Schizophrenia
Schizophrenia is generally regarded as one of the most significant illnesses treated by mental health services. Its significance lies in the profound impact of the illness on sufferers and their families and friends. The illness is long term and treatment is usually ongoing. The person with schizophrenia may suffer relapses in the condition if medication is not continued.
What is Schizophrenia?
Schizophrenia is a disorder of the brain that interferes with thinking and judgement of reality, and may also affect a person’s mood, motivation and ability to relate to others. The causes are not fully understood but there are clear genetic factors coupled with triggers in the person’s environment such as personal stress or substance abuse. These circumstances can produce changes in brain chemistry, which give rise to the symptoms. The effectiveness of treatment varies from person to person. There is no “cure” as such, but medication and therapy aim to control or reduce symptoms. For about 50% of sufferers, they can, with support, maintain relatively normal lives in the community and have productive working careers and family lives. Others may experience episodes of relapse where severe symptoms re-emerge and may require periods of hospitalisation for a few weeks, disrupting their community adjustment.
Schizophrenia is a true illness with biochemical roots. There is no evidence that it results from poor parenting as was once believed.
Who can suffer from schizophrenia?
Schizophrenia typically first emerges in young adults. Both males and females are affected equally. Schizophrenia is diagnosed all over the world in all cultures and races. It is also present in all social class categories but there is some evidence that the inner-city poor are more vulnerable. The world incidence has been stable at about 1 in 100 for the past several decades. From the available data it is concluded that the Bermuda incidence rate is similar (1%). The risk is higher if others in the same family have had the illness.
Symptoms of schizophrenia
Schizophrenia can present with a wide variety of symptoms, not all of which are experienced by every individual. The first of three clusters of symptoms are the “psychotic” symptoms including delusions (false beliefs) and hallucinations (usually voices). These symptoms typically cause the greatest distress to the patient, who may feel threatened by people he believes are plotting against him. There are sometimes feelings of being controlled by others or of being capable of controlling other’s thoughts. The ”disorganised” symptoms include confused thinking and odd speech. Thoughts tend to be jumbled and people have difficultly in understanding the patient. The “negative” symptoms include lack of emotional expression, loss of interest or pleasure, and apathy. The loss of self-care skills and social withdrawal also fall in this category. This rather passive profile is much more common in our clients than the misleading Hollywood depiction of violence in people with schizophrenia.
Treatment
Antipsychotic medications form the first line of treatment. Significant improvements have been witnessed in recent years and modern (“atypical”) antipsychotics produce fewer and less severe side effects than traditional medications. This improvement in side effects has promoted greater adherence to prescriptions.
Psychosocial treatments assist in reinstating life skills. Emphasis is placed on social skills, activities of daily living, and vocational skills. A core goal of rehabilitation services is engagement of clients in meaningful activity such as “sheltered work” placements.
Individual and group psychological therapies are also employed to aid in symptom control, assist adjustment to novel circumstances, and helping the patient to identify and avoid relapse triggers.
Success in treatment depends on a supportive network of family, employer, friends, and clinical staff assisting the individual to achieve the greatest independence possible.
Met and unmet needs
People with schizophrenia in Bermuda are fortunate in having access to the full range of clinical services and professionals found elsewhere. More challenging is their access to affordable housing and suitable employment.
In cases where significant family support is not available, they often have difficulty in maintaining themselves. Recent changes in Financial Assistance regulations and reduced availability of Salvation Army Shelter beds pose further threats to them. These limitations in community resources contribute directly to patterns of homelessness, substance misuse, and petty crime for a subgroup of people with schizophrenia. This group then contribute to keeping our Courts, Prisons and hospital beds occupied on a rotating basis in a cycle, which is detrimental to the community and the individual.
In the past there has been active support from the Bermuda Schizophrenia Society and the Bermuda Mental Health Foundation and other charities. In recent years, this group of clients has lacked a vocal community advocate to press for better conditions. The professionals involved have restrictions on their ability to comment on politically sensitive issues. The need for revitalised advocacy support from the community is apparent.
How to get help
The first source of assistance for emerging symptoms of mental illness is usually the family doctor. After a screening assessment for other (physical) causes for the symptoms, the GP will normally refer to the Acute Community Health Clinic for psychiatric assessment and treatment. Once a diagnosis is made, the patient and his family will be offered further education on the nature of the illness and its treatments.
