Stephen Fray - twice a victim

On April 19, 2009, 21-year-old Stephen Fray stormed a CanJet aeroplane (with Halifax-bound passengers) at the Sangster International Airport. Armed with a gun, he attempted to hijack the flight to Canada. No one was injured, and he was disarmed by the security forces. Dr Wendel Abel, one of our foremost psychiatrists, thoroughly assessed Fray six days after the incident and diagnosed him as being "grossly psychotic".

He was started on antipsychotic medications and examined months later by a government-appointed psychiatrist who reported that, although he could not speak to Fray's mental state prior to his examination, Fray was on medication and exhibited signs of psychosis which became less over three sessions until he was mentally fit enough to stand trial.

I have the greatest respect for our judiciary, but I was bewildered when Fray was judged to be responsible for his actions and sentenced accordingly. I was flabbergasted when he lost his appeal on July 29, 2011, in spite of extremely convincing arguments by the erudite Queen's Counsel, Jacqueline Samuels-Brown.

The court's decision reflects society's misunderstanding of mental illnesses and puts every single person so afflicted at risk of unjust incarceration. Unlike most physical maladies, mental disorders cannot currently be detected by routine laboratory and imaging investigations. A careful history, observation and mental-status examination are necessary to diagnose mental illness.

Loose grip on reality

Mind-related disorders include neurosis - varying degrees of anxiety, obsessive-compulsive behaviour, having difficulty breathing, palpitations, inexplicable pains, phobias and even panic attacks. Another group comprises the mood disorders - cyclothymia, dysthymia, major depression and bipolar disorder - the extremes of the latter two can loosen a patient's grip on reality.

But, the most severe and disabling kind of mental disorder is psychosis. The patient is out of touch with reality and is drawn helplessly into a confused and possibly frightening world of (auditory, visual, tactile, olfactory and/or gustatory) hallucinations and delusions (fixed false beliefs). The patient may exhibit exaggerated emotions, confused or disorganised speech, and behave out of keeping with his/her character.

Psychotic patients can think, plan and carry out tasks that appear lucid and malicious. However, their mentation is totally based on false information and a bizarre, confusing, illusionary, delusionary world generated by their illness. Their world is as real to them as ours is to us.

In paranoid schizophrenia (a psychotic disorder), the victims truly believe that someone or a group of people is out to get them. The victims often hear voices in their heads (irresistible, controlling, 'command hallucinations') telling them to carry out certain tasks usually aimed at self-preservation or destruction of a delusionary threat.

Actions can be misinterpreted

Armed with the genuine belief that there is imminent danger, a victim of paranoid schizophrenia may 'rationalise' that he/she needs to act for his/her own protection. Observers - unless trained in or familiar with mental-health issues, or unless they are relatives/friends familiar with the victim's pre-morbid personality - could misinterpret aggressive, destructive or other antisocial behaviour as criminal acts.

If a driver suffers a severely disruptive physical condition, like a heart attack, and loses control of his/her vehicle, injuring someone or others, the law would not hold him/her criminally responsible. It, therefore, mesmerises me when an individual suffers a severely disruptive mental condition and loses control of his/her mind, yet he/she is not afforded similar consideration, is held criminally responsible, charged, tried, convicted and sentenced.

Many people opine that Fray was indeed ill (psychotic) when he attempted the hijack. However, they also feel that he was doomed because Jamaica wanted to reassure tourists that we are serious about their safety.

Ostensibly, Fray was a victim of his illness (psychosis, over which he had absolutely no control) and a victim of a society badly lacking knowledge on mental health.

Garth A. Rattray is a physician with a family practice. Email feedback to columns@gleanerjm.com and garthrattray@gmail.com.