Why is this happening again?
Personality disorder and its impact on violence in Jamaica — Part I

Earlier this month a staff member recounted to me her community’s discussion surrounding the discovery of charred human remains on the Content main road in St Andrew reported in the media. A community resident had allegedly killed his uncle, chopped him into small pieces, packed him into two suitcases, and boarded a taxi. He told the taxi driver that the suitcases contained his work tools when asked why the cases were so heavy. It is not clear whether the police have caught the man who boarded the taxi with the suitcases.

Nevertheless, that event would now seem pale compared to the savage throat-slashing murders of a young mother and her four children in Chapelton, Clarendon, this week. Having read the headlines early Tuesday morning I wanted to throw up as the pit of my stomach moved sideways.

Why is this happening? And then I rephrased the question to myself: Why is this happening again?

Because human brutality and slaughtering have become a mainstay in our everyday Jamaican reality.

Why was I surprised?

Our media headlines remind us of the savage acts of violence every day, which are met with spontaneous outrage, blockbuster speeches, and comments of “rest in peace”. Yet nothing changes in our attitudes to reprioritise our budgets or policy approaches to find a solution to addressing this problem. So, invariably, we wait on the following gruesome incident and the report. The cycle will continue.

Jamaica has the second-highest murder rate in the world — 48.35 murders per 100,000 people. The international benchmark is 30 murders per 100,000 to establish the state of a civil war.

So what is causing this ongoing scourge of violence across a country that boasts most churches per square mile?

In February 2011 I recalled the late psychiatrist, Professor Fredrick Hickling publicly declaring, “Treatment cannot be explored until the country accepts that something is wrong.” He was responding to naysayers of his medical report, which verified that over 41.4 per cent or two-fifths of the Jamaican population have a personality disorder ranging from mild to severe. Furthermore, 63 per cent were significantly more likely to be single — 60 per cent were male, 77 per cent were between 18 and 44, and 65 per cent experienced a lower socio-economic status.

Hickling and clinical psychologist Vanessa Paisley concluded that this “high risk of behavioural dysfunction in the Jamaican population has significant implications in light of the country’s high rate of crime and violence. The findings highlight the need for effective and targeted prevention and intervention measures.” (West Indies Medical Journal, 2013)

Why did I raise Professor Hickling’s decade-old report?

First, because its conclusions are not only still relevant, but secondly, they are urgent.

Mental disorder vs personality disorder

When we talk about mental health we are talking about brain function or the dysfunctioning of the organ. Everybody will have a mental health problem at some point in life; for example, when they experience death or extreme stress.

There are over 340 mental disorders listed in the Diagnostic and Statistical Manual of Mental Disorders. Schizophrenia is one such mental disorder. Statistically, only 1 per cent to 1.2 per cent of every population in every country will have this. That’s approximately 30,000 Jamaicans. However, it is depression that affects the majority of our people, primarily women (Dr Earl Wright, consultant psychiatrist, Jamaica 2022).

Our national estimate of the prevalence of depression is 14.3 per cent — for men, 9.9 per cent; and for women, 18.5 per cent. The majority was highest among urban women, 19.2 per cent, and lowest among rural men, 7.3 per cent (Jamaica Health and Lifestyle Survey 2016-2017).

Professor of public health and health technology at the University of Technology, Jamaica (UTech) Winty Davidson says that mental health and justice are inextricably linked; the management of mental illness in a country is an index of how just a society is, since the mentally ill are the most vulnerable in society.

Even so, Jamaicans must not be quick to blame our society’s violence on people with mental disorders, as this only contributes to the stigmatisation of mentally ill people. “The fact is that some of the behaviours we are seeing today do not reflect some of the historical mental health behavioural patterns of Jamaican youth. For example, a paranoid schizophrenic may have tendencies to harm. Still, most persons with mental disorders usually do not physically harm people, as they are more likely to harm themselves than others.”

Professor Davidson contends that people who commit crimes in Jamaica do not have a mental disorder, but suffer from the impact of adverse environmental effects on their experiences and personalities.

Consultant psychiatrist Dr Earl Wright states that the human brain has the highest rate of development between zero to three years; between ages 5 years to 6 years a person’s personality and how they will behave emotionally in the future is already in place.

Wright: “The brain develops in a certain way. For example, if a child defines the world as a hostile or loving place by one year old, they will act accordingly. How a child is treated and their reaction is learned behaviour. The first 1,000 days of a human’s life will determine their brain development and personality. Therefore, children need proper stimuli for their positive brain development. If you miss that window, then you must try to modify the stimuli to the brain in adolescence.”

He asserts that Jamaica is paying a high price for the adverse environmental effects our children are experiencing, which is the leading cause of personality disorders in Jamaica and it is people who have developed antisocial personality disorders from an early age who commit the crimes and end up in prison. He contends our current reality will continue because there are no short-term fixes; instead, it will take a generation to see the impact of implementing the right solutions.

Some adverse environmental factors contributing to people feeling hopeless and helpless include general poverty, extreme physical punishment, emotional abuse, and inconsistent or no access to education.

Dr Kevin Goulbourne, director of mental health and substance abuse services, asserts that these factors may also make people feel like they are a burden to their families or society and seek to remove themselves through suicide physically.

More than 60 per cent of people admitted to our hospitals having attempted suicide are under the age of 24 (Ministry of Health, 2014). In a 2018 poll conducted by UNICEF through the social messaging platform U-Report, 53 per cent of respondents said they had considered suicide.

This financial year the Government will spend $1.858 billion to support the Occupational Therapy and Rehabilitation Programme of the Bellevue Hospital and the Kenneth Royes Rehabilitation Centre. The aim is to “improve the quality of life of individuals by helping them to reduce their limitations through purposeful activities, increasing their self-care skills, maintaining maximum function and ability (both physical and social), and preparing persons for employment”. (Source: 2022-2023 Jamaica budget)

In addition, the budgets are geared towards driving the policy of providing more community-based care for individuals with mental disorders, and training community leaders and social workers to identify and report red flags of a mental illness to the formal mental health system for further assessment and intervention (Goulbourne).

Our focus should be treating the cause of violence in Jamaica, rather than the symptoms. Our resources need redirection towards positive stimulation to our children in their formative years of development and lessening the adverse environmental effects they are experiencing. Where should we go from here?

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.

Dr Kevin Goulbourne (Photo: Naphtali Junior)
Lisa Hanna
Lisa Hanna

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