Family members and carers often benefit from the mutual support provided in the weekly Family Support Group. If a wider range of services is required, the patient may be referred on to the Community Rehabilitation services.
For further information on the illness or services available contact the Community Mental Health Clinic on 239-2261 or 236-5208.
Jeremy Lodge completed his postgraduate training in Britain and has been with Bermuda Hospitals Board for 26 years. He is employed as a clinical psychologist working with adults in both the Acute Mental Health Programme and the Rehabilitation Programme at St. Brendan´s Hospital.
Archives
- 1 November - Oncology Service Notice
- 22 October - Reduce your stroke risk with physical activity
- 15 October - Caring for patients at KEMH
- 6 October - BHB to host Mental Health Awareness Fair
- 18 August - Baby Sarai born in the eye of Ernesto
- 29 July - BHB awards $190,000 in scholarships
- 18 July - No through traffic at KEMH on 20 July
- 20 June - No through traffic at KEMH on 21 June
- 10 June - No through traffic at KEMH on 12 June
- 30 May - BHB MRI service up and running
- 22 May - BHB’s MRI temporarily down
- 12 March - BHB celebrates World Kidney Day
- 29 February - Generous donation after life-saving cardiac care
- 3 January - Bermuda’s first baby of 2024 is born
- 25 December - Two babies born on Christmas Day
- 18 December - Scott Pearman appointed as BHB CEO from January 2024
- 15 December - Only visit your loved ones in hospital if you feel well
- 29 November - Green is good for your mental wellness
- 22 November - Donation brings new treatment for enlarged prostate
- 17 November - BHB resumes pre-COVID visiting hours
- 10 November - BHB histopathology tests and post-mortem reports
- 29 September - BHB turns on pink lights
- 18 September - BHB to host free Falls Prevention Mini Expo
- 13 July - Blood donor raffle winners announced
- 24 May - Free CPR training could save a life
- 27 February - Faster and more efficient laundry now in operation
- 6 January - KEMH welcomes first babies of 2023
- 3 January - BHB looks forward to PEARL benefits
- 28 December - BHB COVID update
- 25 December - Three babies born on Christmas Day
- 22 December - BHB jobs fair attracts over 300
- 21 December - Community initiative for old St. James’ Church rectory
- 5 December - BHB updates COVID guidelines
- 1 December - O positive blood donors urgently needed
- 30 November - BHB shines green light for mental health awareness
- 17 November - BHB Traffic Advisory for Monday 21 November 2022
- 13 November - PEARL Implementation Update
- 9 November - O positive blood donors needed
- 3 November - Local newborn makes BHB history
- 29 October - PEARL Go-Live Milestone Celebrated
- 27 October - BHB prepares for PEARL’s implementation
- 19 October - Urgent call for blood donations
- 12 October - HAB donates biomedical van
- 10 October - Residents rate their mental health
- 30 September - Pink lights at KEMH for breast cancer awareness
- 27 September - BHB welcomes new chief hospital information officer
- 23 September - KEMH welcomes baby during hurricane force winds
- 20 September - BHB’s electronic medical record to go live in October
- 20 September - BHB Public Advisory: the hyperbaric chamber has reopened
- 6 September - BHB awards $100,000 in scholarships to eight students
- 9 August - Donate blood and win a ride on a Whip
- 24 July - BHB laundry gets $6.6 million upgrade
- 3 February - BHB CT scan service has resumed
- 27 January - BHB and Brown Darrell collaborate on CT service
- 9 December - BHB COVID-19 Remembrance Tree
- 30 November - BHB turns on green light for mental health awareness
- 2 November - BHB to ease visiting restrictions starting Wednesday
- 22 October - BHB moves to Disaster Alert Level 3
- 18 October - Lamb Foggo Urgent Care Centre resumes normal hours
- 28 September - BHB morgue service impacted by the pandemic
- 17 September - BHB Moves to Highest Alert Level
