In a small community like Bermuda, there is still a stigma attached to mental health, with few willing to admit they have sought help for emotional problems.

But Clinical Psychologist Dr. Maggie Cormack and Community Mental Health Acute Services Clinical Coordinator Elois Savery say a lot of people have everyday, stress related problems. Many are able to work out those problems without having to seek professional help.

"I would say that every person can expect that, at least once in their life, they will reach a point where they think they are not able to deal with what is happening to them, so we're all in the same boat," said Dr. Cormack.

Community Mental Health Awareness Week will be observed starting on October 7, with the idea of raising awareness of the kinds of services the Community Mental Health Acute Services provide.

The aim is also to help educate the public that mental health problems are common and no different from other health issues.

"This year we are doing it in a fairly low key way, the idea is that every other year we have a bigger event and last year we had a day workshop here and invited people from all sorts of groups," explained Dr. Cormack.

"From there we actually set up some focus groups to explore particular issues around mental health and the way it was affecting people in their services. That is still continuing.

"This year, at the main hospital at King Edward, we will be advertising health awareness so that anybody who is coming in and out of the hospital will be able to see posters about it and talk to somebody about it. It's a raising awareness kind of exercise."

"The important thing is recognising you have a problem and seeking help," said Mrs. Savery.

"Some are able to work through it on their own."

The Department provides outpatient care to those who need help.

"When the usual strategy and ways of coping don't work, we're here to help with that," explained Dr. Cormack who added that it is a service for everybody, regardless of whether they have insurance or not.

"If people know that we work as a team then when they come and the particular person they want to see isn't there then somebody else will be able to see them. That's how we operate and we work very well as a team.

"It might be medication for anxiety or depression, or it just might be talking. A lot of people come here with everyday problems but the ones they can't solve get bigger. This can happen to any one of us, that we get a `big-problem-can't-deal-with-it' type of feeling."

Community Mental Health Acute Services moved their offices from the King Edward Hospital to St. Brendan's Hospital in May, where, for starters, they have more office space for their staff of 16 which includes psychiatrists, psychologists, social workers and nurses who are highly qualified as mental health officers.

"The psychologists who work here all do a mixture of things, both at this hospital and King Edward Hospital," explained Dr. Cormack.

Explained Mrs. Savery: "We deal with clients who have schizophrenia, depression, anxiety, stress disorders or people who have everyday problems such as marital issues who need help with problem solving."

There is a 24-hour on call service ( (236-3770) for crisis situations which may occur after 5 p.m., on weekends and on public holidays while there are also two helpline numbers ( (236-5208 or (239-2261) for persons needing help.

"There is a resource person on the line who will access the situation and if need be will call one of us to deal with the emergency," said Mrs. Savery. "There is always help available, but surprisingly not too many people are aware of that."

Mrs. Savery said the service has a client list of about 400, all outpatients. She said a person can be admitted to the hospital for a short term if their conditions warrants it, such as if the person was suicidal.

Though the numbers are fairly even between men and women seeking help from the department, it has shown that men, in general, are more reluctant to come forward.

"They're Mr. Fixit, so why can't they fix themselves," Dr. Cormack said of some men's thinking.

"When you say to them `what do you do to deal with stuff', they just say `I just get on with it'. Part of it is that women are more used to talking about things and also that men still feel that they can't admit that they have a problem."

Said Mrs. Savery: "Some of them will go out drinking or have affairs, anything for an escape instead of dealing with their problems."

There is a stigma about being admitted to St. Brendan's, but confidentiality is assured and information on patients is not given out - not even to employers or family members - without the patients' written permission.

"Confidentiality is very important to us, absolutely vital," stressed Mrs. Savery.

"Depression is a major diagnosis and an equal number of men and women have sought help," noted Mrs. Savery whose department deals only with adults.

"I got a few statistics from Child and Adolescent Services and in dealing with their clients they say they have had an increase in referrals between 12 and 17 years old and there have been more males than females.

"Their primary diagnosis is also depression. They also said there is an increase in social behaviour issues, such as a breakdown in the marriage which causes a lot of stress and depression. Children as well are affected."

Added Dr. Cormack: "The gradual increase in people coming to the service is both that people are recognising that they are stressed, which they didn't think very much about before, and people now realise that it isn't a problem to say `I feel anxious, I feel depressed, I feel I will go crazy if I carry on like this'.

"Now there is much more acceptance that anybody can feel like this, whereas in the past there is a lot of stigma about it. A lot of things in our culture have recognised that this is normal and anybody, at anytime in their life, can have the sort of problem that makes them feel `if I go on like this I'm not going to cope'."

Mrs. Savery admits the Community Mental Health Acute Services was more accessible to the public when they were stationed at the King Edward Hospital. However, the location of their offices at St. Brendan's makes the patients feel uncomfortable about visiting the hospital.

"There are some instances where people might be reluctant to come to our service, so we will go out to them and assess them in their home," she explained.

"In the past few years the services has extended and some people are not even aware of what we have to offer them with the training and qualified staff that we have in our services."

Added Dr. Cormack: "The fact that we are based at St. Brendan's is not the issue, because when we were down at the hospital we were still St. Brendan's workers.

"People had thought if it is a psychiatric problem or is anything to do with St. Brendan's then you are completely crazy and locked up. They hadn't recognised that we had a facility to go out into the community to invite people to come and talk to us.

"That is a huge portion of our work. We're not dealing all the time with people who are locked up and crazy, that's not what it is about. We have a strong liaison with other services, the Police being one in particular, and we have spent a lot of time trying to inform other services of what we do and what kind of help we offer so that we can liaison with them."

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Next week: One woman's story.