He died young when he could've achieved so much.

"All his life Neo* liked to know what to expect. Whenever he went anywhere, he wanted to know who would be there, what would be happening and when we would be coming home. He had a keen interest in world affairs. But world news has been negative all year.

"This month life seemed unpredictable and miserable to Neo the HSC was looming. He did not expect to do well, and had no particular plans for the aftermath. During the holidays Neo worked every day except Sunday. Last Wednesday, he worked about twelve hours and came home tired. We were not around cold dinner had been left on the table but Neo didn't eat it. He should have eaten and rested. But he showered and went out.

"At 11.30pm Neo was with a close friend at the nearby hill top lookout, his usual retreat. It was very cold, dark and bleak. The state of the world seemed miserable. Neo's future seemed uncertain and unhopeful. He was very weary and profoundly sad.

"Neo loved us and if he had paused to consider us at all, he would not have caused us this pain. He was not thinking about us his tired brain was overwhelmed with despair. For a moment he was blinded from reason and it only takes a moment to climb that low rail and leap. Within seconds he was taken from us.

Neo is now absent from his body and present with God, free from suffering. We will miss him till we meet him again in heaven."

A mother's grief, written in memory of Neo, her 17-year old son.

Warning signs

Within a week, I received news of two suicides - both students. A grieving mother, burdened by guilt, attributes Neo's suicide to depression and "heavy metal music". The teacher attributes it to probable drug abuse. Or was it the relentless schoolwork? Pressure to excel? Personal problems, which only they knew? Attempts to understand why - to lighten our guilt - lead to more complex questions.

Warning signs of suicide, cited in research, range from the verbal ("Life sucks, I want to get out"; "They'll be sorry when I'm gone"); and behavioural (acting bored or disinterested; tearful sadness; change in appearance and personal hygiene); to environmental (problems at school, violence) and economics (poverty, unemployment, bankruptcy).

Precise causes of suicide are hard to pin. The World Health Organisation's annual reports point to depression - a treatable form of mental illness - caused by socio-economic instability, unemployment, substance and sexual abuse. The Malaysia Psychiatric Association website lists other causes - apparently culture-specific.

World Health Organisation's report estimates that one person commits suicide about every 40 seconds anywhere in the world, with men aged between 15-34 on average being three times more likely to kill themselves than women. Highest suicide rates were noted in Eastern Europe, and the lowest in Latin America.

In Australia, the Bureau of Statistics show men aged between 15-24 are more likely to die from suicides than other causes. To simplify the picture, everyday, about seven Australians take their own life. The highest rate of reported suicide from 2001 to 2005 was in the Northern Territory ( 24.0 per 100,000 people was more than twice the Australian average (of 11.2 per 100,000 people).

The next highest suicide rates were observed for Tasmania (15.6 suicide deaths per 100,000 people) and Queensland and South Australia (12.8 suicide deaths per 100,000 people). In contrast, the ACT, New South Wales and Victoria all had rates lower than the national average. In 2005, suicide accounted for 4.3% of all Aboriginal deaths compared with 1.6% of deaths for other Australians.

The recording of suicide pattern varies across countries. The rate is usually expressed as suicide deaths per 100,000. Thus, with less populated countries, for instance, Malaysia of (25 million) compared to India's one billion odd, a few deaths may radically change the picture.

Where can they turn to?

Befrienders estimated that in the 1980s, the suicide rate in Malaysia was 8 per 100,000, which increased to 9-12 in the 2000 - which was quite close to Singapore's average of 11 per 100,000.

MPA quoted the Health Minister Datuk Dr Chua Soi Lek as saying that in five to 10 years, suicides would be the country's second biggest cause of death after cardiovascular disease. Highest suicide rate is in the Indian community with 30-35 per 100,000 having committed or attempted suicide compared with 15 Chinese and six Malays in every 100,00 (MPA Newsletter, 22/12/06).

Suicide is considered a crime under the Malaysian Penal Code although the law is not often enforced. Because suicide is a crime, it's often reported as accidental or undetermined death when they are not medically inspected or certified. And I've known a few in the past in my Penang neighbourhood. The reality is suicide rates are under-reported given its stigma, and depression as its major cause ignored.

With risks of student suicides unreported in Malaysian schools, it's a worry that no comprehensive suicide preventive programs are in place or teachers trained to detect the signs. A deputy principal at a PJ high school said, "The Ministry of Education now has made it such that every school has at least one fulltime counselor depending on the size of the school. At my school, we should have five (counsellors) but right now we have three. Their tasks I guess is to be there for the students and provide counseling."

"Suicide is not such a big topic talked about much here the main issue is drugs. I guess more has to be done to recognise the increase in youth suicides. Teachers at least have to be alert to signs but sometimes there are none like in the case of the boy (who recently committed suicide) in my school."

The deputy principal said she was shocked to know during the counselling sessions with students that "some of them have cut their own wrists not just once but several times I had myself seen several cases".

MPA notes that the majority of suicides due to depression are generally not diagnosed early because "their symptoms are not recognised; they are misdiagnosed and wrongly treated; doctors feel their symptoms are due to 'personal weakness' " or the patients tend to "hide their depressive symptoms".

Professor Mohamed Hussain Habil, president of the Malaysian Psychiatric Association reported in the MPA newsletter that suicide rates had increased by 60% for the past 45 years. About seven people attempt suicide daily in Malaysia (which is similar to reported estimates in Australia), one daily in Singapore and 13 daily in Thailand. (29/01/07, MPA website).

With the stigma attached to mental illness ('tanjung rambutan' in local parlance) victims, like Neo, and their carers - where could they have turned to?

*Name changed for privacy.