- 7 September - BHB visitor restrictions reintroduced due to delta surge
- 27 July - HSBC brings Cup Match magic to BHB
- 22 July - BHB cautiously opens up to more visitors
- 21 July - BHB announces breast ultrasound service
- 9 July - Blood donor winners announced
- 13 May - BHB releases BE KIND logo
- 30 March - BHB update in response to COVID-19 surge
- 24 February - BHB Food Services team completes nutrition course
- 2 February - UCC returns to longer weekday hours
- 1 February - Preston Swan takes on acting COO role
- 26 January - More visitors allowed from 27 January
- 18 January - Mental Health Act Code of Practice now available
- 18 January - Bermuda Hospitals Board COVID-19 vaccination update
- 15 January - BHB pilots thermal detectors at its entrances
- 8 January - Why I will be getting the COVID-19 vaccine
- 6 January - New year’s baby makes a late appearance
- 29 December - Update on BHB Long Term Care COVID-19 Cases
- 24 December - BHB Confirms Two Patient Cases in Long Term Care Area
- 23 December - Call for new blood donors to help over the holidays
- 17 December - Dr Wesley Miller appointed as BHB chief of staff
- 14 December - Lamb Foggo UCC Winter Weekday Hours
- 13 December - BHB gives mental health the green light
- 27 November - BHB response to 27 November Royal Gazette article
- 27 October - BHB celebrates Stroke Awareness Week
- 5 August - Agape House maintenance In August
- 24 July - Road closure at KEMH on 27 July
- 21 July - Dr Michael Richmond appointed as BHB CEO
- 2 June - BHB moves to limited visitation
- 19 May - A COVID-19 birthday story
- 29 April - Please wear a mask to the hospital
- 15 April - Police, Fire and Regiment salute KEMH staff
- 13 April - KEMH creates more isolation rooms
- 8 April - Ace Barber Unit converted for pandemic
- 20 March - Only essential visiting now allowed at BHB
- 18 February - BHB releases internal management accounts data
- 18 February - BHB road traffic accident statistics for January 2020
- 31 January - Winter hours at Lamb Foggo UCC extended to February
- 6 January - BHB seeks students for 2020 summer programme
- 1 January - BHB welcomes first babies of 2020
- 2 December - BHB awarded top level of accreditation
- 26 September - World Heart Day: BHB offers free CPR training
- 19 September - BHB welcomes Storm
- 16 September - Hurricane Emergency Kit Guide for Diabetes Patients
- 10 September - 2019 Scholarship Winners Announced
- 4 September - BHB CEO Notifies of Early Retirement in 2020
- 14 August - Improved diabetes management for inpatients
- 16 April - BHB celebrates occupational health nurses
- 25 March - BHB implements hand hygiene audit
- 11 March - Public Advisory: KEMH through road closure
- 22 February - KEMH asphalt resurfacing works
- 6 February - Public Advisory: KEMH roof sealing works
- 5 February - Red Cross Donates Scooter to Gordon Ward Residents
- 22 January - BHB Public Advisory on the Flu
- 5 December - Bermuda Blood Donor Centre thanks polo shirt donors
- 23 October - Walk-in Mammography Day on Thursday
- 12 September - Bermuda Hospitals Board offers free hands-only CPR training
- 26 February - Bermuda Hospitals Board now offers Cardiac CT Scanning
- 14 February - A Valentine’s gift for regular blood donors
- 25 December - Bermuda Hospitals Board welcomes Christmas baby 2017
- 24 November - Public Advisory: Lamb Foggo UCC closed this weekend
- 18 October - KEMH Mammography Department puts breast health first
- 16 October - Bermuda Hospitals Board Traffic Advisory
- 19 September - Bermuda Hospitals Board launches island-wide asthma campaign
- 14 September - Bermuda Hospitals Board has two certified dementia trainers
- 14 September - Lamb Foggo Urgent Care Centre closed this weekend
- 23 March - CEO Venetta Symonds on bed capacity at KEMH
- 17 March - Corporate Blood Drive competition heats up
- 22 February - Lamb Foggo UCC to reopen 1 March
- 1 February - Ms Patrice Dill leaves BHB
