PETALING JAYA: A psychiatrist told the inquest into the death of teenager Zara Qairina Mahathir that the events of July 15 last year were of significant clinical importance from a psychiatric perspective, describing them as likely to have caused acute emotional distress.
Consultant psychiatrist Dr Wong Haw Huo, the 75th witness in the inquest, said available witness testimony indicated that Zara Qairina had been subjected to a group confrontation involving accusations, the inspection of her personal belongings, negative remarks and public ridicule.
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He said the evidence showed she appeared visibly distressed during the incident, crying, denying the allegations against her and later isolating herself.
"The material reviewed also indicates that Zara Qairina was in a severely disturbed emotional state following the confrontation before withdrawing from others," he told the inquest on Friday (June 26).
"The absence of support or any attempt by her friends to comfort her immediately after the confrontation is clinically significant.
"The deceased was later reported to have been alone for a considerable period while in a distressed state.
"Witness testimony also described observations of the deceased displaying signs of emotional distress, social withdrawal and unusual behaviour in the early hours of July 16, 2025," he added.
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Dr Wong said that from a psychiatric perspective, Zara Qairina's distress, self-isolation and unusual behaviour following the confrontation could reflect acute emotional stress, feelings of humiliation and shame, overwhelming emotions, and a declining ability to regulate her emotions.
He said the period between the confrontation on July 15 and the incident in the early hours of July 16 when she was found unconscious.
"The material reviewed indicates that the deceased experienced an acute disruption in emotional regulation that occurred very close to the events of July 15.
"In such circumstances, judgment, rational thinking and behavioural control may have been impaired," he said.
Overall, Dr Wong concluded that Zara Qairina experienced cumulative emotional distress resulting from a combination of developmental vulnerabilities, sensitivity in close relationships, impulsive traits and increasing interpersonal pressures within the boarding school environment.
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"These vulnerabilities interacted with repeated misunderstandings in interpersonal relationships, the spread of rumours, social exclusion, conflicts with peers, accusations, and experiences perceived as humiliating in relation to the events of July 15," he said.
He added that the material reviewed also showed Zara Qairina retained several protective strengths, including the ability to socialise with others, self-reflection, efforts to repair relationships, hope for the future, reliance on religion in coping with stress, and a psychologically significant bond with her mother.
"On the balance of probabilities, the events of July 15 constituted a sudden interpersonal stressor occurring when the deceased was already under considerable emotional strain.
"From a clinical perspective, it is reasonable to conclude that she experienced an acute disruption in emotional regulation associated with a reduced capacity for reflective thinking and diminished ability to effectively use appropriate coping strategies," he said.
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However, Dr Wong stressed that his opinion did not conclusively determine Zara Qairina's actual intentions at the time of the incident.
"As this assessment was conducted retrospectively and no direct psychiatric examination could be carried out while the deceased was alive, no definitive conclusion can be drawn regarding her mental state or specific intentions.
"My opinion is also subject to limitations as it is based on third-party testimony, documents, written material, audio recordings, interviews with relevant parties and evidence presented during the inquest.
"Nevertheless, the available evidence supports the psychiatric conclusion that the deceased experienced cumulative interpersonal stress and overwhelming emotional distress in the context of her experiences at the boarding school," he said.
Zara Qairina, 13, died on July 17 last year at Queen Elizabeth Hospital, where she had been admitted a day earlier after being found unconscious near a drain at her school hostel in Papar, Sabah, at 4am.
