Table of Contents
Introduction
Suicide has been a common issue that happens in Malaysia. This issue usually occurs among youth. In the last decade, the allocation of RM 900 million (262 million US dollars) for the years 2006 to 2010 by the Malaysian government under the Ninth Plan has been an important step forward in improving services for mental health problems including suicide and self-harm in Malaysia. As part of this, the National Suicide Registry Malaysia was established in 2007 to monitor suicides. As yet, a self-harm registry has not been established, which is a potentially important omission, given that self-harm is the most powerful predictor of suicide.
Despite these efforts by the Malaysian government, however, the research literature into suicide and self-harm in Malaysia has been fragmented because it has tended to focus on certain types of self-harm among specific ethnic groups. This means that the prevalence of suicide and self-harm in Malaysia can only be accurately assessed by cross-checking multiple sources. The first major aim of the present review was, therefore, to try to provide a more accurate estimate of the prevalence of suicide and self-harm in Malaysia by drawing together the published research literature systematically.
In developing countries like Malaysia, the highest suicide rate is found among the young (below 30 years) and married women are at higher risk. Consistent with this Suicide and Self-Harm in Malaysia 5 pattern of findings, in Malaysia (Kuala Lumpur specifically), self-harm is highest among women, people aged 16-24 years and people with an Indian background. However, further research is needed to elucidate the role of demographic correlates including gender and age on suicide rates in Malaysia.
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Causes
Suicide often happens among youth in Malaysia. Most of the research agreed that suicide is more connected to mental disorders. There are about 90% of people who commit suicide or have suicidal thoughts suffered from at least one mental illness. Mental illness was found to contribute between 47 and 74% of suicide attempt. The affective disorder is the disorder with the most frequently found in Malaysia. For depression, there were found in 50–65% of suicide cases, more often among young females than males. Cruel abuse, and more specifically wrongly use of alcohol, also strongly contribute to suicide risk, especially in older adolescents and males. Among 30–40% of people who died by suicide had personality disorders, such as antisocial personality disorder. Suicide mostly happens among young people with eating disorders, in particular, anorexia nervosa, as well as in people with schizophrenia, Schizophrenia is characterized by delusion and hallucination but it is rarely found among youth.
Depression is a mental disorder that most people are not aware of. It is frequently happening among youth in Malaysia. Depression, or major depressive disorder, is a serious mental illness that affects the way you think and how you feel. Depression can make you feel extreme sadness and hopelessness. It’s not just feeling sad for a day or two but can happen in months or many years. You are more likely to lose interest in what you have enjoyed before. It can lead you to various physical and emotional problems and decrease the ability of the person to function at work or home. Thus this can lead to suicide.
Malaysians have recently been saddened by the death of a teenage girl who committed suicide after 69 percent of pollsters on her Instagram account embraced the possibility of killing herself. According to local newspapers The Star, the victim posted an online poll status asking her’ Instagram Story ‘ followers: “Very Significant, Help Me Choose D / L.” (D was for death and L for Life). The victim also allegedly posted a Facebook status update in which she said: “Wanna Quit F Life I’m tired.’
Padawan District Police Deputy Chief DSP Merbin Lisa said based on the investigation, the 16-year-old girl identified as Davia Emelia was suspected of being depressed.”Based on the victim’s mother’s claim, however, she displayed no behavioral change before. “According to her mother, the victim was loyal to her stepfather, but since the stepfather had married a Vietnamese woman, he rarely returned to Kuching to visit the victim.” This made the victim feel sad, “he said when he contacted Bernama here on Thursday (May 16).
Another cause of suicide among youth in Malaysia is because of an eating disorder. Eating disorders include three different diseases, including anorexia nervosa, bulimia nervosa and binge eating disorder (BED). Anorexia nervosa has one of the highest rates of death for psychiatric disorders, with a 10% risk of death. Anorexia nervosa is associated with a host of physical conditions that could be life-threatening. Anorexia, although not very common in Malaysia, is an eating disorder that leaves its victims with a skewed self-image. In short, it must be detected early and treated immediately as it becomes progressively more difficult to resolve later. It makes many depressed and suicidal as they are anxious about their weight, and the idea of becoming overweight consumes them despite being underweight. They might even be so malnourished that their hearts would suddenly stop or their kidneys might fail.
Ways To Solve This Issue
Recognizing the severity of this tragedy, the WHO has proclaimed Sept 10 as World Suicide Prevention Day: an annual event that has been taking place since 2003 to draw public attention to and celebrate global efforts and progress in trying to mitigate this epidemic.
World Suicide Prevention Day in 2014 is notable because it marks the publication of the World Suicide Survey (WSR) by the WHO. The study follows the adoption by the World Health Assembly of the Comprehensive Mental Health Action Plan 2013-2020, which commits all 194 Member States (Malaysia being one of them) to increasing their suicide rates by 10 per Member States by 2020.
The World Suicide Report provides the most recent data from a hundred countries around the world on this topic, providing evidence of promising key measures that can minimize suicide attempts, as well as effective national suicide prevention initiatives in several countries. Some of these established strategies include removing barriers and stigma associated with access to mental health care, eliminating or limiting access to means of suicide (e.g. pesticides, toxins, drugs), proactive suicide reporting, increasing public awareness of mental health disorders and suicide, and expanding mental health outreach. Some or all of these may form the backbone of the implementation of a national integrated mental health policy. The Malaysian Government has commendably initiated a 5-year National Suicide Prevention Strategic Action Plan, which started in 2012, representing some of the above-mentioned provisions.
One of the main strategies in this initiative is to move mental health treatment from hospitals to community mental health facilities to increase public access. The use of non-specialized health professionals to increase support for depressed people through online and telephone counseling services (such as Befrienders) is a key part of this outreach initiative.
The Ministry of Health also plans to seek a three-fold increase in the proportion of psychiatrists among the population, from the present 1:150,000 to the 1:50,000 ideal.
There are, however, several areas in which more progress can and should be made on this topic in our country. One of the main findings of this World Suicide Report concerns the legal status of suicide and its impact on the prevention of suicide in these Member States. Of the 192 sovereign countries and states surveyed, 25 have specific laws and penalties for attempted suicide; Malaysia being one of these. Under Section 309 of our Criminal Code, those who survive a suicide attempt or parasuicide face up to one year in prison or a fine, or both, if convicted. The justification for retaining this antiquated rule, inherited from our colonial masters, is that its abolition may facilitate further suicide attempts.
Yet to date, however, no evidence or case-reports are showing that decriminalization increases suicide. Besides, suicide rates tend to decline in post-decriminalization countries; for example, in most industrialized countries such as Germany, France, the Netherlands, Austria, Sweden, Denmark, Finland, and Canada. In recognition of this fact, there has been a recent attempt by the Malaysia Law Reform Committee to revisit this controversial law back in 2012.
Conclusion
There are, of course, some cultural and religious considerations that must also be taken into account when contemplating its repeal. However, the law in its present form has seldom been used, although there have been some cases in which it has been applied.
However, since suicide is considered a criminal act, suicide attempts are often concealed and suicide deaths are not recorded, creating the false impression that suicidal behavior is less prevalent. If the government is serious about addressing the issue of suicide and its underlying causes, this information is crucial to guide its efforts.
The right way forward will have to align the sensitivities of our country’s culturally and religiously diverse populations with effective outreach efforts to high-risk groups.
