behavioural problems, and a desire to die.
“Triggering factors include stressful life events (interrogation) and feelings of isolation.
“Other contributing conditions include chronic sleep deprivation and frustration.
“It should be emphasised that several suicide risk factors existed before the deceased entered the school, namely intentional self-harm, parental separation and divorce, conflict with parents, social sensitivity, anger, verbal aggression, a history of e-cigarette use, and a desire to die,” he said.
He said he had previously prepared an 84-page psychiatric report for the court, based on an analysis of information from 40 individuals who were also witnesses in the inquest, as well as reports related to the incident.
He added that the Sabah Attorney General’s Chambers requested a psychiatric assessment of Zara Qairina from the Health Ministry on Sept 17, 2025, and that a report was prepared to assist the Kota Kinabalu Coroner’s Court inquest into the teenager’s death.
According to him, a three-member team was appointed by the Director-General of Health on Sept 19, 2025. The team comprised himself, child and adolescent psychiatrist Dr Nurulwafa Hussain, and clinical psychologist Norhameza Ahmad Badruddin.
“The team believes that a psychological autopsy is the most appropriate approach to assist the Coroner’s Court in achieving the objectives of the inquest.
“This report focuses primarily on the probability of whether Zara Qairina died by suicide, and if so, the circumstances under which it might have occurred,” he said.
