Fiji: Mental Health Care and Law in an Island Nation

Fiji is an island nation in the South Pacific, with a population of less than a million. This chapter examines the impact of the United Nations Convention on the Rights of Persons with Disabilities (CRPD) on mental health law and practice in Fiji, as well as the logistical, economic and cultural barriers to enacting the principles outlined in the CRPD. Several significant advances are described, including reformation and modernisation of the Mental Health Act, 2010, decentralisation of healthcare services, empowerment of community mental health services and a shift towards recovery-centred care. The current mental health landscape includes the nineteenth century St. Giles Hospital in the capital city of Suva, with a Community Mental Health Team (CMHT) and Stress Management Wards in three divisional hospitals. The CMHT, Telemedicine unit and Primary Health Centres collaborate to deliver community-based mental health services. Further decentralisation, specialised clinics for specific populations, Mind Farm and developing St. Giles Hospital into a Regional Institute of Mental Health Care and Research (RIMHCaRe) are other plans taking shape in a phased manner. Unfortunately, resource constraints pose a significant obstacle in fully implementing reforms to align with the CRPD, leaving a gap between legislative aspirations and the practical delivery of mental health services in Fiji. Through an analysis of Fiji’s mental health law and the impact of resource limitations, this chapter sheds light on the complexities and potential solutions for addressing Fijian mental health needs more in line with the principles of the CRPD.