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KINIGUIDE | Legal vs medical insanity: What the school stabbing verdict really means
Published: Oct 3, 2026 7:00 AM
KINIGUIDE | Last year, 16-year-old Yap Shing Xuen was stabbed to death in a school toilet in Bandar Utama, Selangor, by a 15-year-old schoolmate.
Recently, the Shah Alam High Court acquitted the assailant, LCH, of his murder charge on the grounds of insanity due to untreated and undiagnosed "very early-onset schizophrenia".
The judgment has sparked public debate, including over the difference between legal and medical insanity.
This KiniGuide explores that question.
What is legal insanity?
Under Section 84 of the Penal Code, legal insanity requires the accused to show they were incapable of understanding the nature of their act or that it was wrong or contrary to law.
Former Selangor Bar chairperson Kokila Vaani Vadiveloo (below) explained: "The question is not merely, 'Was he mentally ill?' The question is, 'Did that mental condition affect his ability to understand what he was actually doing, or to understand that what he was doing was wrong, at the time of the incident?'"
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Speaking to Malaysiakini, she stressed that a psychiatric diagnosis alone is insufficient to meet this legal threshold.
In Malaysia, the defence of unsoundness of mind is proved on the balance of probabilities, not beyond reasonable doubt. Courts also consider the accused's conduct before and after the incident, she added.
How does it differ from medical insanity?
Clinical psychologist Shaleen Chrisanne noted that a person with severe mental illness can still be legally sane.
She said medical and legal concepts of sanity arise from different disciplines answering different questions.
"Mental illness sits on a continuum from mild to severe, while legal insanity is binary, where a defendant either meets the threshold of insanity or doesn't," she said.
Shaleen (below) added that the term "insanity" has largely been dropped in medical and psychiatric practice for over a century because it is difficult to determine precisely.
"There is a perception that being acquitted for legal insanity is unfair. However, if someone can't tell right from wrong because of their delusions or mental illness, it is their human right to be tried fairly based on their capacity and condition.
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"In this case, receiving psychiatric care rather than incarceration is an example of equitable justice.
"Nevertheless, being sent to psychiatric care is not always better than prison. The psychiatric care for people deemed legally insane in Malaysia is, unfortunately, not a comfortable experience due to the lack of infrastructure and resources," she added.
READ MORE: Legally insane: 3 takeaways from court judgment on school stabbing
How was LCH’s sanity determined?
To evaluate LCH, court-appointed forensic psychiatrist Dr Ian Lloyd Anthony monitored him for three months, conducted more than 34 interviews, and reviewed forensic evidence including school and clinical records as well as his journal.
Ian testified that very early-onset schizophrenia severely impairs thinking, especially in a still-maturing brain.
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The prosecution argued LCH could organise, weigh risks, adjust plans, and understand his actions were wrong, pointing to his year-long tracking of Yap, months spent procuring knives and replica clothing modelled on the Columbine shooters, and hiding knives under his uniform for two weeks.
Judge Adlin Abdul Majid rejected these arguments, accepting Anthony's assessment that planning ability does not prove knowledge that the plan was wrong.
She ordered his indefinite institutionalisation at Hospital Bahagia Ulu Kinta, at the pleasure of the Selangor sultan. The prosecution is appealing the verdict.
Was he acquitted or not?
Kokila said using the term "acquittal" can be misleading.
"An acquittal on the grounds of unsoundness of mind is not necessarily the same as an ordinary acquittal where the accused is simply found not to have committed the offence and walks out of court."
She said public perception that LCH had "gotten away" with the crime is a vast oversimplification of what truly occurred in court.
The court found that LCH committed the act but could not be held criminally responsible because he was of unsound mind at the time, she noted.
In common law jurisdictions like Malaysia, criminal liability generally depends on proving not only the physical act but also the capacity to form the necessary criminal intent.
"What this particular judgment does highlight is the importance of recognising serious psychiatric symptoms early," Kokila said.
"According to the High Court's grounds, the teenager had experienced symptoms for several years and had not received psychiatric treatment during that period. The court considered that prolonged untreated illness was significant to his condition by the time of the incident.
"So perhaps the broader public conversation should be less about 'mental illness equals violence' and more about early identification, access to treatment, safeguarding, and intervention where there are serious warning signs," she added.
