Mental illness doesn’t have to stop you living a productive and fulfilling life.
Yet, from what Nicholas and Kim Darceuil have observed in Bermuda, the stigma surrounding it often does.
Numerous people choose not to get the help they need simply because they’re so afraid that their condition might become common knowledge, according to Mr and Mrs Darceuil, who run the Dignity House treatment centre in Pembroke.
“Many people find it challenging to discuss their experiences with health, particularly when it comes to mental health issues,” Mr Darceuil said.
“The stigma surrounding mental health crises remains a significant barrier, especially in close-knit communities like Bermuda.
“In this environment, individuals often hesitate to share their struggles for fear of being identified, as describing a situation without divulging names can easily lead to recognition within the community.
“Many of our clients decline to share their progress due to the lingering stigma, which can result in the loss of friendships, limited job opportunities, decreased social integration and a decline in social status.”
But while one individual might feel they’re the only person suffering in silence, the figures emphatically show that they’re not.
More than 9,000 people – about 14 per cent of the Bermuda population – were estimated to suffer from mental disorders in a report from Public Health England and the Pan American Health Organisation in 2019.
Only 16 per cent of the people who needed treatment, however, were actually getting it. For many, it is the stigma that holds them back.
“Much of the stigma associated with mental health is tied to misconceptions about severe psychotic disorders, such as hallucinations and delusions,” Mrs Darceuil said.
“However, mental health encompasses a broader spectrum of issues, including marital problems, job stress, financial difficulties and relationship challenges.
“These factors can lead to inadequate coping skills and, if left unaddressed, can evolve into significant mental illnesses, such as anxiety, substance misuse, depression, psychosis, and personality disorders.”
The PHE report found more than 3,000 people in Bermuda suffered from anxiety disorders, more than 2,000 with depression and more than 1,000 with ADHD.
Mrs Darceuil explained how, when unaddressed due to fears about stigma, these mild forms of mental health can escalate.
“Take, for instance, an individual who lost his brother at a young age,” she said.
“Despite the trauma, he resorted to self-medication with substances to numb his feelings, ultimately facing anxiety and psychosis from THC.
“He struggled to maintain a full-time job and relied on welfare and his mother’s support, yet he refrained from seeking help due to the stigma, opting instead for the culturally accepted method of self-medication.”
Historically, many illnesses have carried stigma within society – yet in some cases this has been dismantled through an intentional effort for the community to talk more openly and make people feel comfortable to seek support.
Cancer, for example, was such a taboo subject 50 years ago many people would only refer to it as “The Big C”. Decades of awareness campaigns have not only helped improved the recovery rate, they’ve also allowed patients to confront their illness without the fear of being whispered about.
Today, thousands of people turn out for Bermuda’s regular cancer awareness events, at which survivors and family members are championed for their courage.
Mental health awareness campaigns are at a comparatively early stage and, while support has grown for events such as the Mental Health Awareness Expo and Steps to Mental Health Wellness Walk, the issue is still playing catch-up.
“The community often rallies around individuals diagnosed with visible illnesses such as cancer, encouraging them to seek help and support,” Mr Darceuil said.
“In contrast, mental health stigma perpetuates silence and isolation.”
Light at the end of the tunnel emerged, however, when mental health issues came more visibly to the fore during lockdown.
“The Covid-19 pandemic has shifted perceptions around mental health, illuminating our mortality and forcing many to confront the feelings they may have previously avoided,” Mrs Darceuil said.
“Isolation, loss, anxiety and various forms of abuse have underscored the importance of mental wellbeing.
“For some, this period provided the first opportunity to truly engage with their emotions rather than relying on distractions or numbing mechanisms.”
Mr Darecuil, an experienced mental health nurse, and Mrs Darceuil, a public health nurse who worked for the Department of Health, opened Dignity House in 2022 after observing an alarming number of repeat patients at the Mid-Atlantic Wellness Institute.
Dignity House aims to break the cycle by providing a residential rehabilitation service to prepare people with mental illness for life in society, with a team of psychologists, psychiatrists, counsellors, occupational therapists, medical support workers and a case manager.
Mr and Mrs Darceuil were not alone in recognising the shortcomings of the island’s mental health services.
After the PHE report, MWI acknowledged there was a “revolving door of clients being institutionalised” and launched a five-year plan to improve services in 2021.
This includes copying the US and UK models of a community-based approach to mental health, instead of institutionalising patients.
The Bermuda Government also announced this September that it was spending an extra $2.29 million on mental health support, aimed particularly at addressing stigma, including recruiting an expert from Britain to train guidance counsellors and educational therapists to support youths with mental health issues.
The Ministry of Health also pledged to run a comprehensive mental health awareness campaign aimed at “striking down stigma”.
Dignity House is helping to bridge the services gap.
“As a private, therapeutic facility, we prioritise mental health rehabilitation over traditional hospitalisation,” Mr Darceuil said.
Services include inpatient and outpatient counselling, with a focus on dialectical behaviour
therapy, psychiatric care, psychology and family support.
“This approach offers individuals access to localised care, minimising the need for travel abroad,” Mr Darceuil said.
“Additionally, our strong commitment to deinstitutionalisation fosters enhanced community support, ensuring that individuals receive the care they need in a compassionate and accessible environment.”
The couple have observed that wealthier people, and those with access to greater education, are more likely to be willing to discuss their emotional challenges.
“People who have obtained this greater level of education are more understanding, sympathetic and can advocate for themselves and others, adding to the reduction of stigma,” Mrs Darceuil explained.
To improve mental health in Bermuda’s community, Dignity House advocates for education about mental health conditions and offered the following advice for anyone who might be suffering in silence:
- Encourage open discussions about problems – don’t fear reaching out to mental health practitioners.
- Acknowledge that feelings are normal and should not be avoided.
- Prioritise adequate sleep.
- Practise mindfulness.
- Engage in regular exercise.
- Maintain a balanced diet.
- Learn to tolerate distress.
- Practise radical acceptance.
“Ultimately, we encourage individuals to embrace vulnerability and seek help from someone they trust,” Mr Darceuil said.
“Remember, experiencing feelings is a fundamental part of being human, and everyone needs support at some point in their lives. If you need assistance, please don’t hesitate to contact us.”
Visit www.dignityhousebm.com for more information.
