Bermuda must consider reorganising mental health care to address an increasing demand for services, a stretched workforce and long wait times, a visiting expert said.

Karin Lemmens, a partner at KPMG Netherlands, who has been working in healthcare for more than 20 years, is visiting the island to share international best practices with relevant stakeholders.

She will deliver a keynote presentation at an open forum alongside Charlotte Reboul, senior manager at KPMG Bermuda, sharing insights with healthcare professionals, community organisations, advocates and patients on the island.

Dr Lemmens, described by the firm as a leading specialist in mental health system transformation, told The Royal Gazette: “In most countries we see there are some similar challenges. One of the reasons for that is there is an ageing population worldwide and it affects the mental health populations specifically regarding dementia problems.

“What we are also seeing worldwide is the changing of society and social structures. The increase of social media is affecting mental health, especially in young people.

“There is not only an increase in demand but we see that it is also the availability of staff — having enough psychiatrists and psychologists is one of the biggest challenges.

“It has to do with the ageing population and the population that is at work. There is a demand for people in many sectors. I don’t think we can solve it with hiring more people, all countries are short in staff.

“As a result, we are seeing long waiting lists and people who cannot have direct access to mental health care. You see that in every country.

“We really have to think about how to organise care differently. That is the challenge organisations and governments are looking at. We can create broader structures.

“You see with this group of people that there are often problems that come together such as social and housing problems so you have to look at it from an integrated perspective. People are trying to connect those systems.

“We have to transform systems worldwide to organise care differently.”

Dr Lemmens used the example of Finland, which has remote communities within its population. To ensure widespread access to mental health care, the Finnish have implemented changes in the way care is organised.

Dr Lemmens explained: “They said, how can we use the knowledge of the larger hospital and connect it to other hospitals in the country to share knowledge. You can educate staff but also think about how we can connect them to local communities so we can increase knowledge on mental health care.

“They didn’t only build a network of hospitals that are connected to the social structures in the country but also supported that by developing a digital network, where lots of information was available and where people could connect with each other.

“Those kinds of examples might be very interesting for Bermuda to think about.”

Dr Lemmens said one of the next steps was the use of artificial intelligence to replace some of the administrative work that is falling to doctors and other professionals.

She added: “We also have a great example from Israel, where they use AI to triage people and to support them. It will always be the final decision by the professional but technology can support them.”

Ms Reboul, a manager for government, healthcare and sustainability at the international professional services firm, is part of the KPMG Islands Group covering the Caribbean, Atlantic and Europe.

The Mental Health Anti-Stigma Bermuda Initiative, a collaboration between the Ministry of Health, third-sector organisations, private companies, healthcare providers and international programmes, is an effort locally.

Ms Reboul highlighted a national study that was conducted by Daniel Cavanagh, a PhD researcher from Australia, in partnership with Shawnee Basden, a clinical psychologist for Bermuda practice Solstice, as well as the Department of Education and participating private schools.

The study of pupils aged 10 to 19 showed that 31 per cent of those surveyed had “moderate to severe” symptoms of depression or anxiety.

“Dr Cavanagh’s research is incredible,” Ms Reboul said.

“That is one of the best data sets that we have now regionally on mental health. It is really difficult on islands to have the necessary data to really make evidence-based policies and programmes.

“If Bermuda is taking leadership on trying to solve these issues, other islands will be looking at Bermuda.”

Ms Reboul also spoke about the need to remove the stigma attached to mental health and seeking care that still exists in Bermuda.

She said: “In the last two years, we have seen an evolution and more interest around mental health. Covid had a lot to do with lifting the veil on the stigma.

"We are so pleased that we can bring together providers, community members, patients and families in an open forum. This signals to me a transformation happening.“

The forum, which takes place today, attracted so much such interest locally that registration had to be closed.

The initiative is part of the KPMG Global Centre of Excellence for Island Healthcare based in Bermuda.

Edward Fitzgerald, KPMG Islands Group’s head of healthcare and life sciences, runs the centre, which supports island communities in meeting “the growing challenges of sustainably delivering accessible, high-quality and affordable healthcare”.

Dr Fitzgerald said: “You can build the perfect system and have perfect access but if there is still a stigma and lack of conversation around healthcare, then people don’t access that perfect system.”