Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

There Is No Health without Mental Health: Implementing the First Mental Health Nursing Postgraduate Program in Fiji

Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

There Is No Health without Mental Health: Implementing the First Mental Health Nursing Postgraduate Program in Fiji

Article excerpt


Globally, mental health is a prevalent health issue, with up to one in four people experiencing a mental illness in a 12-month period (The WHO World Mental Health Survey Consortium, 2004). The World Health Organization (WHO, 2001a) predicts that mental illness will become the second leading health problem in the future. In recognition of this, they have implemented a global prevention and promotion campaign to reduce the significant disability and community impacts related to mental illness. Integral to its call for improved health, WHO (2005, p. xviii) has argued that '?there is no health without mental health?'. However, despite the high demand for skilled care of mental health consumers, many countries experience difficulty attracting and maintaining a sufficiently educated and trained mental health workforce, including nurses. In developing countries such as Fiji, nurses are the primary providers of mental healthcare, yet often do so with minimal specialist education and training, or support from other qualified health professionals (WHO, 2007). In this paper, we discuss the development and implementation of the first mental health nursing postgraduate program in Fiji. In doing so, we also raise a number of issues in respect to educational partnerships between developed and developing countries that may assist others seeking to work together in similar ways.


Fiji is a multi-racial, multi-cultural South Pacific country of approximately 814,000 people. 50.8% of the population are indigenous Fijians, 43.7% are Indian-Fijians, and the remaining are from a range of other backgrounds (WHO, 2001b). Mental health is a prominent health and social issue, with suicide, substance abuse, and mental illnesses such as depression and the psychoses common presentations to healthcare settings (Aghanwa, 2004).

In developed countries such as Australia and New Zealand, deinstitutionalization has progressively shifted mental healthcare from psychiatric institutions to the community. However, this is not necessarily the case globally, and especially not the case in many developing countries including the smaller island nations in the Pacific region. In Fiji, care for people with mental illness is provided primarily by one large institution, St Giles Hospital. The hospital is located in Suva, and provides primary, secondary and tertiary mental health care to consumers throughout Fiji, and also offers inpatient care to consumers from neighboring Pacific Island nations such as the Solomon Islands.

St Giles is a four-ward 190-bed institution that cares for consumers with both acute and chronic mental illnesses, intellectual disability, and those under forensic orders. Care is provided primarily by medical orderlies, with registered nurses forming approximately a third of the staffing and overseeing the delivery of care by these minimally-trained workers (Foster, Usher, Baker, Gadai, & Ali, 2008). Other mental health care is provided in other regions in Fiji through a primary health care community nursing model and via a developing community-based mental health nursing model that is being rolled out in Suva and the surrounding area initially. Despite mental health being a major health issue in Fiji, until recently there has been no specialist post-basic education for nurses working in this field.


In Fiji, nurse education is currently provided through the Fiji School of Nursing (FSN) in Suva and a private nursing school at Labasa. Nurse education initially began in Fiji in 1893 at the Fiji School of Nursing. The original program was of 6-month duration, which increased over a number of iterations to a 3-year course by 1940. A new curriculum, with a diploma-level qualification, was introduced in 1983. Subsequent to this, the diploma curriculum was revised and upgraded as a consequence of a new educational partnership between the FSN and James Cook University (JCU) School of Nursing Sciences in 2004. …

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