Kota Kinabalu: A psychological autopsy into the death of Zara Qairina Mahathir concluded that the manner of death is most consistent with suicide, arising from overwhelming distress rather than a deliberate, pre-planned act.
Consultant Forensic Psychiatrist Dr Chua Sze Hung, testifying before the Coroner Amir Shah Amir Hassan, said the deceased had a predominance of suicide risk factors over protective factors at the time of the incident, significantly heightening her vulnerability to suicidal behaviour.
He said the final act was likely carried out during a state of acute emotional distress, impaired judgement and reduced access to normal coping mechanisms.
“There is no credible evidence to suggest the deceased had been physically pushed, ”Dr Chua said in his witness statement on Thursday.
Dr Chua, who heads Psychiatry Services in Sabah and serves as National Deputy Head of Forensic Psychiatry Services, said the assessment was conducted as part of a psychological autopsy requested by the Sabah Attorney General’s Chambers to assist the coroner.
He also stated that a three-member team comprising Dr Chua, child and adolescent psychiatrist Dr Nurulwafa Hussain and clinical psychologist Norhameza Ahmad Badruddin, were appointed by the Director-General of Health on Sept 19, 2025.
Dr Chua said the team reviewed extensive material, including witness statements, school and counselling records, personal writings such as diaries and notes, forensic reports, and conducted site visits to the deceased’s hostel and classroom at SMKA Tun Datu Mustapha (SMKATDM) in Kinarut.
He further said while there were indications of emotional dysregulation, intense anger, self-harming behaviour, unstable interpersonal relationships and fear of abandonment, these were insufficient to establish a retrospective diagnosis of personality disorder.
He added that although depressive symptoms were present, there was no evidence the deceased suffered from a diagnosable severe mental illness prior to the incident.
In Dr Chia’s finding also stated that among the predisposing risk factors identified in the deceased were stressful life events, negative self-perception, perceived bullying, unsatisfactory academic performance, prior use of e-cigarettes, verbal aggression, non-suicidal self-injury, parental separation, conflict with a parent, social sensitivity, depressive symptoms, conduct issues and prior death wishes.
He said several of these risk factors were present even before the deceased entered the SMKATDM.
The precipitating factors included a stressful interrogation and a sense of isolation, while contributing circumstances comprised chronic sleep deprivation and disappointment following a disciplinary reminder.
“The accumulation and interaction of these factors led to a state of overwhelming distress at the material time.
“The convergence of these factors suggests the act was likely an attempt to end suffering rather than a meticulously planned termination,” he said.
Dr Chua stressed that suicide is an intentional and self-harming act leading to death.
“It is a complex phenomenon with multiple determinants. It is inaccurate to attribute all suicide to a diagnosable mental illness.
“Around one-fifth of lifetime suicide attempts occurred with no apparent antecedent psychiatric disorder. More than half of the suicide decedents were without known mental health conditions,” said Dr Chua.
He further explained that one-fifth of lifetime suicide attempts occur without any apparent psychiatric disorder, while more than half of suicide cases involve individuals without known mental health conditions.
Dr Chua also noted that suicide is among the leading causes of death among older adolescents globally, with studies showing youths aged 13 to 15 face higher risks, particularly those experiencing parental separation.
Dr Chua said the assessment was carried out in line with his duty as an expert witness, and his findings were based on his professional expertise and analysis.
He has prepared and submitted a detailed 84 pages psychiatric report dated Feb 2, 2026, to assist the Coroner’s Court in determining the circumstances surrounding the death.
