The Bermuda Hospitals Board (BHB) plans to boost community-based mental health services over the next several years.

Chantelle Simmons, a consultant psychiatrist at the Mid-Atlantic Wellness Institute (MWI), yesterday outlined plans to reform mental health services at the Devonshire facility.

Part of the aim was to halt the "revolving door" of repeat hospitalisation, she told Hamilton Rotary members yesterday.

The new initiatives, which "will have a staggered implementation over the next few years", were recommended by the Mental Health Plan the BHB released in July.

They include service improvements and reforms of forensic mental health services to better help patients with severe and persisting mental illnesses.

"It is anticipated that [assertive outreach team] services will be available 24 hours a day, throughout the year," Dr. Simmons said.

Such services will include home-based treatment as currently offered in the UK. Meanwhile a newly established clinic has already begun addressing the needs of an estimated 200 patients with autism spectrum disorders.

"The area of geriatric mental health care is another which was identified as having significant potential for service improvement," the psychiatrist said.

She added that a chief of geriatrics has recently been recruited and the BHB expects to roll out local services providing specialised assessment and treatment in this area soon.

Her speech, at the Royal Hamilton Amateur Dinghy Club, also addressed the problem of individuals within the correctional system suffering from mental illnesses.

"They are often lost to follow-up after being released, which is another contributor to the 'revolving door' pattern of institutionalisation," she explained.

In light of that, the Mental Health Plan recommended the BHB establish "an agreement with an overseas medium secure unit, to which Bermudian offenders can be transferred when clinically indicated".

According to Dr. Simmons, the BHB is currently discussing such an agreement with Reaside Clinic in Birmingham in the UK.

She said Bermuda staff also visited Birmingham to study recovery-based services with the Centre for Community Mental Health at Birmingham City University.

MWI hopes to incorporate self-management principles developed in the Birmingham-Solihull Mental Health Trust into its own practice.

"A key aspect of the recovery model is for service users to be able to take control of their lives," Dr. Simmons said.

She highlighted early prevention as a crucial first step, adding that a service user forum at MWI meets on a weekly basis. A dual diagnosis capacity working group composed of clinicians and a service user, aims to refine treatment for individuals with psychiatric and substance abuse disorders.

Consultant psychiatrists from Bermuda also travelled to Madison, Wisconsin this past June to study community-based services.

"We would be not only addressing the target symptoms of an individual's mental illness, but working with them as they strive to assume active and productive roles within our society" if similar principles could be incorporated into MWI programmes, Dr. Simmons said.

The psychiatrist said further research was necessary to determine if Bermuda's mental health problems differ to those of the rest of the world.

She highlighted substance abuse as a serious problem and said a disproportionate number of homeless suffer from mental illness. She added that serious illnesses such as schizophrenia were occasionally rumoured to be more prevalent here than overseas.