Stigma, prohibitive costs and service gaps are the key findings from the first phase of the Acute Mental Health Integrated Care Pathway initiative from the Ministry of Health.

As noted by Anna Nielson-Williams, chief of psychiatry at the Bermuda Hospitals Board, the stakeholder workshops, survey and interviews provided vital insight into what is needed for mental-health care.

“One of the two main barriers to accessing mental healthcare was around stigma and the other was cost. The inability to cover copays within the primary healthcare setting or where an individual has no health insurance, the total cost of service and medication represents an overwhelming barrier to access care in Bermuda,” Dr Nielson-Williams said.

The Minister of Health, Kim Wilson, noted that acute adult mental health is one of three clinical areas of focus for her ministry’s integrated pathways initiative.

Ms Wilson also highlighted the importance of ensuring that all residents have access to quality and affordable healthcare, including for people experiencing mental-health challenges.

The acute mental healthcare initiative was undertaken in 2023. As stated by Ms Wilson: “Its work was driven by a multidisciplinary working group led by Dr Nielson-Williams and supported by KPMG.”

As part of this initiative, over a 16-week period, a comprehensive literature review was undertaken including 20 studies, reports and databases. Ms Wilson noted the 52 interviews undertaken with patients, family members, clinicians, mental health experts, law enforcement agencies, judicial representatives and community members.

There were also two workshops with over 30 mental healthcare stakeholders on the island and one workshop for patients and family.

As part of the initiative, input was taken from the lived experiences of individuals struggling with mental-health issues. Stakeholder workshops and a working group were also established during the initiative.

A community-wide survey of adults was completed, and 348 responses were received. The survey included 30 questions to access “the community’s perceived mental-health needs and experience accessing mental-health services on the island”.

There were 30 key challenges identified along the pathway and pertaining to acute mental-health services in Bermuda. Service gaps, notably no early entry intervention services and lack of housing options following discharge from the hospital were pointed out during the press conference.

The final report highlighted seven priority areas for intervention and 20 recommendations, three of which were highlighted by Dr Williams during the press conference.

They included a public repository of mental-health resources, a national mental-health strategy, and a “one-stop-shop” clubhouse, where people with mental-health conditions can “come together to socialise, learn skills and access various services.”

Dr Williams noted that Bridge House is anticipated to be ready in the spring and will service the needs of eight individuals to begin with.

• For more information on the key findings of the acute adult mental health integrated care report, visit healthstrategy.bm or email kerry@newbeginnings.bm