Thank-you for joining us this morning as I and Dr. Anna Neilson-Williams, Chief of Psychiatry at the Bermuda Hospitals Board, share the key findings and recommendations of the recently completed first phase of work on the Universal Health Coverage Acute Adult Mental Health Integrated Care Pathway initiative.
This will not be the first time you have heard me speak on the importance of ensuring all residents have access to quality and affordable health care. This includes care for those experiencing mental health challenges. The need for holistic and integrated mental health support continues to grow, and I would dare say that most members of our community know someone who is, or they are themselves, directly impacted by mental health challenges. It is for this reason that Acute Adult Mental Health was selected as one of the first three clinical areas of focus for the Ministry of Health’s Integrated Care Pathway initiative.
An integrated care pathway is a multi-disciplinary approach that details the essential care steps for people with specific needs, in this case, adults experiencing mental health challenges. The pathway specifies the care provided from beginning to end and define what happens, when, and who is responsible at each stage of the care journey.
The Acute Adult Mental Health Integrated Care Pathway initiative is one of three undertaken by the Ministry of Health in 2023 – in addition to pathways already completed by the Bermuda Hospitals Board. Its work was driven by a multidisciplinary working group led by Dr. Neilson-Willams and supported by KPMG.
The initiative provided the opportunity to better understand the current provision of acute mental health services in Bermuda, understand patients’ experiences of the available services, and identify both challenges and opportunities to be addressed or capitalised on to ensure an effective, efficient, and patient-centred care that is reflective of best practices.
Over a 16-week period, an extensive literature review was completed, including the review of over 20 studies, reports and databases. In addition, broad stakeholder engagement was foundational to this undertaking.
- 52 interviews were conducted with patients, family members, clinicians, mental health experts, law enforcement agencies, judicial representatives, and community members.
- A community-wide survey was undertaken and received 348 responses, providing 1,117 qualitative inputs.
- Three stakeholder workshops were facilitated, including one with patient and families with lived experiences. Participants also included clinical specialists, nursing staff, primary care physicians, allied health professionals, diagnostic professionals, family and social services, health visitors, and the non-profit sector.
We are truly grateful to all who responded to the call for feedback, especially those patients and families who were willing to share their direct experiences of such a vulnerable aspect of their lives. The level of engagement on the part of the public was excellent. People were keen to connect and help formulate recommendations for improvements.
This first phase of work on the Acute Adult Mental Health Integrated Care Pathway has surfaced those areas where, collectively, the Government, mental health service providers and community-based organisations can come together to improve access to essential mental health services and strengthen the overall support for adults in Bermuda who are struggling with acute mental health issues.
Thirty (30) key challenges were identified in relation to the provision of acute mental health services on island. Not surprisingly, this body of work confirmed that the need for mental health services in Bermuda is high and has increased since the Covid-19 pandemic. However, as is the case in other countries, mental health has received less policy attention than other health conditions. This work begins to address that state of affairs and creates a clear pathway for how to move forward.
The report coming out of this integrated care pathway work makes it clear that systemic change is required to address the existing gaps and opportunities with mental health support. Seven areas for policy intervention have been identified, along with 20 recommendations to improve the Pathway and significantly improve mental health outcomes.
At this time, I would like to invite Dr. Anna Neilson-Williams to share with you the key findings and recommendations of the Working Group, after which I will discuss the next phase of work on this care pathway.
DR. ANNA NIELSON-WILLIAMS COMMENTS
This is the first phase of work on increasing access to and strengthening the provision of mental health care in Bermuda. It is a priority for the Government and fellow health sector stakeholders. The reality is, however, that this will not be a quick fix.
To ensure momentum on this work continues, a working group is currently being formed to drive the next phase of work. This will include actioning the priority recommendations identified in the Integrated Care Pathway. It is important to note that the Government cannot implement all the recommendations – either alone or all at once. Nor can they be implemented by stakeholders working in silos. A holistic and collaborative approach is required between the Government, mental health service providers, community organisations and other key stakeholders. We are committed to facilitating an environment where productive solutions can be developed and implemented for improved access to and quality of mental health support.
Already, one of the organic outcomes of this working group coming together was the creation of the Alliance for Mental Health Advocacy (or AMHA). This group aims to safeguard the rights of individuals grappling with mental health conditions. Ms. Barbara Belton-Brown is with us this morning as a representative of the Alliance. We look forward to engaging with the AMHA and all mental health stakeholders.
The Adult Acute Mental Health Pathway outlines strategic measures to enhance access to mental health services, strengthen support systems and reduce barriers that individuals facing mental health issues may encounter. It is a testament to our government’s determination to foster a society where mental health is a priority, destigmatized, and seamlessly integrated into our broader healthcare framework.
The report on the Acute Adult Mental Health Integrated Care Pathway will be made available for download on www.healthstrategy.bm shortly following this press conference. I urge the members of our community and all stakeholders to take the time to review the findings and recommendations and be a part of the journey of strengthening this aspect of Bermuda’s health system.
Before closing, I want to express my sincere gratitude to the professionals in the mental health sector, community partners, and stakeholders who have contributed their expertise and insights to the development of this pathway. Your commitment has been invaluable and together, we are forging a path toward a more compassionate and resilient Bermuda.
As we move forward let us embrace this moment as a catalyst for positive change. I encourage open dialogue, collaboration, and active participation from all sectors of our community during the implementation process. Your input is crucial in shaping the final stages of implementation, ensuring that the Adult Acute Mental Health Pathway aligns with the diverse needs of our population.
Let us reaffirm our shared commitment to building a healthcare system that not only promotes physical wellbeing but also nurtures the mental wellbeing of every individual. Together we are 4 laying the foundation for a Bermuda where healthcare is truly universal, leaving no one in the shadows of neglect.
