Where do we go from here?
Personality disorder and its impact on violence in Jamaica — Part II
GAYLE...murders can be brought down across the region within 15 years if scientific approaches are used to handle violence.

Dr Herbert Gayle argues that murders can be brought down across the region within 15 years if scientific approaches are used to handle violence, with preventative, structural, and long-lasting programmes on both the individual and community levels: “Education and training, with parenting skills, mentorship, and alternative justice interventions, while providing economic opportunities that afford ontological security to all,” which are urgently vital, especially when the data reveals approximately 53 per cent of our murders are done by repeat killers.

Sadly, most repeat killers express being “tortured” by their caregivers as children. In fact, Dr Gayle’s research reported that 59 per cent of those who killed once and 75 per cent who had killed twice experienced harsh abuse by their mothers, including those who killed more than three people and killed women (‘Securing a safer Jamaica’: The National Crime & Violence Prevention Summit, July 30, 2019).

Nearly two-thirds of children aged one to 14 in Latin America and the Caribbean experience violent discipline at home. These levels are exceeded by 80 per cent in Jamaica, Haiti, and Suriname. (Violence against children in Latin America and the Caribbean 2015-2021, UNICEF)

Currently, male youth between 18 and 30 years represent 12 per cent of the Jamaican population. This age cohort makes up 48 per cent of our prison system, with a recidivism rate of 41 per cent. Moreover, 48 per cent of our children who appeared before our courts were mainly for “care and protection, child abandonment and child abuse; 21 per cent were for uncontrollable behaviour and 10 per cent for wounding, assault occasioning bodily harm”. (Economic and Social Survey of Jamaica, 2021)

Addressing the impact of the profound social dysfunctionality and toxicity coupled with other social factors such as abusive family relationships is critical now if we truly want a safe Jamaica to live in, work, and raise our families.

California’s Surgeon General Dr Nadine Burke Harris has observed that, even with the “best practices for immunisations, asthma, obesity treatment and other preventive health measures, adverse childhood experiences (ACEs) and toxic stress are major risk factors affecting people’s health”. Her research concludes that if children are consistently exposed to trauma and traumatic toxic stress, adverse harm can be made to their developing brains and bodies if not addressed, leading to debilitating adult health conditions or, worse, them becoming violent adults.

Where do we go from here?

Breaking the cycle of violence must be part of the mix of attending to our children’s psychosocial and emotional well-being and their daily experiences from the pre-primary school stages of their development. No one is born a murderer. But, unfortunately, something went wrong, and it went unchecked. We must see this issue as our collective responsibility and play our roles better, or we will continue to reap the detrimental effects for future generations.

Therefore, we need an urgent readjustment to how we care for our children with modern scientific approaches to help those struggling with behavioural and personality disorders, so that a child doesn’t grow up believing it is customary to strangle a young woman to death at his house in Portmore and then go back to work. Or a sixteen-year-old St Thomas boy doesn’t get sentenced to three years for severing the penis of a six-year-old boy.

The signs of sociopathic, psychopathic, masochistic, and even misogynistic behaviours are exhibited early, and the carefully curated narrative many parents have built for themselves to justify people who need counselling is outdated.

Consequently, we must create the budget to provide more avenues to support our women and men with ongoing parenting and life-coping skills. These programmes should educate them to better plan only for children they can care for, while giving them increased access to beneficial child guidance clinics.

Throughout 2021, child guidance clinics islandwide were visited by approximately 7,345 children and adolescents (4,060 males). While the south east region accounted for 51 per cent of the visits, the Western Regional Health Authority had the least due to limited space for conducting clinics (Economic and Social Survey of Jamaica, 2021).

Even so, a significant part of this mix will require that cognitive behaviour therapy (CBT) be introduced and implemented within our education system from early childhood to the sixth form. CBT is a common type of talk therapy or psychotherapy when a person works with a mental health counsellor (psychotherapist or therapist) in a structured way, attending a limited number of sessions. It mainly focuses on allowing the person to become aware of inaccurate or negative thinking to help them to better approach challenging situations and react to them more effectively. This mode of therapy can be advantageous in assisting the individuals in managing stressful situations and treating mental health disorders, such as depression, post-traumatic stress disorder (PTSD), or an eating disorder (mayoclinic.org).

Winty Davidson, professor of public health and health technology at the University of Technology, Jamaica, suggests that Jamaica implement a “four stage integrated prevention system” to aid our populace’s cognitive, psychosocial, and physiological growth and development. The system includes addressing the following stages:

1) Pre-primary prevention: At this earliest stage healthy lifestyle and wellness practices are critical for the child, the family, and the community. There are five pillars of a healthy lifestyle.

(a) good nutrition

(b) physical exercise

(c) coping with stress

(d) restful sleep

(e) maintaining harmonious environmental conditions

These constitute the foundations for achieving a balanced state of health and wellness.

2) Primary prevention: This seeks to inhibit the development of new cases through early screening assessment, early detection, and diagnosis. This stage assists with identifying potential risks and precursors of personality disorder and mental illness to which a child may be generally predisposed due to their circumstances, so that necessary assessment and treatment can be administered.

3) Secondary prevention: Involves early and late diagnoses and treatment. This stage documents the condition’s prevalence with programmes for the treatment and management of not only the child, but their family, the community, and other dysfunctional cultural practices they may be exposed to. It is aimed at preventing the spread and prevalence of personality disorders and mental illnesses, both old and new, for treatment in communities through the support in the health centre and communities.

4) Tertiary prevention: Requires ongoing rehabilitation for the person that has developed chronic dysfunctions. It employs retraining, re-motivation, and reintegration in the community to avert chronicity.

When these four stages of prevention work together with integrated, consistent progression it presents the best health option for managing the conditions we are witnessing in Jamaica.

Currently, crime is costing Jamaica approximately 5 per cent of our gross domestic product (GDP); that’s $105 billion or $39,000 per person. Imagine what an additional $105 billion could do for our country and people? However, because of the high levels of violence, there are business losses, reduction in property values, missed investment opportunities, instability across sectors, and our people seeking safer countries for jobs and retirement.

As I have said before, criminals are not born, they are made. We all watched with our eyes wide shut for decades as underserved communities incubated resentment, anger, neglect, and generally frustrated parents who did not have the means to take care of their children. We have to face some hard truths together. The failure to create a progressive nation that provides equal opportunities for all Jamaicans with targeted behavioural interventions, especially for persons between zero to six years old, will be our death knell. It’s time to press the reset button on how we nurture, protect, and develop our children.

If you or someone you know need emotional help or is in a crisis, please call the Mental Health and Suicide Prevention Helpline at 888-NEW-LIFE (888-639-5433); 24-hour service, free of cost, seven days per week.

Lisa Hanna is Member of Parliament for St Ann South Eastern, People’s National Party spokesperson on foreign affairs and foreign trade, and a former Cabinet member.

DAVIDSON... suggests that Jamaica implement a “four stage integrated prevention system” to aid our populace
Lisa Hanna
Lisa Hanna

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