?We do not know the exact incidence of mental illness in Bermuda, as this would require a population wide study. Global statistics tell us, however, that about one in every five people will experience a mental health concern at some point in their life.

?It means you will have friends or family who are affected. With 65,000 people in Bermuda today, that equates to 13,000 of us who will experience a mental health condition.

?The good news is that these conditions are becoming better recognised and treatment, counselling and medication mean that most patients can live positive, contributing lives in the community.?

?From hospital data, the most common form of mental illness is depressive disorders. The main symptoms are low mood, increased tiredness and/or feelings of fatigue and loss of interest in general work/study. These symptoms are associated with poor concentration and/or attention, loss of sleep or sometimes excessive sleep, unusual loss of appetite or excessive eating, loss of libido and feelings of pessimism.

?In patients with a severe degree of depression, symptoms can include ideas and plans of suicide, often associated with negative thoughts about self, slowed and reduced speech and a general physical retardation.?

?The next common groups are anxiety disorders and dependence on substances (tobacco, alcohol and other drugs). The common disorders (categorised as anxiety disorders or neurotic disorders) are not generally seen at psychiatric units. Patients with these symptoms tend to go to their general practitioners, at least initially. In Bermuda, it is common for these patients to see a clinical psychologist or a psychiatrist in the private sector.

?Most of the heroin and cocaine dependent people seek treatment from our drug-use related treatment facility, Turning Point. We also see some alcohol-dependent patients at Turning Point.

?The symptoms of dependence are compulsion/craving/irresistible desire to use a substance on a regular or continuous basis, a desire to use increasing amounts to experience the effects (development of tolerance), development of withdrawal symptoms (depending on the substance used) in the absence of use, use despite the knowledge of negative health and social consequences and use becoming the most important activity of the person, even at the expense of other pleasures and responsibilities.?

?Yes, these are common illnesses universally. One of the differences in Bermuda is the high incidence and prevalence of illicit drug use. In most countries, the incidence is around two percent. A recent survey in Bermuda of non-criminal offenders found 17 percent of them to be positive for illicit drug use. Easy availability and access to drugs and the ability of many to afford illicit drugs may contribute to this increased statistic. Some people in Bermuda believe that cannabis is not a drug, but just another harmless herb.?

?Drug/substance dependence is the most preventable illness. Intervention needs to be done at several levels. The first level is health promotion, particularly for children and young people, to teach them basic life skills, such as creative and critical thinking, problem solving, the ability to manage emotions and establish and maintain human relationships, the ability to become sensitive to other peoples? thoughts, feelings and needs and to develop an accurate and adequate self awareness. These are now taught in many schools and should be emphasised and made mandatory education.

?In addition, adequate and effective measures should be undertaken to reduce both the supply of drugs and the demand for drugs.

?All health care personnel should be trained to help people who use these substances to help them stop use and of course there should be adequate treatment and rehabilitation services to those who are already dependent on these substances.

?Teaching good parenting skills, protecting children from deprivation, providing at least the minimum for normal development and growth of children will hopefully reduce the incidence of depression and anxiety related disorders.

?For the less common major mental disorders like psychotic illnesses and major mood disorders which have a genetic basis, early diagnosis and treatment offers the best prognosis.?

?A very small percentage. Universally only about five percent of those suffering from a mental illness need specialised psychiatric care. Most are best treated by their primary care practitioner (GPs).?

?No, most criminals are not assessed. Those who are assessed include people charged with a major crime like murder, rape or GBH, or if mandated by the court. Those who have a past history of mental illness are also seen. One of the consultant psychiatrists conducts a weekly clinic at both Westgate and the Co-ed Facility. The prison also has a clinical psychologist in its service. Initial plans to build a unit have already been undertaken.?

?Seven out of ten test positive for one or more illicit drugs on admission. Some of them would be dependent on a drug/s. As much as half of them tend to be in prison because of drug-related offences.?