Fri | Sep 24, 2021

Anthony Clayton and Holly-Rose McFarlane | Toxic link between child abuse and crime

Published:Sunday | July 18, 2021 | 1:16 AM
A little stress is necessary for survival; it teaches us how to be resilient. Severe stress in early childhood is completely different, it can destroy lives.
A little stress is necessary for survival; it teaches us how to be resilient. Severe stress in early childhood is completely different, it can destroy lives.
Holly-Rose McFarlane
Holly-Rose McFarlane
Professor Anthony Clayton
Professor Anthony Clayton
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Research on the effects of toxic stress and trauma on the brain suggests that cruelty and neglect of children could be the cause of much of the violence in Jamaica.

A little stress is necessary for survival; it teaches us how to be resilient. Severe stress in early childhood is completely different, it can destroy lives. This includes prenatal exposure to alcohol and drugs, being subjected to sexual or emotional abuse, neglect, poverty and malnutrition, or physical violence, family conflict, or the trauma of seeing others killed. If a young child is left for a long time in a situation of horror and unrelenting misery, and cannot escape, the child’s brain is likely to be profoundly affected – and without intervention, the harm can become irrevocable.

Early childhood is a vital stage in the development of the brain. There is a high rate of neurogenesis (the process of forming new cells in the brain) and a high level of structural neuroplasticity (the ability of the brain to change its physical structure in response to experience). Children need support and positive stimulation at this time so that they can develop a healthy brain. If a child gets toxic stimulation instead, the brain does not develop properly.

Stress makes the brain trigger the release of hormones, such as cortisol and adrenalin, which prepare the body to either fight or run away for survival. However, when a child is exposed to toxic stress, the hypothalamic-pituitary-adrenal hormonal regulatory system becomes permanently sensitised. This means that the body cannot stop producing cortisol.

The elevated levels of cortisol then result in inflammation and reduced immunity, with changes in brain structure and even gene expression. The effect on the developing brain includes reduced volume and life-long problems in learning, behaviour, physical and mental health. The child is left with a severely reduced ability to reason, remember, manage their emotions or control their behaviour.

The child may end up with Post-Traumatic Stress Disorder (PTSD), Attention Deficit Hyperactivity Disorder (ADHD), or both. Children with PTSD or ADHD have trouble concentrating and difficulty learning. They are easily distracted, don’t listen well, interrupt others, tend to be disorganised and restless, and have antisocial behaviour. They may be agitated, aggressive, or self-destructive. They often feel anxious, scared, and helpless, and have low self-esteem. These symptoms often get the children into trouble both at school and at home, which adds to their stress and makes their symptoms worse. And if the child’s home is the main source of toxic stress, the child has no escape.

BAD DECISIONS

The fact that the child has largely lost the ability to control their mood and behaviour can then lead to bad decisions, including early onset of sexual activity and substance abuse, and result in poor performance in school. The longer-term consequences, if the child survives to adulthood, include increased obesity, inflammatory and cardiovascular disease, anxiety, depression, and bipolar disorder.

Most of these children come from broken homes and dysfunctional families. And without an intervention, most of these children fail at school. With very few options, they may end up hustling on the street, selling their bodies, stealing to survive, or joining gangs. For some of them, the first time that they feel powerful and respected is the day that they get a gun, which gives them the ability to strike fear into others. And so, inevitably, many of them go to jail.

Research in a number of countries has found that young people with ADHD are significantly more likely to be involved in crime. One study in Denmark found that nearly half of the children with ADHD had criminal convictions by the time they were adults, while research in the UK and elsewhere has found that much as 30-50 per cent of the prison population suffer from ADHD, compared to just three to five per cent in the general adult population. So people with ADHD are far more likely to commit crimes and about 10 times more likely to end up in jail.

This is also likely to be true in Jamaica. About half of the males in prison in Jamaica did not complete their secondary education, and over 40 per cent of the people in prison in Jamaica are repeat offenders in spite of the rehabilitation and educational programmes run by the Department of Correctional Services. One possible reason is that many of these prisoners have PTSD or ADHD, which are actually being made worse by their experience in prison. If so, the rehabilitation programmes are unlikely to work because the inmate has lost the ability to focus.

The Department of Correctional Services has a budget of $8 billion for 2020-2021. It is likely that a significant part of that is the cost of incarcerating the youth who were abused as children.

The even more serious cost is that Jamaica now has one of the highest rates of homicide in the world. It is also likely that many of these murders were perpetrated by young people with PTSD or ADHD.

EARLY INTERVENTION

A child – and a nation – can be saved from this dreadful fate. The first, and most important, is early intervention. It is vital to get children out of the toxic environment where they are being abused. Schools are usually in the best place to see the early signs of psychological damage, and they could give the alert that an expert intervention is urgently needed.

Some people believe that a child is best raised by at least one biological parent. That may be true in most cases, but it is not true when that parent is the abuser (sometimes because they themselves were abused as children). The priority is to rescue the child.

The next step is even more problematic. Where should that child go? Most of the children that go into institutional care do almost as badly as the children that are raised in abusive homes. The only solution that has a relatively high success rate is that the child should go to a foster family that can give that child love and protection. Over time, that love and protection can help that child to heal and recover. The chances of success start to go down after the child is about five, so early intervention and fostering are very important.

The fundamental solution is to break the cycle in which damaged families raise broken children that then become parents themselves. Family interventions, fostering, counselling and mental health support all have a key part to play. At present, however, as CAPRI pointed out recently, the Child Guidance Clinics (which are the main provider of child mental health services) have less than a third of the clinical staff that they need. There are only 12 clinicians in Jamaica who specialise in child mental health. More support is desperately needed. But an investment in the health, safety, and sanity of Jamaica’s children could be the best investment we ever make.

Anthony Clayton is the Alcan Professor of Caribbean Sustainable Development at the University of the West Indies, Holly-Rose McFarlane is the programme director for the “For the Child Foster Care Programme”, which is implemented by Family Life Ministries. Send feedback to columns@gleanerjm.com.