THERE is a poem which hangs inside the new Child and Adolescent Services facility which aptly articulates its need in the community (see sidebar).<@$p>Written by a youngster being treated for depression, it talks of suicide and helplessness. One comes away with the distinct impression that were it not for the programme’s remarkable success, the poem wouldn’t exist.Such has been the fortune dealt to thousands of youngsters since Child and Adolescent Services was first established at St. Brendan’s Hospital in 1986. Five years later demand necessitated a move to a larger facility and Montrose Cottage on Berry Hill Road was offered. It proved an adequate stopgap for approximately 16 years.

Today the facility caters to a host of inpatients and outpatients admitted for a variety of mental health problems including ADHD-related behavioural problems, depression, conduct disorder, adjustment reactions and parent/child relationship problems. With that growth came the realisation that Montrose was no longer capable of meeting the needs of those involved, and the Government programme was moved to a new multi-million dollar facility in April.

Located just off Devon Spring Lane in Devonshire, Child and Adolescent Services plays host to approximately 250 youngsters between the ages of four and 18 currently enrolled in its various programmes. Each benefits from a wealth of expertise offered by a respected team of 19 comprising social workers, child psychiatrists, occupational therapists, psychologists and nurses.

At the head of it all is programme manager Sharon Apopa. Nominated as Social Worker of the Year in 2007, she joined Child and Adolescent Services while the programme was still operating on Berry Hill Road.

As explained by Mrs. Apopa, what is most remarkable about the new facility is it allows an inpatient unit as well as a day programme which takes the form of a classroom, complete with a full-time teacher and teacher’s aide. The recent additions allow for more specialised care than in the past when, as inpatients, youngsters were placed in either the paediatric ward at King Edward VII Memorial Hospital (KEMH) or in the adult psychiatric unit at the Mid-Atlantic Wellness Institute.

“Young children should be kept in an environment that is separate from adults and that is child-specific in the type of care that we can give them,” Mrs. Apopa insisted. “So this has been an improvement. And in terms of the day programme, we identified a gap in the services for young people excluded from school due to mental health problems. Because of space we were never able to respond to that need and we now have a comprehensive programme that provides short-term intervention for young people.”

The day school can cater to as many as ten youngsters, although only eight are enrolled at the moment.

The facility has continued to provide programmes it offered in the past — outpatient psychiatric and psychological care treatment, take the form of family, group and one-on-one counselling.

Previously Child and Adolescent Services were sharing office space at the Montrose Cottage facility. Mrs. Apopa said she and her staff have welcomed the additional space, as it has allowed them to improve the quality of delivery by enhancing the scope and services they provide.

“One thing about providing treatment for young people is that you remain consistent in terms of the space that you use,” she explained, “and because we had more staff than space, we weren’t able to provide the consistency which helps improve the structure they need to go towards recovery.

Staff have been allocated their own office space at the new facility and a multi-purpose, high-tech conference room was added which enables doctors and parents to stay in touch with youngsters receiving treatment abroad through the wonders of teleconferencing.

“There is always going to be a population of young people that will not be able to be treated in Bermuda because there are some diagnoses that are best treated in group settings,” Mrs. Apopa said. “By shared numbers, based on the population of children in Bermuda, we will never have enough children to be able to service them locally with a group treatment model, so they have to go overseas.

“Through the process of teleconferencing and telepsychiatry, we can connect a young person with their family and offer treatment for the family and the young person while they are overseas. What we believe that does is reduce the length of stay overseas and also helps reduce the level of disconnect that occurs between a child and their family when they are treated outside their natural environment.”

It is Mrs. Apopa’s view that the new facility is a monumental step for Child and Adolescent Services as, for the first time since it opened in 1986, it provides their clients with everything they need to succeed - modern and high-tech facilities combined with professional staff allow an unmatched service. Although the social worker added that the “support and confidence of the community” is just as important to its success.

To that end, Mrs. Apopa insisted it is important that families get involved in as much of the treatment process as possible: “They (the children) are part of the system and what is going on in the system is definitely impacting on the child’s mental health problems, so we have to intervene in that system to bring about recovery.”

This includes a family therapy group and a family social skills group for the inpatient unit, during which time families come to the facility and prepare a meal together.

“Even playing a board game together teaches us to follow rules and regulations — we are learning to take turns and think of other people. We are teaching ethics and values ... fair play, and while it looks like they are just having fun, there is definitely some therapeutic value in going through these activities.”

The programme manager explained that the efforts also help in improving communication. In many cases, she said, families today only see each other as they head out the door. Because they are often too busy to eat together, they miss out on the opportunity to pass down family values through dialogue.

“In this environment we create an opportunity for these things to occur,” she stated.

The expected length of stay in the inpatient unit is seven days for what Mrs. Apopa terms “stabilisation”, after which time the young patients return home and participate in various outpatient programmes.

“Since we’ve opened that has not been the reality. So far all the children we’ve admitted have stayed a minimum of two weeks,” she said. However she was quick to point out that they were still “fine-tuning” various programmes as the facility has only been open for a month.

The public is invited to tour the new facility today during an Open House from 1 p.m. to 4 p.m.