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Home / Talanoa

Opinion: Stigma attached to poor mental health in Fiji is part of an ongoing colonial hangover

By Emmaline Pickering-Martin
NZ Herald·
5 Oct, 2022 05:00 PM5 mins to read

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Emmaline Pickering-Martin. Photo / Supplied

Emmaline Pickering-Martin. Photo / Supplied

Opinion

OPINION:

Ni sa Bula Vinaka, na yacaqu o Emmaline Pickering-Martin. Na yacai Tinaqu o Makareta, na yacai Tamaqu o Lindsay. Na Tuakaqu o Ratu Joni Kalougivaki, na nona koro o Nauluvatu, Nakelo. Na noqu Bubu o Emmaline Levy, na nona koro o Sawaieke, Gau.

This week is Macawa ni Vosa Vakaviti - Fijian Language Week - and as an iTaukei woman living in the diaspora with children, it's always important to me to acknowledge and celebrate our language and people in all aspects of my life.

One of the ways in which I have chosen to give back to my homeland is through research.

I am what some may call a baby academic and a baby writer.

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My Masters thesis, titled: Na gaunisala me vakavinakataki kina na bula ni vakasama: The way towards positive mental wellbeing. Frontline perspectives of the mental health system in Fiji is a long love letter to my homeland; filled with in-depth research into the Fijian mental health system and what it is like for frontline workers to work in that system.

I interviewed 13 frontline workers, ranging from those in the Ministry of Health and Medical Services Fiji, counsellors, nurses, to policy and advocacy workers.

Fiji is considered a low to middle-income country and, as such, has a limit to its resourcing across all sectors.

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Fiji is an island paradise, but its people have the same issues all indigenous peoples do. Photo / NZME
Fiji is an island paradise, but its people have the same issues all indigenous peoples do. Photo / NZME

One of the findings of my research was that the mental health system in Fiji is in desperate need of resourcing, both financial and human.

The lack of mental health professionals within the country puts them at a huge disadvantage regarding appropriate care for citizens - alongside this is the obvious need for financial resourcing.

The stigma connected to poor mental health

Something that is sorely needed across healthcare in general, but the need in mental healthcare is extremely dire.

The stigma attached to poor mental health in Fiji is part of an ongoing colonial hangover.

The only primary care hospital dedicated to mental health care is St Giles, located in Suva.

St Giles was founded as Fiji's Public Lunatic Asylum in 1884.

As you can imagine, the legacy of that name and those descriptors of being unwell have deep roots within Fijian society.

The stigma attached to the hospital is so deep that it isn't uncommon to hear it being spoken aloud.

As someone who has had multiple family members 'admitted' to St Giles, I speak from experience when I say the stigma runs deep and it is one hell of a colonial hangover.

Prior to colonisation and the introduction of Christianity, there were many ways in which our people dealt with poor mental health, as evidenced by some of the conversations with participants in my research.

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Our people did not institutionalise those with needs, nor did they isolate them. Healing was a communal effort and one that was based on love and care for the vanua.

Another important point was that St Giles has seen an increase in admissions since the Covid-19 pandemic and, as such, the pressure it has put on staff and the system is untenable as we move forward.

The decentralisation of the mental health system is something that all frontline workers agree is required for the best possible care for everyone back home.

Western ways vs indigenous ways

Another recommendation that sprang from my research was the idea of integrating Western models of care with indigenous ways of knowing and being - with the idea that Vuniwai Vakaviti deserve to have their knowledge valued at the same level as Western medicine.

Again, however, another roadblock to that is the colonial hangover - that is, many things indigenous being considered 'unholy' and in a deeply religious country, it can be difficult to truly impress upon people the importance of traditional healing working in association with Western models of care.

However, hope is not lost and many Fijians work with traditional medicines daily; with layalaya and such always present in homes (much to the dismay of many Fijian children).

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So, there is the possibility of educating people along the path of the integration of two world views within a refreshed mental health system.

At the end of the day, what is needed in Fiji the most is both resourcing and education.

A lifelong education programme around mental health and wellbeing, from birth through to old age, is required to remove the huge stigma attached to mental distress and mental illness.

This, alongside financial and human resourcing, would make the biggest difference in the system for Fijians right now.

But how to do this, and where to get support, remain some of the biggest questions for our beautiful island nation; ones that I hope we can find answers to as soon as possible, for all of our babies.

Vinaka vakalevu.

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Emmaline Pickering-Martin was born and raised in Fiji. She has three children of Fijian, Māori, Samoan and Tuvaluan whakapapa. She works as the Pacific media advisor for the University of Auckland, the policy and advocacy lead for E Tipu E Rea Whānau Services and the communications advisor for Hāpai Te Hauora. She holds a Masters in Pacific Studies and her mahi revolves around storytelling and advocacy for Māori and Pacific peoples in Aotearoa.

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