Child & Adolescent Services | Bermuda Hospitals Board

Mid-Atlantic Wellness Institute

8:45am to 5pm Monday to Thursday • 8:45am to 4pm Friday

Tel: (441) 239-6344 • Fax: (441) 232-1512
24-hour Mental Health Crisis Line: (441) 239-1111

Emergencies outside business hours: Go to the KEMH Emergency Department or call 911

Child & Adolescent Services delivers comprehensive, quality mental health services to children, adolescents and their families. Services are for youth aged four to 18 who demonstrate psychiatric symptoms of a severity, frequency and duration that impacts their social, vocational and educational functioning through access to multidisciplinary inpatient, outpatient day services and community care.

Our Philosophy

Children have the unique ability to thrive in the face of adversity with each new day presenting as an opportunity for growth and change.

Our core services 

Acute Inpatient Care

  • Nursing Care
  • Medication Management (clinically Indicated)

Outpatient Care

  • Individual therapy
  • Psychiatric consultations
  • Family therapy
  • Community-based interventions

Support Services

  • Day services
  • Autism spectrum disorder clinic
  • Camps
  • Groups
  • Mental health awareness & prevention

Criteria for acceptance

  • Aged from four up to 18 years (day of birthday)
  • Lives in Bermuda for the duration of engagement with Child & Adolescent Services
  • Moderate to severe presentation of mental health symptoms relating to anxiety, depression, mood disorder, psychosis, autism spectrum disorder (ASD) or attention deficit hyperactivity disorder (ADHD)
  • Experiencing serious emotional disturbance which interferes with their ability to function in more than 2 life areas
  • Termination of pregnancy (up to 18 years)

Inpatient admission criteria:

  • Presents with high acute safety concerns to themselves or others
  • Requires further assessment of moderate/severe mental health presentation

Exclusions

Intake exclusions (where items listed below are a primary concern):

  • Conduct disorder
  • Substance abuse
  • Social or education issues
  • Care and protection concerns
  • Mild mental health concerns that could be addressed at a community or school level

Inpatient admission exclusions

  • Homelessness or accommodation needs

Support Services

  • Day services
  • Autism spectrum disorder clinic
  • Camps
  • Groups
  • Mental health awareness & prevention

Glossary of Children’s Mental Health Terms

A

Accessible services. Services that are affordable, located nearby, and open during evenings and weekends. Staff is sensitive to and incorporates individual and cultural values.

Acting Out. Self-abusive, aggressive, violent and/or disruptive behaviour.

Acute. Marked by a sudden onset, sharp rise, and lasting a short time, demanding urgent attention.

Advocacy. The process of actively supporting the cause of an individual (case advocacy) or group (class advocacy), speaking or writing in favour of, or being intercessor or defender. Action to assure the best possible services for or intervention in the service system on behalf of an individual or group.

Affect. Feeling, emotion.

Affective Disorder. A disorder of mood (feeling, emotion). Refers to a disturbance of mood and other symptoms that occur together for a minimal duration of time and are not due to other physical or mental illness.

Anxiety Disorder. Exaggerated or inappropriate responses to the perception of internal or external dangers.

Appropriate Education. An individual education program specially designed to meet the unique needs of a child who has a disability.

Assessment. A professional review of child and family needs that is done when services are first sought. The assessment of the child includes a review of physical and mental health, intelligence, school performance, family situation, and behaviour in the community. The assessment identifies the strengths of the child and family. Together, the Child and Adolescent Services team and family decide what kind of treatment and supports, if any, are needed.

Attachment Disorder. An attachment disorder is a condition in which individuals have difficulty forming loving, lasting, intimate relationships.

Attention Deficit Disorder (ADD). The essential features of this disorder are developmentally inappropriate degrees of inattention, impulsiveness and sometimes hyperactivity.

Autistic Disorder. A disorder (usually appearing by age 3) characterised by lack of communication, lack of social skills, withdrawal and developmental delays.

Avoidance. A symptom of a disorder manifested by avoiding the establishment of new interpersonal contacts to the extent that social functioning is impaired.

B

Bipolar Disorder. A mood disorder with elevated mood, usually accompanied by a major depressive episode.

Brain-Injury. A condition in which an individual before, during, or after birth has received an injury to or suffered an infection of the brain. As a result of such organic impairment, there may be disorders that prevent or impede the normal learning process.

C

Care Coordination. Brokering services for an individual to ensure that their needs and met and their services are not duplicated by the organisations involved in providing care.

Case Change. Changing the services for an individual.

Child Psychiatrist. A physician (M.D.) specialising in mental, emotional, or behaviour disorders in children and adolescents. Qualified to prescribe medications.

Child Psychologist. A mental health professional with a Ph.D. in psychology who administer tests, evaluates and treats children’s emotional disorders. Cannot prescribe medication.

Children and adolescents at risk for mental health problems. Children are at greater risk for developing mental health problems when certain factors occur in their lives or environments. Factors include physical abuse, emotional abuse or neglect, harmful stress, discrimination, poverty, loss of a loved one, frequent relocation, alcohol and other drug use, trauma, and exposure to violence.

Chronic. Marked by long duration or frequent recurrence.

Collaboration. A helping relationship between a family member and a professional in a reciprocal relationship in which the family and professional share power and responsibility. The relationship is grounded in the belief that the family of a child with an emotional disorder can be a resource to the professional and vice versa.

