Forensic psychiatrist testifies psychological autopsy points to suicide in Zara Qairina’s case

KOTA KINABALU (April 2): A psychological autopsy has concluded that Zara Qairina Mahathir’s manner of death is most consistent with suicide, the Coroner’s Court here has heard.

Consultant forensic psychiatrist Dr Chua Sze Hung, who is the 67th deponent for the inquest on Zara’s death, testified that in his opinion, Zara “exhibited a predominance of suicide risk factors over protective factors at the time of the incident”.

“This 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.

“Therefore, this psychological autopsy concludes that the manner of death is most consistent with suicide,” he said.

Dr Chua, who has been at Hospital Mesra Bukit Padang since 2022, testified before Coroner Amir Shah Amir Hassan, that it was unlikely suicide would have occurred that particular morning or night if there had been no confrontation in the dorm.

He explained Zara’s coping mechanisms largely involved seeking support and interactions with her peers, diary entries, and, to a certain extent, Non-Suicidal Self-Injury (NSSI).

“On the night of the incident after the confrontation, I believe that she was devoid of her usual coping mechanisms,” he explained.

The witness further testified that he did not come across information that pointed towards Zara being pushed.

“At the completion of Zara’s psychological autopsy and after exhaustive interviews of 40 witnesses, there were abundance predisposing factors and precipitating factors to suicide.

“I didn’t come across information that pointed towards Zara being pushed and I refer to forensic pathologist documents that it is unlikely Zara has accidentally fell or being pushed,” he stated.

He further testified that the presence of risk factors alone do not necessarily lead to suicide.

“It is tempting to assign suicide to a single factor; this is human nature. Suicide rarely occurred due to a single factor, it is most of the time a combination of existing vulnerabilities in the form of multiple risk factors and acute destabilising factors and lack of proper support and coping mechanisms,” Dr Chua said.

To a question from deputy public prosecutor Mohd Fairuz Johari, the witness explained that “most consistent” did not mean absolute certainty.

“This psychological autopsy is a retrospective procedure, what I meant here was most likely than not it is a conclusion of probability,” he said.

He highlighted several suicide risk factors that existed before Zara entered the religious school, namely NSSI, parental separation/divorce, conflict with parent, social sensitivity, anger/aggression (verbal), history of e-cigarette use, and death wishes.

“The findings and conclusions of the psychological autopsy of Zara are as follows; I do not believe Zara had been somehow physically pushed, as there was no credible evidence at the point of report writing to suggest this.

“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 prior to the alleged incident,” he said.

He explained that suicide is an intentional and self-harming act leading to death that is a complex phenomenon with multiple determinants.

“It is inaccurate to attribute all suicide to a diagnosable mental illness,” he stressed.

In Zara’s case, he found precipitating factors included a stressful life event (interrogation) and a sense of isolation. Other contributing circumstances include chronic insufficient sleep and disappointment from the school prefect reminders, he said.

Dr Chuah also explained that the Sabah Attorney General’s Chamber had requested a psychiatric assessment for Zara from the Ministry of Health on Sept 17, 2025.

On Sept 19, a three-member team was appointed by the Health director general – Dr Chuah, child and adolescent psychiatrist Dr Nurulwafa Hussain, and clinical psychologist Norhameza Ahmad Badruddin.

The inquest continues on April 13.

Zara, 13, was found unconscious under her dormitory building on July 16, 2025 and died the next day in hospital.

On Aug 20, five minors, who were give the pseudonyms Student A, B, C, D, and E, were charged with using insulting words against Zara, with the court case currently ongoing.