A consultant forensic psychiatrist is of the view that if the mentally ill former Jamaica Defence Force (JDF) physiotherapist Kyodia Burnett, who stabbed his wife to death in December 2018, is given a custodial sentence it is highly likely he would regress and sink beyond the state he was in when he committed the murder.

Burnett, who was first diagnosed with generalised anxiety depression in 2008 according to the evidence led in the matter by his attorney Jacqueline Samuels-Brown, King’s Counsel, declined over the years, leading to him being diagnosed with major depressive disorder with anxious distress in January 2018.

Burnett murdered his attorney-at-law wife Nordraka Williams-Burnett on December 13, 2018 at their West Kirkland Heights, St Andrew, apartment.

Last Thursday Dr Clayton Sewell, who for 16 years worked as a sessional psychiatrist with the Department of Correctional Services, told the court that his diagnosis when he first examined Burnett after he killed his wife was that of schizo-affective disorder.

A schizo-affective disorder, he said, is a “chronic, enduring, psychotic condition characterised by abnormal thoughts, abnormal perceptions, and behaviour and mood changes”.

Sewell, who is now involved in private practice and also works in the psychiatry department (Ward 21) at University Hospital of the West Indies, said Burnett was removed from the facility by multiple police officers in January 2019 and placed at Tower Street Adult Correctional Centre (General Penitentiary), based on a court order.

Sewell, a witness for the defence, was one of several doctors to assess the 41-year-old. He furnished several assessment reports from his interactions with Burnett between January 2019 and February 2024, which were placed into evidence at the start of the trial last week.

According to Sewell, this kind of confinement is not in keeping with his diagnosis of the army man as he feels it is best for Burnett to be kept in a therapeutic environment.

He said it is the opinion of even the Psychiatric Association of Jamaica, of which he was once president, that the correctional facilities here are “non-therapeutic”. He also testified that despite it being said over the years that mentally ill inmates receive medication and benefit from psychiatric care, there are significant gaps which cause the inmates to regress. Furthermore Burnett, based on his level of responsiveness to treatment now, is not in need of that level of restriction.

He further claimed that Burnett has moved from being classified as “high risk” in 2018 to “consistently low risk for at least two years”, and is on a suite of medications which are suitable for his condition and which have been effective.

The doctor said that in order for Burnett to not regress he needs to be supervised closely, kept on his medication, and kept in a stable environment. This kind of support does not exist in the correctional facility, however, but is present at the community level.

Asked whether Burnett would relapse if he is placed at a non-therapeutic facility within the penal system, Dr Sewell said, “I believe that a non-therapeutic environment would not only trigger a relapse but would also prevent maximum recovery — and in my experience, a number of patients who spend time in those facilities ultimately emerge significantly depleted in terms of their ability to function.”

“Time in a non-therapeutic environment would impact negatively on his symptoms, and his level of functioning is likely to deteriorate at the end of that,” Sewell opined under probe by trial judge, Justice Dale Palmer.

Asked what would contribute to that reversal he said, “generally the fact that it is supervised by correctional staff versus medical personnel, challenges with access to appropriate medication, the exposure to traumatic experiences, and the decrease in access to family members and other forms of support, in my view”.

He also said that Burnett’s “interactions with his two young daughters was an essential part of his significantly and maximally” improved state.

As to the stressors that could impact negatively on Burnett’s well-being on the outside, Sewell, in admitting that he was worried about the age of Burnett’s parents — who are 69 and 70, and would be his caregivers if the court decides on a non-custodial sentence — responded, “I would say the stressors would have to be significant. Stress is unavoidable but what could cause significant decline in Mr Burnett would include significant loss (death of someone) as well as loss of opportunities for his own development, for example academic or employment challenges.”

Sewell said Burnett’s job complications with the JDF and his non-compliance with his medication requirements prior to the murder had contributed to his decline.

Asked whether his experience at the Tower Street prison showed a therapeutic treatment environment he said, “I don’t believe it is. That’s why I believed the hospital environment was best suited for this particular patient. In managing psychiatric patients we take the bio-psychosocial approach; that means providing medication and, in addition to that, psychological therapy in a safe, supportive, social environment that will facilitate the recovery, rehabilitation, and reintroduction of the individual into society.”

This, he added, is a principle that governns psychiatric care globally.

Under further questioning from Samuels-Brown he said Bellevue Hospital no longer has a dedicated section for forensic psychiatric treatment for people with mental disorders who had matters before the courts. The section, which was closed in the 1970s, saw some 400 mentally disordered patients being removed to the Tower Street prison, which has a section that houses inmates with chronic mental illnesses.

Dr Sewell said that while Burnett was fit to plead and able to participate in court proceedings, “having options for the disposal of matters with the mentally ill is important because their risks are not all the same and the level of support afforded for them may vary”.

He said he stood by his earlier recommendation that the former army man can be effectively managed in the care of his family.

Asked about Burnett’s risk profile and whether he had swept under the carpet the fact that the physiotherapist had killed his wife, Sewell said he had taken Burnett’s medical history into consideration as well as the fact that he had murdered his wife in forming his opinion.

Sewell took the stand based on a request from Justice Palmer who last Wednesday ruled that it had been established, on a balance of probabilities, that there was substantially diminished responsibility on the part of Burnett and that it was appropriate for the prosecution to accept his plea of guilty of manslaughter.

The judge had invited submissions based on his concerns about the “availability of facilities that can attend to this type of malady” ahead of his sentencing decision.

The tribunal is to hear from another medical doctor when it next meets. Burnett’s bail was extended, allowing him to return to the community group home where he now resides as a condition of his bail. His mother last week told the court that it costs $100,000 monthly for his stay at that home.