- 24 January - BHB introduces Patient-Centred Medical Home
- 20 January - Community invited to open up about BHB services
- 2 January - BHB welcomes New Year’s baby
- 26 December - BHB welcomes Christmas baby
- 22 December - Notice: Holiday hours at UCC and Emergency Department
- 3 December - King’s College urologist joins BHB
- 6 November - BHB focuses on ethics and youth
- 10 October - Being Alive
- 28 September - General Wing Lobby Doors Closed on Thursday 29 September
- 27 September - END OF FISCAL YEAR (2015/16) UPDATE
- 16 September - Urgent Care Centre Closure this Weekend
- 7 September - BHB Update on the Lamb Foggo Urgent Care Centre
- 1 September - Outpatient clinics at KEMH have moved
- 5 August - New hours at Craig Appin House reception
- 25 July - Call for O Negative Blood Donations
- 24 July - Agape House has reopened
- 21 July - BHB Releases CEO Salary Data
- 15 July - BHB Releases 2012 Annual Report
- 16 May - BHB releases salary data
- 4 May - Teen suicide public debate
- 27 April - Dr Keith Chiappa Appointed as Chief of Staff
- 22 February - Agape House 25th anniversary
- 10 February - Update on Genito-Urinary Cancer Care
- 8 February - Blood Donor Centre request to recent donors
- 3 February - BHB Rehabilitation Day Hospital temporarily moved
- 3 February - MRI service at BHB has resumed
- 2 February - Agape House now in Curtis Ward
- 12 January - Kiwanis Clubs Donate $21,000 To Maternity
- 6 January - MRI service interruption
- 5 January - BHB to demolish two buildings on KEMH campus
- 30 December - BHB Posts Hospital-Wide Accreditation Report to Website
- 5 October - Hurricane Joaquin babies at KEMH
- 28 September - MWI sewage treatment plant completed
- 14 September - Acute Care Wing first anniversary – shorter hospital stays
- 18 June - Second Oncologist Joins BHB
- 21 May - BHB Spring Talent Showcase
- 15 April - CCU patients have a new home in KEMH
- 16 February - BHB to dispose of condemned items
- 12 February - Bermuda Hospitals 2014 Update
- 5 February - Operating Rooms now in the Maternity Ward
- 14 September - Emergency Department opens in new Acute Care Wing
- 4 September - Acute Care Wing opens next week
- 29 August - Letter to the Editor of The Royal Gazette
- 12 August - Acute Care Wing opens next month
- 22 July - Tour D´oeuvres and Public Tours
- 15 July - Chance to win a tour of the new wing
- 4 July - Consultant Geriatrician Appointed
- 19 June - BHB mount exhibition
- 9 June - Retiring Blood Donors Honoured
- 15 May - The Back-up generators
- 28 April - We´re connected!
- 21 April - Acute Care Wing: – new features on the face
- 16 April - Atrium- Bringing light to the interior
- 10 April - The New Emergency Department
- 13 February - BHB introduces Eddie the Elephant
- 30 January - Road Works on Point Finger Road this weekend
- 27 January - BHB announce revised opening date
- 16 January - Craneiom comes down
- 7 January - New Chief of Pathology Appointed
- 29 November - Urgent Care Centre Hours Confirmed
- 28 November - Dr Sam Mir Appointed Director of Cardiology
- 14 November - Chairman, CEO speak at Sandys Rotary
- 1 November - BHB Goes Back to Ethics Basics
- 31 October - Quarterly BHB Update – October 2013
- 15 October - New Acute Care Wing Construction Update
- 10 September - CEO and Chairman Speak at Hamilton Rotary
- 6 September - Planned Power Outage at MWI this Weekend
- 26 August - New temporary pedestrian entrance to KEMH
- 24 July - BHB Board Update – 24 July 2013
- 30 April - New Chief of Staff Appointed
- 5 February - Auditor General Informs BHB of Review
- 1 November - BHB Tackles Healthcare Ethics in the Digital Age
- 8 October - Mental Health Awareness Week Tackles Depression
- 2 October - Clinical & Corporate Governance Review Update
- 27 September - Voices Against Stigma: MindFrame PhotoVoice 2012 Launches
- 19 September - BHB´s 2011 Annual Report Released
- 7 August - Chief of Human Resources Appointed
- 16 February - BHB Sees Patient Satisfaction with Services Rise
