Complete statistics of traffic fatalities and drug use i Bermuda 2002 - 2014. This lecture has been rated as outstanding in an internal survey.

1. Forensic psychiatric work in Bermuda
Dr Marcel Westerlund
Consultant Forensic & General Adult Psychiatrist
MRCPsych, FRSM, MD, RN
Bermuda Hospitals Board
No conflict of interest

2. Objectives
•Overview of crime, traffic accidents and drugs in Bermuda
•Overview of 14 individuals with forensic psychiatric reports
•To establish who dies of what and where
•To establish what BPS is doing
•To conclude what needs priority
•Recommendations

3. Brachial plexus syndrome (Thoracic outlet syndrome)

4. 14
Number of traffic casualties in Bermuda 2002 – 2013 excl. MC
12
10
Livery cycle
8
Auxiliary cycle
Car or Taxi
Bicycle
6
Other
Pedestrian
4
2
0
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
Total
Ref: Bermuda Police

5. 100
Number of all traffic casualties in Bermuda 2002 - 2013
90
87
80
70
60
Livery cycle
Auxiliary cycle
Motorcycle
50
Car or Taxi
Bicycle
40
Other
Pedestrian
30
20
12
9
8
10
2
3
2003
2004
10
9
7
9
5
2
2002
10
1
0
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
Total

6. Number of traffic fatalities in Bermuda 2002 - 2013
Fatalitites
18
16
14
12
10
Fatalitites
8
6
4
2
0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
Ref: Bermuda Police

7. Number of traffic fatalities and murder in Bermuda 2002 - 2013
18
Number of traffic fatalities and murder Bermuda 2000 - 2013
16
14
12
10
Fatalitites
Murder
8
6
4
2
0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
Ref: Bermuda Police

8. Age standardised traffic mortality rates/100 000
30
25
20
2010
15
2011
2011, 2012, 2013
10
5
0
Romania
Bermuda
Germany
Sweden
Ref: Source: Eurostat Statistics Database. Data are age-standardised to the WHO European standard population.
Bermuda numbers based on fatalities/100 000 calculated on official statistics provided by Bermuda Police.

9. Low – high numbers of illicit drug users world wide in millions
350
300
250
200
Low
High
150
100
50
0
Cannabis
Opioids
Opiates
Cocaine
ATS
"Ecstazy"
Any illicit drug
World Drug Report 2012, WHO

10. Current prevalence of drug use in Bermuda
90
% of n=293
80
76.8
70
64.2
60
50
% of n=293
40
30
20
15.5
11.3
10
4.1
2
1.7
0.3
0.3
Ecstazy
BZ
Other
0
Alcohol
Marijuana
Crack
cocaine
Heroin
Methadone Cocaine
powder
BDIN (Bermuda Drug Information Network) 2011

11. Estimated numbers of drug users in % and 1 000 in Bermuda 2011
90
80
70
60
50
% of n=293
40
1000 users in Bermuda
30
20
10
0
Alcohol
Marijuana
Crack
cocaine
Heroin
Methadone Cocaine
powder
Ecstazy
BZ
Other
BDIN (Bermuda Drug Information Network) 2011

12. Drug seizures by total street value 2009 - 2012
60000000
50000000
40000000
2012
30000000
2011
2010
2009
20000000
10000000
0
Cocaine
Cocaine crack
Heroin
Cannabis
Cannabis resin
Cannabis
plants
Ecstazy
BDIN (Bermuda Drug Information Network) 2012

13. Enforcement of drink and driving by BPS
450
400
390
350
300
280
250
259
2006
2007
205
200
177
175
193
178
169
2008
172
150
145
141
100
57
50
37
28
0
Numbers of persons
stopped
Numbers failed
Passed
Number of accidents
Impaired driving
BDIN (Bermuda Drug Information Network) 2011

14. Risk of homicidal death – Swedish Nationwide Cohort Study
10
9
9
8
7
6
Substance use disorder
Any mental disorder
4.9
5
Personality disorder
Depression
4
Anxiety disorder
3.2
Schizophrenia
3
2.6
2.2
1.8
2
1
0
Substance use
disorder
Any mental
disorder
Personality
disorder
Depression
Anxiety
disorder
Schizophrenia
Mental Disorders and Vulnerability to Homocidal Death: Swedish
Nationwide Cohort Study, BMJ 2013;346:f557

