Wilson: stigma and cost are obstacles to mental healthcare
Results of a study showed that access to mental healthcare was hindered by cost and stigma, the Minister of Health told attendees of a conference.
Kim Wilson opened the second day of the Bermuda Mental Health Foundation’s Moving Forward Together event on Friday.
More than 100 people attended the conference, which was held virtually on Thursday and at the Bermuda Underwater Exploration Institute on the following day.
Ms Wilson shared key findings from the ministry’s study on mental health.
Conducted last year, the research revealed 30 main challenges within Bermuda’s mental healthcare system.
The issues fell into six categories — prevention, pathway entry, community care, inpatient and outpatient services, and getting discharged.
Ms Wilson said: “One of the key findings from this study is that the primary obstacles to accessing mental healthcare in Bermuda are cost and, of course, no surprise, the stigma associated with seeking such care.”
Addressing the challenges, Anna Neilson-Williams, the Bermuda Hospitals Board’s chief of psychiatry, explained that stigma surrounding mental health was “not unique to Bermuda, it is prevalent worldwide”,
She added: “But I think that in a small jurisdiction you feel that more all around you and it can create another layer or barrier to accessing care.”
Dr Neilson-Williams, who works with the Ministry of Health to reduce stigma, said: “If your needs are lower and not necessarily at the level of mental illness, or you have self-screened away [from the Mid-Atlantic Wellness Institute], then you may not be able to access care, even if you have insurance.
“That can become another barrier to people accessing our services.”
In another session, Karen Grant-Simmons, the director of the Bermuda Hospitals Board’s mental health services, and Rebecca Fisayo, the clinical director of mental health services, highlighted how the obstacles — as well as discrimination — could result in people developing low self-confidence, avoiding social activities and being reluctant to seek help.
Ms Grant-Simmons said: “Challenging these stigmas and discrimination starts with the language we use — we need to use respectful and accurate language and be aware of outdated, prejudicial language.”
Nurses Karen Grant-Simmons and Rebecca Fisayo pointed out some ways to make language around mental illness more respectful.
They suggested:
Replacing “substance abuse” with “substance use” or “substance use disorder”
Using “person living with a mental health problem [or illness]” instead of “patient”, “client” or “case”
Replacing “committed suicide” with “died by suicide”
Using “a person who has lived experience with a mental health condition” in place of “an insane person”
The nurses also addressed the need to change attitudes towards mental illness and to treat people suffering from such challenges with respect.
Ms Grant-Simmons said: “When the public and policymakers know the facts about mental health conditions, they can contribute to a better understanding in society.”
Other panels at the conference discussed mental health in young people.
PhD student Daniel Cavanagh and psychologist Shawnee Basden conducted a survey involving 76 per cent of middle and high school students on the island.
The results found that 31 per cent of adolescents surveyed showed “moderate to severe” symptoms of depression or anxiety.
According to a survey conducted by Daniel Cavanagh and psychologist Shawnee Basden, 34 per cent of Black adolescents on the island exhibit symptoms of depression.
This compares with 22 per cent of White students surveyed and 37 per cent who identified as other race.
The study also showed that 25 per cent of Black students had symptoms of anxiety, compared with 22 per cent of White pupils and 29 per cent of adolescents of other races.
It found that 503 students exhibited signs of both anxiety and depression.
According to Dr Basden, this number is about 5 or 6 per cent higher than post-pandemic global averages, but not unusual compared to other Caribbean countries.
She added: “While this may be alarming and should cause us to think a little bit differently, our numbers were probably higher pre-pandemic, and this is just continuing.”
During another session, Sandy De Silva, the executive director of Family Centre, talked about how social media may contribute to students developing conditions.
She highlighted that, in addition to anxiety and depression, social media can lead to addiction, poor sleep quality, cyberbullying and a negative self-image.
Dr De Silva explained: “We don’t want to prohibit social media completely; it is here to stay and has some benefits.
“However, we need to intervene, because young people will not self-regulate [their usage] all the time.”
She urged parents to teach their children social media etiquette and accountability, set time limits and have phone-free spaces throughout their homes.
• To learn more about BMHF, e-mail info@bmhf.bm, call 703-0003 or visit bmhf.bm. The Mid-Atlantic Wellness Institute can be reached on 236-3770 from 8am to 5pm Monday to Friday and runs a 24-hour Mental Health Crisis Line, 239-1111