special report Studies have shown that under-reporting and discrepancies in statistics are major hindrances for suicide prevention measures to be taken.

According to the Ministry of Health's National Suicide Registry Malaysia (NSRM), suicide is a significant but preventable public health problem.

suicide 231209 suicide methods However, studies have shown that under reporting and discrepancies in statistics are major hindrances for suicide prevention measures to be taken.

The National Statistics Department quoted figures as low as one to two people per 100,000 each year of suicide cases while researchers and psychiatrists are looking at a more realistic figure of 10 to 12 per 100,000, matching global statistics.

The lack of accuracy and discrepancy in the total number of deaths caused by suicide leads to difficulties, which make suicide assessments and prevention almost impossible.

NRSM admitted that the degree of subjectivity in classifying death of suicide, the lack of structured data describing 'the manner of death', inconsistencies in the way terms are defined and how data are collected are the main obstacles to gathering precise information on suicidal cases.

In Malaysia, a more comprehensive data on suicide rates have only been made available in recent years, with even NSRM providing very limited official statistics.

Dr T Maniam, psychiatrist and medical researcher from UKM, reveals that neither the government nor any other organisation in Malaysia has any comprehensive data on suicides.

Maniam, who has spent the last 25 years researching suicide, also points out the discrepancies in the official data, which he finds to be inconsistent with his own research based on the police and coroner's records.

Suicide classification

One of the major problems faced in trying to estimate the prevalence of suicide in Malaysia is the lack of proper classification of suicide cases.

To illustrate this, earlier this month Deputy Home Minister Jelaing Mersat told Parliament that suicide cases were classified as sudden deaths . This was in reply to Batu Gajah parliamentarian Fong Po Kuan, who called for the law against suicide to be repealed.

As it stands, deaths classified as 'sudden death' comprise suicides, and deaths with unknown causes.

suicide series 211209-241209 dr t maniam 04 Maniam ( right ) believes this should not be the case and called on the police to clarify why suicide cases are categorised as sudden death.

"In my opinion, sudden deaths are more likely suicide because if it was homicide or caused by an accident, then it should be easily classified as such," he explained.

To support his theory, he pointed out that there is a mirror effect between undetermined death rates and suicide rates. When one goes up, he said, the other goes down.

Furthermore, the deceased in both categories often share identical characteristics, leading him to conclude that it is a case of mis-classification.

The stigma on suicide

Befrienders Kuala Lumpur chairperson Gangadara Vadivel offers another explanation as to why the authorities have classified suicide as sudden deaths.

suicide 231209 befrienders breakdown He said the prevailing stigma on the issue of suicide leads authorities to pronounce many deaths by suicide as "cause unknown" on compassionate grounds.

He explained that in cases of suspicious deaths, the police or the victim's family has the discretion to call for a post-mortem, and the coroner will pronounce the cause of death upon inspection.

Most of the time, Gangadara said, the coroners will "spare the families the pain and trauma of suicide" and therefore classify these deaths as sudden death.

"The police are quite compassionate and often do not probe into suicide deaths, thus no post-mortem is conducted so as not to further alleviate the grief of the family members," he added.

According to Maniam, Malaysia is not alone in this problem, with countries worldwide facing similar issues of under-reporting.

A recent study in Australia into mis-classification of causes of death also found a mirror effect between sudden deaths and suicide rates, he said.

But Maniam noted that having the NSRM is a big step forward in attaining accurate data on suicide in Malaysia, which will ultimately help contain the problem.

Tomorrow: More young people contemplating suicide

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