Five clinical jobs at the Mid-Atlantic Wellness Institute have been reduced as Budget cuts take their toll on the health service.One Bermuda Alliance Senator Kathy Michelmore yesterday revealed how the Island's mental health services were struggling to make savings of $1m.She told the Senate that MWI was being forced to make cutbacks because of the three percent decrease in Government funding this year. The MWI subsidy for this fiscal year is $38.578 million.It means MWI's chief of psychiatry Michael Radford will be leaving the Island when his contract expires in August. The contract of a junior doctor will also not be renewed.This leaves MWI's current compliment of ten psychiatric support staff reduced to eight; four psychiatrists and four resident doctors.The three positions of art therapist, occupational therapist and physiotherapist are also being frozen.The art therapist position is currently vacant, the occupational therapist is leaving in August and the physiotherapist has been transferred to the King Edward VII Memorial Hospital where MWI patients can also be seen.Dr Michelmore, Shadow Minister for Health, said the front-line job losses would impact mental healthcare in our community as it would be difficult to implement plans with limited resources.She said: “The main concern is that implementation of the new Mental Health Plan as envisaged will be very difficult.“I believe that existing services will remain, and that the Mental Health Care professionals will continue to do their best to deliver quality care for our community within the constraints of budget measures.”Dr Michelmore explained to the Senate that mental care services are often stigmatised and less well supported than other areas of medical care.She said: “Yet mental health issues are anticipated to affect between 20 and 25 percent of the population in our lifetime.“We must support continued reform and bring Bermuda into line with current best practice, we need to support our service providers and help to equip them with the tools needed to serve our community.”Dr Michelmore said it was therefore “quite a relief and welcome” that a need analysis for Bermuda's mental health services was submitted in October 2009.The report, commissioned by the Ministry of Health, went on to be approved by the Bermuda Hospitals Board and Cabinet and it was announced in the Budget speech in February 2010.Dr Michelmore said the need analysis outlined the importance of a ‘recovery model' to avoid “the tendency for revolving door patients in mental health services”.She explained it was MWI's aim to expand its community-based core model, including establishing home treatment programmes, long-term residential care and relocating community rehab from MWI to Hamilton.She said: “It was agreed that we need to stop the revolving door phenomenon. That's treating patients then releasing them into the community then seeing the same cycle repeat itself over and over again.”The report also states that specialist services were autism, geriatric psychiatry and residential treatment for addiction needed to be improved, as well as a reformation of forensic mental health services.It was at this point that MWI established links with a medium secure unit in Birmingham, UK.Dr Michelmore said this would provide more appropriate facilities rather than MWI or the prison service, although it is understood that no patients have yet benefited from this overseas facility.Dr Michelmore said: “This plan met with widespread approval and service users and providers welcomed the intent of the proposed changes.“Changes were implemented and parts of the new model implemented however in spite of acceptance of a plan with a wide scope and overarching vision, there was no increased funding for the plan in 2010.“The Budget was cut in 2011-2012 and MWI now needs to find savings of around $1 million.”A Bermuda Hospitals Board spokeswoman said there would be minimal impact to services as they remained committed to “the provision of safe, quality care in all service lines”.She said: “As was announced by the Minister in the March Budget debate, MWI experienced a $1 million reduction in its budget in this fiscal year due to the current economic climate.“Our goal has been to meet this reduced budget, while minimising the impact on services with regards to quality, and safeguarding Bermudian jobs, where possible.“The reduced budget means we will be challenged implementing the new Mental Health Plan to schedule, but existing services will remain, and they will be run safely.”