Howard Brings Psychiatric Expertise to Island Where It's Scarce

Howard University's Department of Psychiatry will soon provide consulting and training services to the island of Bermuda under an agreement signed last October.

The relationship will also open research opportunities for Howard residents and faculty, said William Lawson, M.D., Ph.D., a professor and chair of Howard's Department of Psychiatry and Behavioral Sciences, in an interview.

The agreement was signed on the territory's behalf by family practitioner Ewart Brown, M.D., M.P.H., who was born in Bermuda and was the island's premier until elections in October 2010. Brown received both his undergraduate and medical degrees from Howard.

Credit: Howard University

Lawson and others from Howard will go to Bermuda, 670 miles east of North Carolina, to consult with local physicians and staff about diagnosis and treatment of patients. Howard will also set up a telemedicine system to allow consultation between visits.

Bermuda is a British overseas territory. Currently, six psychiatrists serve its 70,000 residents, according to Lena Ostroff, a public relations specialist with the Bermuda Hospitals Board, which employs five. Of those, two are Bermudian and the remaining three are from the United Kingdom or from St. Lucia in the Caribbean. One other psychiatrist is in private practice, she said in an interview.

There are also two clinical psychologists on the island and several nurses and social workers providing mental health services, said Lawson.

Bermudians are not covered by Britain's national health system but use a mix of mandatory hospitalization insurance paid for by equal contributions from employer and employee along with a government-administered health insurance plan covering standard hospital benefits and routine office care, said Ostroff.

In addition to former premier Brown, another connection exists between the Washington, D.C., university and Bermuda.

Psychiatrist Chantelle Simmons, M.D., was born in Bermuda, graduated from medical school at McGill University, trained at Emory University, and returned to the island just over a year ago. She now serves as the medical director of the Mid-Atlantic Wellness Institute, Bermuda's psychiatric hospital. Simmons also holds a faculty appointment at Howard, and her clinical work is aided by Howard's support, mentoring, and consultation.

Howard staffers will also help train mental health personnel in Bermuda, concentrating on cultural issues and community psychiatry, said Lawson. Most of the island's genetically and geographically isolated population is descended from former slaves who settled there two centuries ago.

Bermuda also offers an opportunity for psychiatric research analyzing the interaction of genetics, culture, and ethnopsychopharmacology.

There may also be opportunities for direct patient care.

“Patients from Bermuda who have been refractory to treatment might also be brought to Washington and hospitalized in Howard's inpatient psychiatric unit,” said Lawson.

“The Howard agreement does not directly allow U.S. physicians to practice in Bermuda under their existing state licenses,” said Ostroff. Any physician practicing in Bermuda would need to register with the Bermuda Medical Council.

Howard will also lead some research programs in Bermuda.

“They have excellent outreach programs but need a formal epidemiological survey of mental disorders and services,” said Lawson.

Such epidemiological data from Bermuda's largely black population may not be confounded by socioeconomic issues as is often the case with studies on African Americans, said Lawson.

“Hopefully, this project will open the door for other academic medical centers to partner with other countries that need support and personnel for strengthening their mental health systems,” said Annelle Primm, M.D., M.P.H., deputy medical director and director of the Office of Minority and National Affairs at APA.

APA played no direct role in the Howard-Bermuda project but has served as a convener for similar programs, most recently with the U.S. Virgin Islands, said Primm in an interview.