More than 1,000 persons die violently in Jamaica each year. Their lives are snuffed out in various circumstances, including robbery, child abuse, reprisals, gang warfare, domestic violence and police killings.
Death of a loved one can be frightening, but sudden, violent death can leave families reeling with incomprehensible grief, pain and confusion.
Night after night, families of murdered loved ones are featured on the news and they say things like, "I feel like I am going crazy," or "I don't know how I am going to cope."
These expressions about the impact of grief weighed heavily on Fourth Floor participants as they met in search of solutions to the violence that has created so many bereaved families, and which continues to threaten the stability of Jamaica.
Professor Wendel Abel, who heads the Psychiatric Department at the University of the West Indies (UWI), confirmed the heavy toll of violence on the society.
"The physical scars associated with acts of violence may heal, but often the emotional scars never heal. And if they do, they take a long, long, long time," he said.
In the context of a society where murder has become commonplace, the wounds are even harder to heal and the grieving process is extended whenever the survivors relive the pain of death by watching the news or hearing stories of violence.
As a psychiatrist, Abel says he often feels the weight of the effects of violence. "There are many times when I walk out of my office and I have to say, 'This is too much for me. I am actually going through it every single day.'"
Drawing the picture of a society overwhelmed with crime, violence and trauma, consultant psychiatrist Dr Earl Wright and his 24-member task force said this in their report: "Jamaica has become plagued by very high rates of violence, giving rise to many children and adults with post-traumatic stress disorder, personality disorders, depression and anxiety."
So where do grieving people go for help?
Therein lies the challenge, Abel responded. "We do have within the public-health system, mental-health services, but the services are overwhelmed and cannot adequately respond to the violence. The bulk of the professionals are concentrated in the Kingston Metropolitan Area. And the Ministry of Health faces a shortage of personnel."
This was confirmed in Wright's report: "The community mental-health services are severely under-resourced and unable to cope with the many needs, including early diagnosis and treatment."
The breach is often filled by professionals like the Rev Dr Devon Dick, pastor of the Boulevard Baptist Church and president of the Jamaica Baptist Union, who confirmed that counselling is a significant part of his ministry.
"First of all, you have to listen to allow the person to speak and being non-judgmental ... over a period of time, you try to lead the person to some form of acceptance and then integration, and help them put their life back together, otherwise they are going to be depressed."
It was stressed that there is no time stamp on grief. Because of the complexity of grief, there are clearly no quick fixes.
Berthlyn Plummer of the Peace Management Initiative (PMI) talked about the numbness that takes over a community in grief.
"When there is a violent incident the community is numb. In most cases, they are held to ransom in the community because of fear. Some people will actually move out of the community ... . Then there is that cry for blood."
Recognising the need to bring professional help to these shattered communities, the PMI has developed a Counselling and Therapeutic Reprisal Prevention Team. The team comprises volunteers, social workers, psychiatrists, psychologists, nurses and ministers of religion. PMI offers counselling to everyone including the perpetrators of violence.
From all accounts, reprisal is never far from the minds of grieving families. Sometimes this hurt spans generations, as anthropologist Dr Herbert Gayle explains.
"It's intergenerational," declared Gayle, who told Fourth Floor of a 59-year gap between the time a grandfather was murdered and when his grandson killed the perpetrator.
Professor Wendel Abel, head of the Psychiatric Department at the University of the West Indies, believes reprisals, or what is termed revenge fantasy, will continue if persons are not allowed to work through their emotions and bring closure to their traumatic experience.
Fourth Floor discussions considered the idea of compensation for the surviving relatives of murder victims. Victor Hemmings, an investigator in the Office of the Public Defender, confirmed that it is possible to file a motion in court to seek redress and to get compensation for caring for dependents. Many people do not currently go this route, maybe because they are ignorant of their rights under the law.
In cases where the State is adjudged to be at fault, such as the Tivoli Gardens incursion of 2010, the constituted commission allowed community members to work through their emotions to some degree to resolve their pain and at the end of the day, they were compensated.
"It's a model that works, and obviously we have to repeat that many times over to deal with the victims of police killings, " said Abel.