When police found Melvin Theuma in a pool of blood, with wounds to his neck, kidneys and wrist, speculation was rife as to whether the high-profile state witness had been targeted by an assassin.

Medical experts say suicidal attempts through self-stabbing, while highly unusual, are not completely unknown.

Forensic psychologist Roberta Holland and forensic scientist Christopher Farrugia said they do not recall ever coming across one.

Farrugia said that from his experience between 1990 and 2009, there was an attempted suicide every 10 days, but that he had never encountered this method.

“Normally, we would not hear of self-stabbings, but rather, slashing, suffocation or driving off a cliff,” said Holland.

However, while it was “unusual”, she said it was not impossible.

Questions as to whether someone could physically stab himself and inflict deep injuries in different places, and if the first wound was mild enough to have the strength to inflict the second, were justified, she said.

A person predetermined to kill oneself would know where to hit

From a scientific point of view, an examination of the nature of the wounds, including the direction of the weapon’s insertion, in this case a knife, could determine clearly whether they were self-inflicted.

Multiple stab wounds, while very common features of homicidal stabbings, differ from suicidal stabbing in terms of the location, shape and direction of the wounds, according to the Journal of Forensic Science and Medicine.

A suicidal stab wound would be more horizontal due to the way the victim holds the knife, while a homicidal stab is likely to be distorted in an attempt to fend off an assailant.

Examinations could be done at the scene of the incident by a forensic doctor, or even emergency doctors, who would have “quite a good eye to establish facts”, said Farrugia. But it also depended on the gravity of the injuries and the priority to save the victim’s life.

Theuma’s mental state and any pressure he was under also had to be considered, Farrugia said.

While crisis psychiatrist Mark Xuereb could not comment on the individual case, he said any key witnesses in a court case are exposed to constant and crushing pressure.

Theuma is the main witness for the prosecution, having been granted a pardon in exchange for his testimony in the case against millionaire businessman Yorgen Fenech, who is accused of conspiring to kill journalist Daphne Caruana Galizia in a car bomb in October 2017.

The pressure and public scrutiny can make key witnesses vulnerable to potentially destructive behaviour and limited pro-life choices, irrespective of their coping mechanisms, Xuereb said.

He said this type of self-inflicted harm can be premeditated or impulsive and reactive, and is not necessarily intended to cause serious harm but could lead to death.

It would see the person hitting himself in a flurry of rage and exasperation, he explained. In general, it is a means of internalising anger.

Generally, a person predetermined to kill oneself would know where to hit, how deep and the type of weapon to use, he said, appealing to anyone in crisis to reach out for help.

Police at Melvin Theuma's appartment after he was stabbed in an incident police say was self-inflicted

Why police think Melvin Theuma's wounds were self inflicted

A police statement issued shortly after Melvin Theuma was rushed to hospital on Tuesday night immediately indicated that investors considered his injuries to be self inflicted.

In a news conference on Wednesday morning police commissioner Angelo Gafa was keen to qualify why police had come to that conclusion. 

Gafa said that lead inspector Keith Arnaud, who was among the first repsonders on site, had asked Theuma if he had tried to commit suicide.

Although he was unable to speak, the murder middleman "indicated" in the affirmative and paramedics at the scene witnessed this. 

Furthermore, there were no signs of a struggle in Theuma's apartment and none of the other residents in the apartment block had heard a commotion, police said.

The windows were locked, and the officers standing guard at the entrance to the building had not logged any movements. 

Inside the bloodied bedroom where Theuma was discovered, there were no signs of an intruder.

Theuma, who police say is right-handed, was found holding a knife in his right hand, with lacerations to his left wrist and along his throat, which were deep enough to damage his voice box.

He had multiple puncture wounds to the left side of his torso as well. 

Gafa said Theuma had not exhibited any defence wounds either and there was no blood spatter as would be expected, were he to have been attacked by an assailant. 

If you are feeling suicidal or need help, contact Supportline 179, the Crisis Intervention Service 2545 3950 or 24/7 crisis line Fondazzjoni Sokkors fil-Pront 9933 9966.

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