- 16 February - New CT Scanner Provides Faster and More Accurate Results
- 10 February - Road Works Planned for South Shore
- 31 January - Hospital Marks Healthy Heart Month
- 22 November - Bermuda Hospitals Board Achieves Full Accreditation
- 7 November - Hospital Celebrates Advances in Diagnostic Imaging
- 27 October - Ethics Week 2011 Offers Food For Thought
- 12 August - Venetta Symonds To Be BHB CEO from 7 April 2012
- 6 April - Construction Begins
- 23 November - MindFrame PhotoVoice Exhibition Winners Announced
- 28 October - MWI Host Mental Health Forum for Community
- 28 October - Ethics Week Keeps it Confidential
- 13 October - Premier Visits Site of New Hospital Facility
- 10 September - BHB evaluates three bids
- 4 June - Parking Lot Takes Shape
- 4 May - KEMH Hosts Asthma Day Open House
- 26 March - Site preparation work begins
- 18 March - New Online Applications Process for BHB Jobs
- 23 December - Specifications for New Facilities Complete
- 23 December - BHB Releases Request for Proposal to Shortlisted Bidders
- 28 October - BHB Approves Shortlist of Qualified Bid Teams
- 27 October - New Chief of Nursing, Quality & Risk Appointed
- 14 October - Specifications Take Shape
- 10 September - New Director of Facilities Appointed
- 3 September - New Ambulance Fleet Unveiled
- 1 September - Pembroke Rotary Helps MWI Clients Snap into Action
- 25 August - Hospital Appoints Psychiatrists at MWI
- 29 July - Advisory Teams Evaluate KEMH Site
- 24 June - Robot Enhances Patient Care
- 11 June - World Blood Donor Day- June 14
- 8 May - Market Briefing Presentation
- 30 April - KEMH Hosts World Asthma Day Fair
- 16 March - Redevelopment Update
- 3 February - Presentation To Contractors
- 3 February - Presentation To Architects & Engineers
- 2 February - Hospital Opens New Pilot Patient Rooms
- 12 November - Johns Hopkins Phase II Report Released
- 20 October - Hospital Launches Infection Prevention Week
- 16 October - Mind Frame Art Exhibit Opens at City Hall
- 14 October - BHB Invests to Strengthen Nursing
- 29 July - Mother Support: Going for the Gold
- 27 March - Hospital Improves Laundry Service
- 23 January - Hospital Switchboard Undergoes 2-Hour Upgrade
- 20 December - New Director of Human Resources Appointed
- 27 November - Opening the Doors to Wound Care
- 11 October - Mind Frame Art Exhibit Opens at City Hall
- 6 September - Emergency Department Staff Receive Specialized Training
- 21 August - Dr Donald Thomas Appointed as Chief of Staff
- 15 February - Single Largest Donor Funds Improvements at Hospitals
- 1 February - Have You the Heart to Find Out Your Risk?
- 22 November - Day Hospital Provides Rehabilitative Services
- 17 October - Bermuda Hospitals Board Update on Estate Master Plan
- 16 October - Infection Control Week – It’s In Your Hands
- 9 October - Mental Health Awareness Week 2006
- 26 September - Deputy CEO Comments on Bermuda Hospitals Board Next Steps
- 21 September - Bermuda Hospitals Board Changes First Public Meeting Venue
- 20 September - Bermuda Hospitals Board Public Meetings
- 18 September - Safer and Faster X-ray Service Now Available to Patients
- 7 September - Community Open Houses to be Held at KEMH
- 10 July - BHB and BPSU Reach Three Year Agreement
- 21 February - Bermuda Hospitals Board Appoints Acting CEO
- 30 December - BHB Chairman Steps Down
- 12 September - Community Newsletter Available to Island Residents
- 6 September - Bermuda Hospitals Board Awarded Three-Year Accreditation
- 30 August - BHB Chairman Addresses Hamilton Rotary Club
- 7 April - Hospitals Launch New Web Site
- 1 November - November is Hospice Awareness Month in Bermuda
- 8 October - DEPRESSION
- 8 October - Schizophrenia
- 8 October - Substance Use
- 8 October - ANXIETY
- 7 October - Learning Disability
- 6 October - CHILD AND ADOLESCENT MENTAL HEALTH
- 6 October - CHILD AND ADOLESCENT DEPRESSION
- 5 October - Bermuda’s Mental Health Awareness Week
- 4 October - STIGMA AND MENTAL HEALTH