Developing our mental health services

With the aging population, alcohol and drug problems, mental health and offending, developmental disorder and suicide prevention remain high on the priority list, as the team maps out its strategic direction for the future.

Addressing the unmet needs across the Cook Islands is a priority for Te Marae Ora – Cook Islands Ministry of Health, Mental Health Services. With the aging population, alcohol and drug problems, mental health and offending, developmental disorder and suicide prevention remain high on the priority list, as the team maps out its strategic direction for the future.

Visiting from New Zealand, Dr Collin Patrick, a Psychogeriatrician and Clinical Director for Waikato District Health Board’s Older Persons Mental Health Service has been working closely with Dr Fariu and the Te Marae Ora – Cook Islands Ministry of Health (TMO) Mental Health Team to identify dementia and provide initial treatment, and develop pathways for our aging population. Dr Patrick says “it is vitally important that we identify our loved ones with dementia early, so that treatment and support mechanisms can be put in place as soon as possible.”

Wheels are in motion as Alcohol and Drug/Addiction services are being developed, with plans to establish service delivery in 2020.  An Arrangement of Cooperation with Waitemata District Health Board (WDHB) which was signed at the July Health Conference this year has helped formalise the partnership between TMO and WDHB mental health services. “As a country and team, we are very aware of the relationship between substance use and our unsatisfactory domestic violence record, and this is a community issue that is a challenge for all of us… …that it appears to be increasing and what we are doing does not seem to be meeting the social and health needs. Culturally we know it is happening and we need to speak up and address this” – Dr Fariu, Head of the TMO Mental Health Team

A meeting occurred this week to focus on increased collaboration between TMO and Corrective services in order to address the needs of those suffering mental health problems in prison, in order to ensure that the mental health needs of those in prison are met. Secretary of Health, Dr Josephine Herman said “mental health services in the Cook Islands require further resourcing, and the recruitment of our clinical psychologist Dr Evangelene has been important to help identify areas of concern. While some of our patients requiring mental health services reside in prison, there is a wider need for the community to help us provide a more therapeutic and safe environment for our patients, to enable them to live quality lives. The removal of high risk environments where drugs and alcohol are readily available is an important first step for our families and community.”

Suicide is an ongoing priority with suicide management protocols being developed within mental health services to ensure that those in need can be met with the best possible service. TMO is developing four training packages that address different aspects of suicide prevention. These include parenting, resilience, managing the acute event, and postvention (managing after an event). The community can anticipate that these will be rolled out later this year.  Dean Tangata, community mental health nurse says “prevention of suicide requires an ongoing sustained effort throughout the year rather than sporadic responses following tragic events, and our people need to show more compassion”.

Developing service provision across the whole country is a challenge, and includes outreach to the Pa Enua – with challenges especially from Aitutaki for more Mental Health Service there. “Exciting initiatives and collaborations are beginning to happen that will pay dividends in the upcoming years- It’s a very broad area, and so it is important that we go step by step in implementing these initiatives” says Dr Evangelene Daniela-Wong – Clinical Psychologist. Senior Mental Health nurse, Anna Paniani is enthusiastic with progress to date. “I am pleased to see recent developments in our mental health services, and feel positively about the future of our services. With the addition of more mental health nurses, we will be better positioned to provide higher quality mental health nursing services for our people”.