The High Court’s acquittal of a teenager charged with murder, on the grounds of insanity, in the Bandar Utama school stabbing has understandably generated strong reactions.
A young life was lost, a family has experienced unimaginable grief, and the wider community remains deeply affected. Acknowledging the teenager’s mental condition must never be interpreted as minimising the tragedy or the suffering of the victim’s family.
However, public discussion must be guided by medical evidence, psychological understanding and the law—not stigma, anger, or assumptions about mental illness.
Mental health professionals do not assess patients to “take sides.” Psychiatrists and psychologists are ethically responsible for evaluating a person’s mental state objectively and reporting their clinical findings honestly. Their conclusions are based on professional interviews, behavioural observations, mental-state examinations, developmental and medical history, collateral information and, where appropriate, psychological assessments.
When a psychiatrist concludes that an individual has a serious mental disorder, that conclusion is not made simply to protect the individual from legal consequences. It is a clinical opinion based on the person’s condition. Such professional findings deserve respect, particularly when they have been carefully considered and accepted as evidence by the court.
At the same time, the respective roles of mental health professionals and the court must be understood correctly. Under section 84 of Malaysia’s Penal Code, the presence of a mental illness alone does not automatically establish legal insanity.
The law requires a two-stage consideration. First, medical evidence must establish that the person was suffering from a mental illness at the time of the alleged act. Second, the court must determine whether that illness impaired the person’s reasoning so severely that the person was incapable of understanding the nature of the act or knowing that it was wrong or contrary to law.
Therefore, psychiatrists provide the medical findings, lawyers present and examine the evidence, and judges ultimately decide whether the legal requirements have been met. These are distinct but interconnected responsibilities.
Receiving psychiatric care is also not equivalent to being released without supervision or accountability. Psychiatric treatment may involve continued assessment, medication where clinically indicated, psychological intervention, risk management, rehabilitation and monitoring. The objective is to treat the underlying condition while protecting the patient and the wider community.
This case should encourage a much broader conversation about how we understand mental health—not only after a tragedy occurs, but before someone reaches a point of crisis.
Severe psychiatric deterioration does not always begin with an extreme act. Warning signs may appear much earlier as sudden behavioural changes, social withdrawal, disturbed thinking, unusual beliefs or perceptions, intense emotional dysregulation, worsening academic or occupational functioning, threats of self-harm, or significant changes in sleep and self-care.
Not every person experiencing psychological distress will become violent. In fact, most people living with mental illness are not violent and may be more vulnerable to stigma, exploitation and harm from others. We must be careful not to create further fear or prejudice.
Nevertheless, significant warning signs should not be dismissed as attention-seeking, bad behaviour, poor parenting, indiscipline, or “just a phase.” Early psychiatric and psychological intervention can reduce suffering, improve functioning and sometimes prevent a condition from progressing into a serious crisis.
Mental health care must also be multidisciplinary. Psychiatrists, clinical psychologists, counsellors, behavioural therapists, occupational therapists, social workers, teachers and family members may all contribute different but important information.
Psychiatry can address diagnosis, biological factors and medical treatment, while psychology helps us understand cognition, emotions, behaviour, trauma, development and the person’s social environment. Neither discipline should be treated as optional or secondary.
It is especially concerning when even health care professionals misunderstand psychiatric and psychological conditions. Expertise in neurology or another medical speciality does not automatically provide comprehensive training in psychopathology, psychological assessment, or the management of severe mental disorders.
This raises an important question: are medical and neuroscience programmes providing sufficient education on mental illness, behavioural science, psychological formulation and the early recognition of psychiatric warning signs?
Mental health cannot be reduced to brain structures, neurotransmitters, or neurological disease alone. Human behaviour is shaped by a complex interaction of biological, psychological, developmental, and social factors.
We should not wait for another tragedy before acknowledging the importance of mental health care. Families must be encouraged to seek help without shame. Schools must have proper referral pathways. Health care professionals must recognise when specialist psychiatric or psychological assessment is needed. Mental health services must also be accessible before a person reaches an emergency.
Respecting psychiatric and psychological evidence does not mean condoning violence. Recognising mental illness does not mean forgetting the victim. We can mourn the life that was lost, stand with the bereaved family, protect the public, and still ensure that a seriously unwell young person receives appropriate care.
If warning signs continue to be ignored or dismissed, the next person who deteriorates without help could be someone within our own family. Mental health must be taken seriously long before a crisis reaches the police station, hospital, or courtroom.
The author is a behavioural therapist and clinical psychologist in training.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.
