Renowned psychiatrist Dr Geoffrey Walcott says efforts to stem crime and violence will need to be underpinned by an understanding of what drives the individuals responsible for the acts which have tarnished Jamaica’s image.

“A lot of the behavioural problems is not about what’s wrong with people but about what has happened to them,” Dr Walcott told the Jamaica Observer last Friday in an interview backgrounded by a 2013 study which examined personality disorders in convicted murderers.

The 2013 study, conducted by the late Professor Federick Hickling and Dr Walcott, analysed data from the psychosocial case study interviews of 36 convicted murderers from the Jamaican Government Barnett Commission of Enquiry in 1976.

It showed marked paternal rejection and an absence of integrated family life among 21 of the individuals examined; 24 experienced severe parental disciplinary methods, and two-thirds were illiterate or barely literate. Twenty-nine were from very poor socio-economic conditions.

Further, the study showed that most fathers, 21 (59 per cent), had showed little or no interest in their sons’ upbringing, and 20 (56 per cent) had not cohabitated meaningfully with their sons’ mother.

“When we did the study, we found that there were three main problems that formed the core of most of the behavioural challenges. The first was the breakdown in power management; these people were having challenges and difficulty interacting with either authority or interacting while being in authority. So, there were power management challenges which led to conflict and impulsivity,” Walcott outlined.

“The second thing we identified was the issue of dependency; in that there was a high level of either physiological dependency or financial dependency and in some instances the dependency issue was couched not just in terms of wanting things but also in a very complex sociological way where people would have a delusional sense of entitlement which also led to conflict,” he said.

“The third area was issues of psychosexual dysfunction or psychosexual pathology, and that was more in keeping with the power management issues of conflict where their construct in terms of intimacy was geared more toward power and control than it was geared towards making human connections. So, they had great challenges in making intimate connection to another human,” Walcott added.

According to Dr Walcott, not much has changed in present day Jamaica.

“The data from the prison population was from the 1970s — the Barnett Commission that was done at the St Catherine Correctional facility. Some of those findings are still pertinent and relevant today in terms of what we see in the population,” he said.

“People often wrongfully think that morality is an innate quality, it is not. It is what you are taught by society, and it pins on to your characteristics and ability to empathise, and empathy is something you learn through parenting and your socialisation. So, if you are not taught empathy in childhood, and for the first thousand days of life you are left and there is physical neglect and abuse, you are not taught how to attach to human beings, it is not going to emerge spontaneously; something must be done to get you to that place,” the psychiatrist pointed out.

“If the family is not able to do it, then the schools have to be able to do it. If the schools are not able, then it is going to be the community groups and the churches, and if they are not doing it, then it is going to be the gangs, and the gangs have become exceedingly efficient at providing that particular aspect of attachment and loyalty and support. So we have to find a way to connect [with] them before they do, because the gangs use the same psychological tenet of involvement, interest, investment, attention and, camaraderie. It’s not rocket science; it’s a very simple methodology. We just have to find way to attach those children before they end up in those situations,” he told the Observer.

The psychiatrist, who said researchers are currently poring over a data set for a group of children who have been polled about adverse childhood experiences, shared that correlations are being observed between their behaviours and their experiences at that level as well.

“One of the most impactful adverse childhood experience is actually neglect — physical neglect — where children’s basic needs are not provided for and what we have seen is that there is a correlation between that and the presence of what we call externalising behavioural problems,” he told the Observer.

“Externalising behavioural problems refers to aggression, rule-breaking, and disruptive actions. On the flip side, those who do not exhibit negative behaviours outwardly, manifest internalised behavioural problems which include anxiety, low self-esteem and depression,” Dr Walcott said.

“Those are some of the things that we have seen aligning and so those are some of the factors that we have to look at when we are thinking about issues of prevention of violence and criminality,” he said.

Essentially, such individuals are driven to either hurt themselves, or hurt others, Dr Walcott noted.

“The core is still the same, it’s just the direction that is different. They either express outward or turn inward and that is something we have often looked at paradoxically. It is one of the very interesting things about our country’s statistics. Jamaica has one of the lowest suicide rates in the world, but we have the second highest murder rate,” he said.

“The question is, is it that we are not having suicides or is it that the pathological elements which fuel the behavioural pattern are there but [are] being expressed in a different way? It is something we really need to explore because I don’t think there has been much in terms of the correlation of the core pathological elements between murder and suicide,” argued Walcott, who has worked as the consultant psychiatrist in charge of mental health services for Kingston and St Andrew.

He, in the meantime, said the public health model which is aimed at prevention is paramount in correcting societal ills.

“Worldwide, the public health approach is being pushed. If you think about the public health model, a public health system is a healthcare system that provides all the different niches within the context of a community, and it is a merging of what used to be separate, independent disciplines into one package that they can collaborate and provide holistic treatment for the patients. The same thing needs to be done in terms of societal transformation,” Walcott stated.

He said this approach is not to be confused with crime-fighting, which has often been the case.

“Crime-fighting has to do with someone who has committed a crime and that’s a matter for investigation, conviction and punishment. That’s a separate issue. The major focus of the public health aspect is about prevention. It’s about identifying the persons who are at risk and providing them with the support and the guidance to transform their behaviour so they become engaged, healthy, happy and productive members of the society,” he noted.

“Often times because there is this misconception and interplay between the business of prevention and crime-fighting, solving, and punishment, people get confused and then lay people and others tend to conflate the matter about being soft on crime and so on, which is ridiculous,” he stated.