Increasing mental health access across Vanuatu’s 83 islands

Access to mental health services is a major challenge for people throughout Vanuatu. Coupled with a social and cultural stigma about mental health in general, many Ni-Vanuatu struggle to access the support they need, leaving many people misinformed and hesitant to seek help.

Spread across an archipelago of 83 islands, ensuring access to mental health services for over 300,000 inhabitants in Vanuatu isn’t an easy task. The Ministry of Health Mind Care Unit, the country’s only psychiatric facility, is staffed with just one psychiatrist and three psychiatric nurses, making it impossible to serve all island communities while also providing services at their regular clinic in the capital Port Vila.

In order to meet this challenge head-on, IsraAID and Mind Care Unit are training and mentoring volunteers (of which 60% are women) across the Pacific archipelago to ‘open the dialogue’ and help deliver Mental Health and Psychosocial Support (MHPSS) outreach and awareness to the community. To support this work, IsraAID has created a MHPSS Training Manual, the first of its kind to be officially endorsed by the Ministry of Health.

The MHPSS volunteers work closely with key community members and leaders such as pastors, women leaders, youth leaders, police officers, teachers, and Chiefs, creating an interwoven network of community members in different leadership roles. Together, they provide basic MHPSS services and work closely with the Mind Care team for referral cases.

As an MHPSS volunteer with a multiple sensory disability, Rosina has dealt with this stigma from both a personal and professional perspective. She advocates for people living with a disability, and champions mainstreaming disability and gender inclusion in all MHPSS messaging and activities.

“People asked, ‘What can you do? What is your ability to help?’ They would accuse me of being crazy for working with people who have a mental illness. We are not here to judge; we are here to help. I know that my disability is a strength, and I can offer a unique way to help people.”

Lawrence is one of three psychiatric nurses at the Mind Care Unit. He recognizes the need for a change in the current attitude towards mental health in Vanuatu and encourages young people to become involved and learn about the field.

“MHPSS is a new field in Vanuatu, and there is still a lot of stigma, even towards health professionals. The stigma creates a barrier preventing people from accessing our services.”

As one of the world’s most natural disaster-prone country, psychological distress and trauma is common in Vanuatu, especially among people who have suffered from property loss or damage. Psychology and Social Work student Desiree has learnt through her practical experience as an MHPSS volunteer more about the great need for increased mental health services.

“Every time we experience a disaster it affects people’s mental state and amplifies existing issues such as domestic and gender-based violence. MHPSSS is necessary so that we have the tools to stay mentally healthy and cope with any disaster or difficult situation.”

Not every case needs a professional trained in psychiatry. Many can be addressed at the community level by the volunteers, preventing the clinic staff from becoming overwhelmed. For the issues that cannot be solved with trained volunteers, a referral system is in place. Peter is a psychiatric nurse at Mind Care Unit and one of the facilitators of IsraAID’s MHPSS training.

“We are not training people to become qualified nurses. We are training them to be able to go to communities where there are limited services to share information and make a referral, if necessary.”

As a senior psychiatric nurse, Norah explains that there are not enough professionals to reach everyone, but the volunteers can be the first step for people receiving the support they need.

“The most important thing is to make the patients feel safe and heard. This is paramount to them recovering. Our clinic is the last part of the hierarchy of care and is where we provide medication and counseling based on an individual’s needs. But that individual will return back to their community and it is the community that plays the most important role in restoring the individual’s feeling of safety and belonging.”

Challenging the deep-rooted stigma surrounding mental health in Vanuatu is a long-term process, but IsraAID’s volunteer training, in collaboration with partners including the Ministry of Health Mind Care Unit team, is the first step to ensuring access to inclusive mental health services and support for all.

Jeanine Shem is IsraAID Vanuatu’s Program Manager, the longest member on the Vanuatu team after six years.