Ruthlyn James | Fix it or fail our children

In Jamaica, families are fighting battles that few ever see. These are not the battles of indiscipline or “bad behaviour”, as is too often whispered. They are the daily struggles of parents raising children with neurological and neurodevelopmental disorders — autism spectrum disorder, attention-deficit/hyperactivity disorder, Rett syndrome and others.

These children, full of potential, face debilitating challenges that can include self-injury, uncontrollable stimming, severe meltdowns, psychosis, insomnia, and dangerous elopement from safe spaces. And too many of their parents are silently drowning in exhaustion, panic, and despair.

What they need is not judgement. They need structured support, proper rehabilitation, and clear education about medical interventions. Yet, what they face instead is stigma, misunderstanding, and systems unequipped to respond.

THE FEAR OF “MAD PEOPLE MEDICATION”

One mother’s story illustrates the painful intersection of desperation and distrust. Her child was prescribed medication after months of escalating crises, violent meltdowns, self-harm, and sleepless nights that left her shattered and barely functioning. A leading child and adolescent psychiatrist recommended Risperidone, a medication widely used in the management of irritability and aggression in autism. But when she searched online, what appeared were words like “bipolar disorder” and “schizophrenia.” Terrified and already carrying the cultural weight of stigma, her immediate reaction was: “Mi nah gi mi pickney no mad people medication!”

This is not ignorance. It is fear! deeply rooted in cultural mistrust, compounded by the lack of accessible, empathetic education on medication. Without intensive counseling and reassurance, parents can hardly be expected to confidently administer drugs like Risperidone, Abilify, or Concerta, despite their proven benefits in reducing aggression, hyperactivity, and severe dysregulation in children with autism and ADHD.

The problem is not that parents do not care. It is that the system has failed to meet them where they are, in their language, with clarity and compassion.

NOT A CURE

Medication is not a cure. It is a tool, often one component in a wider therapeutic plan that includes behavioural intervention, sensory integration, and structured education. Yet, the narrative around psychiatric medication in Jamaica remains clouded by shame and misinformation.

Dynamic maturational model of attachment and adaptation theory reminds us that a child’s behaviour is communication. The self-injury, aggression, or withdrawal we see is often the manifestation of neurological dysregulation, not defiance. Medications like Risperidone or Abilify can reduce the neurological “noise” enough to allow therapies to work, to give a child the capacity to engage, learn, and grow. Concerta, a stimulant, helps many children with ADHD achieve the focus and self-control needed to participate meaningfully in school and social life.

When prescribed and monitored by skilled child psychiatrists, these medications are evidence-based, safe, and life-changing. But without national campaigns that explain this to families, we leave parents vulnerable to Google searches, gossip, and generational fear.

Medication alone cannot solve the crisis. Jamaica urgently needs a rehabilitation centre for neurodivergent children, a facility designed not only for therapy and education, but for crisis intervention.

NOT EQUIPPED

Currently, when children descend into severe psychosis or dysregulation, they are often hospitalised. Yet, our children’s hospital is not equipped to provide the specialised, sensory-sensitive, behavioural, and psychiatric care they need. Families report harrowing experiences of children restrained by being tied to hospital beds, not out of cruelty, but because staff lack the training and resources to do otherwise. This is unacceptable in 2025.

A national rehabilitation centre would offer:

- Crisis stabilisation units designed for children with autism, Rett Syndrome, and other disorders.

- Integrated care teams including psychiatrists, neurologists, developmental psychologists, occupational and speech therapists and behavioural specialists.

- Family training programmes so that parents leave not only with hope, but with skills.

- Safe sensory environments to reduce distress and prevent retraumatisation.

- Medication education clinics where parents are guided through the process of understanding prescriptions,

side-effects, and expected outcomes.

This is not a luxury. It is the standard of care in countries where policymakers take their children’s futures seriously.

Behind the advocacy, behind the petitions, behind the carefully worded letters, lies raw human pain. Parents are breaking. They are being crushed under the weight of sleepless nights, violent meltdowns, and the unrelenting responsibility of keeping their children safe.

Some carry shame so deep they cannot speak publicly. Others are discredited because of poverty. Their stories rarely make headlines unless tragedy strikes. Meanwhile, policymakers quietly fly their own affected children overseas; to Canada, to the United States, while Jamaican families are left with no option but survival.

Are these not citizens too? Are their cries not worthy of urgent response?

Advocacy inspired by personal experience is powerful. But to be effective, it must move beyond anecdote to clinical grounding. Recent studies underscore the effectiveness of early intervention with medication in reducing long-term psychiatric hospitalisations for children with autism and ADHD. DMM theory highlights the necessity of understanding dysregulation as adaptive signalling gone awry, not as “badness”.

To policymakers, the science is clear, the need is urgent, and the human cost is staggering. Jamaica cannot afford to continue silencing its most vulnerable.

This is not just about children with diagnoses. It is about what kind of society we are building. Do we abandon families to desperation, or do we rise to meet them with compassion, science and infrastructure?

Parents are calling out: Help us! Not just with kind words, not just with seminars. If we failed to respond, the loss will not only be borne by these families. It will be borne by us all, in wasted potential, in fractured communities and in a nation that turned its back on its children.

Ruthlyn James is the founding director of Adonijah Group of Schools Therapy and Assessment Centre. Send feedback to columns@gleanerjm.com