Psychologist strikes out on her own
A virtual retirement tsunami could be reaching Bermuda’s shores as the first wave of baby boomers turns 65 this year.
The Island is expecting a 25 percent jump in the number of senior citizens living here in the next few years psychologist Robyn Montarsolo believes there will a similar increase in the number of senior citizens requiring psychological services.
It’s one of the reasons why she has focused on the psychological issues of the elderly in Equilibrium, her new practice on Bermudiana Road in Hamilton.
“I see older adults who may have a diagnosis of, or suspected diagnosis of, depression, bipolar mood disorders, mood disorders associated with other brain disorders, complicated bereavement or anxiety, for example,” she said. “One of my specialities is dementia. While I was working at the (King Edward VII Memoorial) hospital I set up the Mood and Memory Clinic there and I am planning to continue to provide that service in private practice.”
The Mood and Memory Clinic assesses older adults and younger adults with possible early onset dementia who have symptoms such as memory problems, cognitive difficulties and behavioural changes, to determine if their problems are related to a dementia such as Alzheimer’s disease or frontotemporal dementia, or are actually normal ageing or mild cognitive impairment.
“The problem with dementia is that it is going to become more of a problem as our ageing population increases,” said Dr Montarsolo. “The problem is that many people are not recognising dementia or depression for what it is. They are attributing it to old age. There is an attitude that it is normal to be depressed if you are old. It is normal to be depressed because you’re old! That is a terrible belief. It is a form of ageism. We are labelling old age as a time when you are going to be miserable and not remember anything, which is really unfortunate.
“People need to understand that if they have memory problems, it is best to be assessed so that they can determine if this a normal part of ageing or over and above what we would expect for someone their age. If someone is depressed then we treat it because depression causes so many other issues, physical and cognitive. If you are depressed it will exacerbate memory difficulties. You would be much worse off then if you had had your depression treated.”
She said that early assessment and identification of dementia is important so that intervention and support can be put in place as early as possible for the individual and their family members. This could be medication as appropriate, additional support services; or direct work with patients and families to help identify helpful strategies.
“In so doing the individual’s quality of life and functioning can be maximised and they are better able to plan with their families and be involved in decision-making ab`out their future,” said Dr Montarsolo. “It is also important to identify and treat disorders other than dementia that might be contributing to the patient’s problems, such as depression.”
Dr Montarsolo qualified as a psychologist in 1999 and is registered to practice in Bermuda and the United Kingdom. She is currently chair of the Bermuda Psychologists Registration Council.
“As a member of that council we are trying to look at getting a sense of demand versus provision of services,” she said. “We are looking at when will the market be saturated (with psychological services)? I imagine, knowing that there are a large number of people out there who require psychological services, it will be hard to determine. Many psychologists have wait lists. There is a need within the hospital for services.”
She said in terms of the ageing population, different agencies in Bermuda need to collaborate to better identify where the real gaps are and to be able to develop services to meet all of the needs.
“Psychological needs are only one small piece of the problem,” she said. “If we do that, then we really have a chance of developing a comprehensive range of services that will meet everyone’s needs. That is what I would love to see.”
She was previously clinical psychologist for the rehab day hospital and continuing care programme at King Edward VII Memorial Hospital. There, she was working with patients who had suffered strokes, head injuries, or had neurological conditions that needed physical rehabilitation but had a psychological element neuropsychological as well as psychotherapeutic.
“It was great because it allowed me the opportunity to be focusing more with older adults and be developing the memory service,” she said. “I really enjoyed being able to do that. But the time was right to go out on my own and I have always wanted to be working providing community-based services, accessible and inclusive services, for people who need psychological help. My goal is to increase awareness of psychological but also cognitive issues associated with ageing.”
Dr Montarsolo’s interest in psychology first started when she was in high school. She was interested in both the arts and biology, so a teacher suggested the psychology field might be a good fit.
“I did some placements at St Brendan’s Hospital (now the Mid-Atlantic Wellness Institute) with the psychology department as it was then,” she said. “I went to university and did psychology as an undergraduate and it was clear then I wanted to be focusing on the more clinically-significant issues so hence that is where I went to the path of clinical psychology.”
She did her undergraduate degree in psychology at University of Scotland at St Andrews, Scotland. She did her research master’s degree at University College London, and she did her clinical training in Australia.
“Psychology really did fit for me,” she said. “I loved doing the academic research side, but also the clinical side, and the direct patient care. I have always enjoyed working with the more vulnerable populations. I initially was working in learning disability services here, but always had an interest in working with older adults. Those are two areas where psychologists don’t tend to focus. It is not the glossy side of psychology.”
She called her new practice Equilibrium because she believes that the whole notion of balance, particularly psychological balance, is very important.
“Your psychological balance can have a profound impact on physical health and well being,” she said. “If you get the balance of both then you have equilibrium and harmony. Ultimately, my role is to help people understand themselves better, what influences them and for them to be able them to be able to help themselves on their own, basically self-management.”
Useful website: www.equilibrium.com