KINIGUIDE | Last year, 16-year-old Yap Shing Xuen was stabbed to death in a school toilet in Bandar Utama, Selangor, by a 15-year-old schoolmate.
Recently, the Shah Alam High Court acquitted the assailant, LCH, of his murder charge on the grounds of insanity due to untreated and undiagnosed "very early-onset schizophrenia".
The judgment has sparked public debate, including over the difference between legal and medical insanity.
This KiniGuide explores that question.
What is legal insanity?
Under Section 84 of the Penal Code, legal insanity requires the accused to show they were incapable of understanding the nature of their act or that it was wrong or contrary to law.
Former Selangor Bar chairperson Kokila Vaani Vadiveloo (below) explained: "The question is not merely, 'Was he mentally ill?' The question is, 'Did that mental condition affect his ability to understand what he was actually doing, or to understand that what he was doing was wrong, at the time of the incident?'"
Speaking to Malaysiakini, she stressed that a psychiatric diagnosis alone is insufficient to meet this legal threshold.
In Malaysia, the defence of unsoundness of mind is proved on the balance of probabilities, not beyond reasonable doubt. Courts also consider the accused's conduct before and after the incident, she added.
How does it differ from medical insanity?
Clinical psychologist Shaleen Chrisanne noted that a person with severe mental illness can still be legally sane.
She said medical and legal concepts of sanity arise from different disciplines answering different questions.
"Mental illness sits on a continuum from mild to severe, while legal insanity is binary, where a defendant either meets the threshold of insanity or doesn't," she said.
Shaleen (below) added that the term "insanity" has largely been dropped in medical and psychiatric practice for over a century because it is difficult to determine precisely.
"There is a perception that being acquitted for legal insanity is unfair. However, if someone can't tell right from wrong because of their delusions or mental illness, it is their human right to be tried fairly based on their capacity and condition.
"In this case, receiving psychiatric care rather than incarceration is an example of equitable justice.
"Nevertheless, being sent to psychiatric care is not always better than prison. The psychiatric care for people deemed legally insane in Malaysia is, unfortunately, not a comfortable experience due to the lack of infrastructure and resources," she added.
READ MORE: Legally insane: 3 takeaways from court judgment on school stabbing
How was LCH’s sanity determined?
To evaluate LCH, court-appointed forensic psychiatrist Dr Ian Lloyd Anthony monitored him for three months, conducted more than 34 interviews, and reviewed forensic evidence including school and clinical records as well as his journal.
Ian testified that very early-onset schizophrenia severely impairs thinking, especially in a still-maturing brain.
The prosecution argued LCH could organise, weigh risks, adjust plans, and understand his actions were wrong, pointing to his year-long tracking of Yap, months spent procuring knives and replica clothing modelled on the Columbine shooters, and hiding knives under his uniform for two weeks.
Judge Adlin Abdul Majid rejected these arguments, accepting Anthony's assessment that planning ability does not prove knowledge that the plan was wrong.
She ordered his indefinite institutionalisation at Hospital Bahagia Ulu Kinta, at the pleasure of the Selangor sultan. The prosecution is appealing the verdict.
Was he acquitted or not?
Kokila said using the term "acquittal" can be misleading.
"An acquittal on the grounds of unsoundness of mind is not necessarily the same as an ordinary acquittal where the accused is simply found not to have committed the offence and walks out of court."
She said public perception that LCH had "gotten away" with the crime is a vast oversimplification of what truly occurred in court.
The court found that LCH committed the act but could not be held criminally responsible because he was of unsound mind at the time, she noted.
In common law jurisdictions like Malaysia, criminal liability generally depends on proving not only the physical act but also the capacity to form the necessary criminal intent.
"What this particular judgment does highlight is the importance of recognising serious psychiatric symptoms early," Kokila said.
"According to the High Court's grounds, the teenager had experienced symptoms for several years and had not received psychiatric treatment during that period. The court considered that prolonged untreated illness was significant to his condition by the time of the incident.
"So perhaps the broader public conversation should be less about 'mental illness equals violence' and more about early identification, access to treatment, safeguarding, and intervention where there are serious warning signs," she added.
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