15. Offence in relation to offenders diagnosis
Attempted murder
Assault
Assault
1
1
1
1
Wounding with
intent, bladed
article, intimidating a
witness
Stealing
1
Stealing
2
Unlawful
wounding, bladed
article
1
1
1
Willful damage
1
Schizophrenia/schizo-affective disorder
Offensive
words, bladed
article
Drug induced psychosis/drug dependence
1
1
Murder
Stealing
Sexual assault
1
PD & Klüver–Bucy's syndrome
© Dr Westerlund MWI/BHB

16. 14 offenders diagnosis and sentencing following reports
Diagnosis
Sentencing
2
2
Schizophrenia/schizoaffective
1
1
Sentence agreed
6
Drug dependence
5
PD
11
Klüver–Bucy's
syndrome
Schizophrenia
Klüver–Bucy's syndrome
Age 17 – 54 Median 31 years All males
© Dr Westerlund MWI/BHB

17. Homicide rate/100 000 in European countries
2.5
2
1.5
1
Homicde rate/100 000 in European countries
ranked high to low
0.5
0
Ref: Homicides, Firearm Offences and Intimate Violence 2010/11: Supplementary
Volume 2 to Crime in England and Wales 2010/11
Kevin Smith (Ed.), Sarah Osborne, Ivy Lau and Andrew Britton

18. Homicide rate/100 000 in European countries
9
8
7
6
5
4
Homicde rate/100 000 in European countries ranked
high to low
3
2
1
0
Ref: Homicides, Firearm Offences and Intimate Violence 2010/11: Supplementary
Volume 2 to Crime in England and Wales 2010/11
Kevin Smith (Ed.), Sarah Osborne, Ivy Lau and Andrew Britton

19. Number of murders/100 000 in
Bermuda, England/Wales, Sweden and USA
14
12
10
Bermuda
8
England/Wales
Sweden
6
USA
4
2
0
2009
2010
2011
2012
Ref: USA - FBI
Bermuda Police
UK, Citizens Report
Sweden, BRÅ

20. Fire arm fatalities/100 000 in U.S, UK, Sweden and Bermuda
2008 - 2012
12
10.79
10
7.69
8
7.69
Bermuda
6.15
USA
6
Sweden
UK
4
3.04
2.93
3.2
2.83
2.74
2
0.04
0.19
0
0
2008
2009
2010
2011
2012
Ref: FBI and Bermuda Police
“Guns in Sweden: Facts, Figures and Firearm Law”. Gunpolicy org. University of Sydney School of Public Health.
“Guns in UK: Facts, Figures and Firearm Law”. Gunpolicy org. University of Sydney School of Public Health

21. Fire arm fatalities/100 000 in
Bermuda, USA, Sweden, UK, Jamaica & Honduras 2008 - 2012
70
64.8
60
50
39.4
40
2008
2009
2010
30
2011
2012
20
7.69
10.79
10
6.15
7.69
2.93
3.04
2.74
2.83
3.2
0.19
0.04
Sweden
UK
0
Bermuda
USA
Jamaica
Honduras
Ref: FBI and Bermuda Police
“Guns in Sweden: Facts, Figures and Firearm Law”. Gunpolicy org. University of Sydney School of Public Health.
“Guns in UK: Facts, Figures and Firearm Law”. Gunpolicy org. University of Sydney School of Public Health
“Guns in Jamaica: Facts, Figures and Firearm Law”. Gunpolicy org. University of Sydney School of Public Health
“Guns in Honduras: Facts, Figures and Firearm Law”. Gunpolicy org. University of Sydney School of Public Health

22. Conclusions
•Too many young black males die on our roads under influence
•MANY people are constantly under influence on Bermuda roads
•MC’s are 9x more dangerous than any other vehicles
•A combination of MC’s, drugs, speeding & poor driving skills is fatal
•Substance use, PD’s, & mental disorder increases risk of being subject of
homicide
•More people die on Bermudas roads than due to violence
•BPS needs to start enforcing drivers under influence to save lives NOW
•Gov. of Bermuda needs to prioritise the huge costs of traffic deaths and injuries