SOME of the most chilling murders have taken place between family members recently, with most of the perpetrators having no history of mental disorder and were not under the influence of drugs.

Among those that hogged media headlines and consequent public attention was the case of a man who was suspected of slaying his wife and their three-month-old baby in a house at Kampung Bakar Batu in Johor last July.

The suspect was alleged to have committed the brutal and senseless murder in a fit that was uncharacteristic of the 24-year old man. Family members had said that the suspect was not known to be hot-tempered.

He was later found by police along a highway in Permas Jaya, riding his motorcycle naked several hours after his wife and their baby were found lying in a pool of blood near the front door of their home. During the arrest, police seized a cleaver from him.

The case was mind-boggling as many questions were raised on what drove the man to commit the grisly murder.

How could an individual who appears on the facade to have no problem, cheerful and happy-go-lucky, commit such a gruesome murder? Could this be a case of mental health problem or disorder?



DOUBLE WHAMMY

According to Consultant Psychiatrist at MSU Medical Centre Prof Dr Zulkifli Ghaus, various aspects need to be carefully looked into on what triggered family homicides.

Among others, the impact of a difficult birth on the infant as he develops into a child and adult can be especially significant, he said, noting that children who have had traumatic births are more likely to have difficulties in controlling their emotions.

Besides that, during their school days, were they bullied or physically or emotionally abused as well as having had negative influences from their friends.

"A person's personality, whether introvert or extrovert, comes into the equation too. Introvert refers to someone who is quiet and does not share his problem with others, enjoys staying at home, not aggressive, and finds difficulty in guiding others but rather loves to be guided and is socially awkward.

"Extrovert refers to an individual who is dynamic, ambitious, loves to guide others, aggressive and loves outdoor activities and adventure. However, there are other personalities who can influence others such as those who are paranoid, anti-social, histrionic (a condition where an individual constantly seeks attention and exhibit extreme emotions) and others," he told Bernama recently.

Dr Zulkifli said detailed information on the murder case should be collated including before, during and after the incident.

He did not rule out that the individual was having a double whammy of problems, among others, marital, workplace, debts, neighbours, personal health issues, including poor appetite, infection and sleep disturbance.

"Psychological trauma of any sort can have a damaging effect on human beings, and faced with a double whammy, they lose all sense of reason and lose control of themselves. What's worse is their personal health is also affected due to lack of rest, sleep, water and food, causing an imbalance of neurotransmitter levels in the brain that can trigger psychotic symptoms.

"Psychosis refers to a condition in which a person loses contact and fails to differentiate between reality and fantasy including riding on a motorbike naked.

"Hearing voices that aren't there (hallucinations) such as insults, verbal abuse or certain instructions will intimidate them and cause them to act beyond their control including committing suicide or killing others," he said, adding that this group can also suffer from delusions, that is when a person firmly believes in something that is untrue.



ORGANIC FACTORS

Elaborating on the issue, Dr Zulkifli said for such cases mentioned earlier, if the affected individual is still young, the medical division will trace the source as to how the incident could have happened.

"Other matters such as organic factors need to be weighed in, that is a condition when the brain cells are disturbed or damaged, causing the individual to have problems.

"Among the organic factors that need to be looked at are whether the individual is under the influence of drugs, brain infection, cerebral haemorrhage due to trauma, electrolyte blood level, endocrine system disorder, brain tumour, certain vitamin deficiencies and even food poisoning can also be among the sources.

"If the doctor is unable to detect the sources as above, then he will look at the mental health problem that is categorised as non-organic factor or functional factor due to genetic, environment, psychology and sociology aspect. These cases include Brief Psychotic Disorder, Dissociative Disorder, amuk and hysteria," he explained.

According to 2019 National Health and Morbidity Survey statistics by the Ministry of Health (MOH), among the leading risk factors for mental health problems in Malaysia are smoking which contributed 21.3 per cent and alcohol consumption 11.8 per cent.

Based on the statistics, 2.3 per cent of adults suffer from depression while 7.9 per cent or 424,000 are children aged five to 15 years.

At present, some 100,000 drug addicts suffer from mental health problems with marijuana, as among the highest of drug abuse cases in the country.

According to MOH, within the period March 2020 to May 20, 2021, 85.5 per cent out of 145,173 calls received related to mental health issues which needed emotional support and counselling such as acute stress, anxiety, depression, abuse and suicidal tendencies.



