A forensic consultant psychiatrist told the Coroner’s Court in Kota Kinabalu today that the death of 13-year-old Zara Qairina Mahathir was most consistent with an act of self-harm.
Dr Chua Sze Hung, the 67th witness in the inquest, said his assessment showed the victim had more dominant suicide risk factors compared to protective factors at the time of the incident, according to Berita Harian.
He said he had prepared, signed and certified an 84-page psychiatric report dated Feb 2, which evaluated the likelihood of self-inflicted harm and the circumstances surrounding the teenager’s death.
Dr Chua explained that his evaluation was based on multiple sources, including Zara’s personal diary, the post-mortem report by forensic pathologist Dr Jessie Hiu, the incident scene, counselling records, and visits to her hostel and dormitory. He also interviewed family members and school staff from SMKA Tun Datu Mustapha as well as her primary school.
He told the court that while there were indications of emotional distress, anger issues, self-harming behaviour, unstable relationships and fear of abandonment, these were not sufficient to diagnose a personality disorder retrospectively.
He further stated that although depressive symptoms were present, there was no evidence to suggest the victim suffered from a diagnosable severe mental illness prior to her death.
According to him, the combination of predisposing and triggering factors pointed towards a final act likely driven by an attempt to escape emotional suffering under acute stress, impaired judgement and reduced access to protective support systems, rather than a planned act.
Dr Chua listed multiple risk factors, including stressful life events, negative self-image, perceived bullying, academic struggles, substance use history, anger or verbal aggression, non-suicidal self-injury, parental separation, family conflict, social sensitivity, depressive symptoms, behavioural issues and suicidal ideation.
He also identified triggering elements such as interrogations, feelings of isolation, chronic sleep deprivation and distress linked to disciplinary reprimands at the student hostel.
He added that several of these risk indicators were already present before the victim entered her school.
Dr Chua noted that self-harm is among the leading causes of death among older adolescents, adding that nearly three in five youth cases involve individuals without prior documented mental health diagnoses.
He further cited studies showing Malaysian adolescents aged between 13 and 15 face a higher risk of attempting self-harm, particularly those from separated families.
On Sept 17, the Sabah Attorney-General’s Chambers requested the Health Ministry to conduct a psychiatric evaluation to assist the inquest proceedings.
Following this, Dr Chua, child and adolescent psychiatrist Dr Nurulwafa Hussain, and clinical psychologist Norhameza Ahmad Badruddin were appointed by the Health Director-General on Sept 19 to carry out a psychological autopsy assessment.
Zara was pronounced dead at Queen Elizabeth Hospital on July 17, 2025, a day after she was found unconscious in a drain near her school dormitory.
