Community-based care helping to reduce mental health stigma
Work to provide care settings in the community is helping to remove stigma against people with mental health challenges, according to the acting clinical manager for rehabilitation inpatient units at the Bermuda Hospitals Board.
Simone Ebanks believed that as people were more exposed to clients with mental health challenges, there was greater understanding.
She was speaking ahead of the opening of Bridge House in Somerset, a purpose-designed residential treatment facility for people who need mental health treatment.
A collaboration between the BHB, Habitat for Humanity of Bermuda and the Anglican Church, the facility is to accommodate eight clients who are presently at the Mid-Atlantic Wellness Institute.
They follow eight others who moved to a community-based setting at Tarheel House last April with funding from the Mental Health Foundation.
Ms Ebanks told The Royal Gazette: “When we moved out to Tarheel, where we have been for just over a year, we saw with our clients there is more normalcy, the things that we do every day — they get to experience that in the community setting.
“We see the option of social inclusion being accepted by neighbours and people in the community. When you think of MWI, people think of St Brendan’s and there is that stigma attached to the institution.
“With moving out into the community, there is that benefit of awareness, we decrease the stigma related to persons who have a mental illness.”
She said: “Having that inclusion within the society is definitely rewarding for the clients and something the staff have also really seen the benefits of.
“It is more flexible, there are more partnerships with occupational therapists, physiotherapists, being able to participate in community activities … for example, on May 24 they were able to go to the parade.”
Unlike MWI, an isolated facility on Devon Springs Road, Devonshire, Tarheel House, in Pembroke, and Bridge House, in Sandys, are in neighbourhoods.
A stone’s throw from Somerset Bridge, clients of Bridge House will have the opportunity to go fishing, and there is a gas station, supermarket and bus stop near by.
The facility has a large yard for recreational activities including BBQs, picnics and gardening.
Inside, the clients have personalised rooms and there is a large multi-purpose area as well as kitchen facilities that can be used by the clients under supervision.
Preston Swan, the BHB’s acting chief operating officer, said: “Everyone is on board; there is so much positivity around this.
“It has been very positive in terms of how it has been received, and our clients and families seem to be very enthused about it.
“There is always a settling-in period but we were really surprised how the clients settled into Tarheel so well.
“At MWI, we do organise events for the clients but it is not the same. It’s location, it’s transport, staffing … a host of things, you can’t get the same level of community integration.”
Mr Swan said he believed it will take a generation to remove the stigma that exists in Bermuda against people with mental illness.
He added: “We want to get the public to view physical and mental health very similarly.
“We don’t turn away when we see someone walking down the road with a broken leg or arm. If someone is having a mental health episode, it’s OK; this person may need to get some intervention.
“We definitely view it differently and it’s going to take a generational change where the children coming up are exposed at an early stage and understand that mental health is as important as physical health.
“We are going to be doing a lot more education including around how the community has a role to play.
“I think it will take a generation to truly understand it; there is nothing to be afraid of. I think there is an opportunity for the younger generation.”
Ms Ebanks said that after clients were settled, members of the community will be invited to visit them.
She said: “This idea of the stigma, it’s what you are perceiving or what someone told you but when you meet with them, sit with them, have conversations and get to know them, you realise they are just like us and we want them to be included.”
The relocation of clients from MWI to Tarheel House and to Bridge House is part of a wider move to integrate mental health clients into the community.
It is expected that in about ten years, MWI will close.
Mr Swan said: “It will take major financing, a master estate plan for BHB in terms of all the properties and a plan for how we want the services to amalgamate.”
He said once the clients were settled into Bridge House, the BHB will put out feelers for another community-based location to house more clients from the 75-bed facility at MWI. With the latest developments, MWI is down to accommodating 54 clients.
“It is not going to happen really quickly but we will let the interested parties know that this is what we want to do,” Mr Swan said. “We know that it doesn’t end with Bridge House.
“We are also looking at this for our outpatient settings. It is all part of that plan to move service away from the building.
“We will always need acute services. When we talk about MWI closing, acute services will always be required. We have Somers and Somers Annex; we will have to decide where those wards will go.
“If they move out of that facility there will have to be a purpose-built facility for them and not likely in the community but likely connected with acute services that we have at the hospital.”
The male and female clients at Bridge House will benefit from 24-hour staffing with a nurse and one or two community support workers on each shift.
Ms Ebanks added: “We are bringing the care to the people.”