#DEPRESSIONISREAL

The gruesome murder of a mother and baby which went viral on the social media, saw netizens sharing their thoughts through #depressionisreal on their respective platforms. There were some who expressed sympathy for the suspect. In this situation, how will the people understand that depression, stress, etc are major issues that should not be taken lightly?

To this question, Dr Zulkifli said depression should be regarded as an issue of serious concern as failure to deal with the problem can affect an individual's quality of life, work as well as academic, social and spiritual aspects.

He said the public should enhance their knowledge and understanding of the mental health issues through their engagement in programmes organised by the relevant agencies, including the methods of overcoming depression as well as other symptoms such as anxiety, mania, short-temper, aggressive and psychosis.

"The community should be given a more proactive exposure on early signs of mental illness. We should know the basic method in facing people with depression or aggressive individuals as well as working hand-in-hand with doctors to treat such patients.

"The stigma and negative perception towards mental health patients should be alleviated. The word crazy or insane as an example should not be used but instead, family members, close friends, the community as well as the government should provide guidance and be ready to offer assistance," he noted.

An individual might feel devastated on the inside, but puts up a facade by concealing his feelings or problems as he does not wish to blow an issue out of proportion, said Dr Zulkifli, noting that all these will have serious psychological impact on his wellbeing, including suicide or killing others.

"This attitude may occur due to the stigma issue. They do not want to be labelled as negative or worse still, mental disorder. This is because members of the public often regard mental health patients as those who are problematic, weak, socially awkward, no future, aggressive, unreliable, etc.

"On average, men are less likely to talk or open up about their feelings given that they have been conditioned to lead and not to be guided. Asking for help from others would make them appear to be weak, mentally and physically.

"Women however are more likely to seek support for mental health issues than men with similar illness. Avoid suppressing your emotions, engage with a trusted individual such as your parents, siblings, counsellors, psychologists or psychiatrists," he advised.

Seeking help from an expert in the field is the best approach as information shared will be confidential and a report will only be issued upon consent by the individual concerned.



SHORTAGE OF PSYCHOLOGISTS, PSYCHIATRISTS

According to the National Institute of Health (NIH) 2018, Malaysia is still grappling with the shortage of experts in psychology and psychiatry.

At present, Malaysia has 200 psychologists for a population of 33 million people compared to Britain with 9,500 experts to a population of 67 million people.

Malaysia has a national average of 1.27 psychiatrists per 100,000 people, a stark contrast to the World Health Organisation (WHO)'s recommendation for a ratio of one psychiatrist per 10,000 people. (1:10,000).

"To confront the issue, psychiatry and mental health are often given priority during training of doctors. They are usually encouraged to focus on these fields as Malaysia is in dire need of such experts. Housemen are also advised to undergo psychiatry attachments to develop interest in this field.

"Programmes related to mental health are popular on social media platforms. Doctors should also share the knowledge and support those with problems," he said, adding that every medical officer has been advised not to treat the issue on stigma and discrimination toward mental health patients, lightly.



TOXIC FAMILY MEMBERS

Meanwhile, renowned Motivational and Counselling expert Hushim Salleh said based on his own experience handling cases involving married couples and families, financial problems including losing jobs during the COVID-19 pandemic were among the main causes of emotional stress that triggered mental health issues.

A worrying trend is the recent spate of family murders post pandemic - a man, believed to be a drug addict, killed his mother for refusing to give him money; and an elder brother was killed by his younger brother over alleged property dispute, among others.

"In this issue, family members can actually become toxic due to discontent, envy and most of these problems are due to lack of communication. Many of these cases today occur when most of the affected parties are tight-lipped and choose not to share their problems with other family members.

"If you bottle up your emotions for too long and remain quiet, you will explode at one point. In such cases, the individual's emotions turn to anger (towards the family member) and in the end, voices are heard (hallucinations) asking the affected party to kill," he said.

Hushim said there are also cases of married couples with marital problems who pretended to be happy to protect their family's good name and their own reputation.

"Such cases are common. On the outside, they seem constantly happy and absolutely perfect, sharing their stories on Facebook and Instagram. But the perfect couple that seems happy isn't quite as perfect as they may seem on the outside.

"When the couple meets during their counselling session, they suddenly explode as both sides have been suppressing their emotions much too long but have not shared or communicated with each other. Such acts are detrimental to the marriage.

"Couples having issues in their marriage should immediately seek help from marriage counsellors before the problem worsens, don't pretend to be happy when you're not. What's important is spouses need to communicate effectively with each other," he said, adding that counselling and family therapy sessions can help save a family institution.

-- BERNAMA