Community-Based Services. The practice of having the locus of services as well as management and decision-making responsibility at the community level.

Conduct Disorder. Repetitive and persistent patterns of behaviour that violate either the rights of others or age appropriate social norms or rules.

D

Day Treatment. Community-based, non-residential program of services for children with emotional disorders. It is the most intensive program available that still allows the child to remain in the home.

Defensive Behaviour. Behaviour that is for the purpose of protecting the individual or avoiding unpleasant ideas, thoughts, and consequences.

Delinquency. Violation of law by a child or youth (usually under 18).

Depression. A type of mood disorder characterised by low or irritable mood or loss of interest or pleasure in almost all activities over a period of time.

Developmental Disorders. Disorders that have predominate disturbances in normal development of language, motor, cognitive and/or motor skills.

Deviant Behaviour. Breaking formal or informal rules or laws relative to social customs or norms, including sexual behaviour.

Dual Diagnosis. A diagnosis of an emotional disorder and another disorder such as developmental delay, drug and alcohol use or a mental illness.

E

Eating Disorders. Disorders that are manifested by gross disturbances in eating behaviour, including anorexia nervosa and bulimia.

Elimination Disorders. The essential feature of these disorders are the lack of control over bladder (enuresis) or bowel (encopresis) not caused by a physical disorder.

Emotional Disorder (or Disability). Behaviour, emotional, and/or social impairment exhibited by a child or adolescent that consequently disrupts the child’s or adolescent’s academic and/or developmental progress, family, and/or interpersonal relationships.

Empowerment. The ability to exercise influence and control over the services one’s child receives.

Evaluation. A process conducted by mental health professionals which results in an opinion about a child’s mental or emotional capacity, and may include recommendations about treatment or placement. See Assessment.

Exceptional Children. Children whose performance deviates from the norm (either above or below) to the extent that special programming is needed.

Experiential Therapy. The therapist incorporates one’s experiences into treatment.

Expressive Therapy. The use of the creative arts as a form of treatment/therapy

F

Family Support Program. Programs available in the community that assist children and their families so that children can remain in their homes, and all members of the family can live balanced, healthy lives.

Family Therapy. A treatment model that involves interaction with family members and family interactions as well as with the individual.

G

Guidance Counsellor. An individual working in a school who is trained to do screening, evaluations, and career and academic advising.

I

Identity Disorder. Severe subjective distress caused by child’s inability to achieve an integrated sense of self.

Inpatient. Services received while residing in the hospital or residential care facility.

L

Learning Disorder. A chronic condition that interferes with development, integration and/or demonstration of verbal and/or non-verbal abilities.

Least Restrictive Environment. An educational, treatment or living situation that provides appropriate services or programs for a child with disabilities while imposing as few limitations or constraints as possible.

M

Medical Social Worker. A professional trained to provide services to individuals, families, and groups.

Mental Illness. General term applied to severe emotional problems or psychiatric disorders.

N

Neurological Impairment. Damage or deficiency to the nervous system of the body.

o

Obsessive Compulsive Disorder. An anxiety disorder manifested by intrusive and persistent thoughts (obsessions) or impulses and compulsive behaviours or rituals (compulsions).

Oppositional Disorder. The covert display of underlying aggression by patterns of obstinate, but generally passive behaviour. Children with this disorder often provoke adults or other children by the use of negativism, stubbornness, dawdling, procrastination, and other behaviours.

Outpatient. Children receiving this type of treatment generally live at home and go for treatment at a local mental health clinic or from private therapists.

P

Parent Training. Classes or individual instruction designed to improve parenting skills in such areas as discipline, consistency, and communication; and Parent Training and Information (PTI) provide information and assistance to parents so they can be knowledgeable and effective advocates within service and policy systems.

Phobic Disorders. Disorders that cause extreme and irrational anxiety when encountering particular situations, objects or activities.

Post-Traumatic Stress Disorder (PTSD). Anxiety disorder following a traumatic event.

Psychiatric Nurse. A registered nurse specialising in the care of patients with emotional or psychiatric disorders.

Psychosis. A general term used to describe any of several mental disorders characterised by social withdrawal, distortions of reality, loss of contact with environment and disintegration of personality.

Psychotherapy. A broad term applied to a variety of approaches to the treatment of mental and emotional disorders.

R

Residential Treatment. Live-in facilities that provide treatment and care for children with emotional disorders who require continuous medication and/or supervision or relief from environmental stresses.

S

Schizophrenia. A serious mental disorder characterised by verbal incoherence, severely impaired interpersonal relations, disturbance in thought processes, cognitive deficits, and inappropriate or blunted affect. The child may also exhibit hallucinations or delusions.

School Phobia. Fear of going to school associated with anxiety about leaving home and family members.

Screening. An assessment or evaluation for the purpose of determining the appropriate services for a client.

Social Maladjustment. Extreme difficulty dealing appropriately with other people.

Substance Abuse/Dependence. The misuse of alcohol or drugs.

T

Transition. The change from moving from one program to another, starting or leaving school, or other important life changes.

Treatment. Changing behaviours or other conditions related to the child’s emotional or behavioural disorder; and/or helping the individual and his or her family to cope with the disability.

W

Withdrawing Behaviour. Behaviour characterised by reduced interest in or contact with other people, and can include absence of speech, regression to babyhood, exhibition of many fears, depression, refusing contacts with other people.