WHO MIND Mental Health in Development PIMHnet The WHO Pacific Islands Mental Health Network WHO proMIND: Profiles on Mental Health in Development COOK ISLANDS Mental Health Policy and Service Development Department of Mental Health and Substance Abuse World Health Organization WHO Library Cataloguing-in-Publication Data WHO Profile on mental health in development (WHO proMIND): Cook Islands. 1.Mental Health. 2.Mental Health Services. 3.Health Policy. 4. Cook Islands. I.World Health Organization. ISBN 978 92 4 150960 2 (NLM classification: WM 140) © World Health Organization 2015 All rights reserved. Publications of the World Health Organization are available on the WHO website (www.who.int ) or can be purchased from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: [email protected] ). Requests for permission to reproduce or translate WHO publications –whether for sale or for non-commercial distribution– should be addressed to WHO Press through the WHO website (www.who.int/about/licensing/copyright_form/en/index.html ). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. The named authors alone are responsible for the views expressed in this publication. Suggested Citation: Fariu R, Wichman V, Funk M, Mulliez Z. Drew N. WHO Profile on mental health in development (WHO proMIND): Cook Islands. World Health Organization, Geneva, 2014. This and other profiles on mental health in development can be sourced from: http://www.who.int/mental_health/policy/country/countrysummary/en/index.html For feedback or suggestions for the improvement of this publication, please email Dr Michelle Funk ( [email protected] ). COOK ISLANDS "The provision of an integrated community-based mental health service that addresses the needs of all persons with mental disorders." Acknowledgements This publication has been produced as part of the World Health Organization's (WHO) profiles on mental health in development (WHO proMIND), and has been written and edited by: Dr Rangiau Fariu, Director of Community Health Services, Ministry of Health, Cook Islands Mr Valentino Wichman, Monitoring and Evaluation Manager, Policy and Research, Ministry of Health, Cook Islands Dr Michelle Funk, Coordinator, Mental Health Policy and Service Development, Department of Mental Health and Substance Abuse, WHO, Geneva Ms Zoe Mulliez, Mental Health Policy and Service Development, Department of Mental Health and Substance Abuse, WHO, Geneva Ms Natalie Drew, Technical Officer, Mental Health Policy and Service Development, Department of Mental Health and Substance Abuse, WHO, Geneva The preparation of this profile would not have been possible without the support of the following staff from the Cook Islands and WHO: Mrs Elizaberth Iro, Secretary of Health, Ministry of Health, Cook Islands Staff from the Ministry of Health in the Outer Islands of the Cook Islands Te Kainga Community Mental Health Services, Rarotonga, Cook Islands Mental Health Services, Ministry of Health, Cook Islands Dr Yang Baoping, WHO Representative in Samoa, American Samoa, Cook Islands, Niue and Tokelau, Apia, Western Samoa Dr Temo Waqanivalu, Coordinator, Office of the WHO Representative in the South Pacific, Suva, Fiji Dr Yutaro Setoya, Technical Officer, Mental Health, Office of the WHO Representative in the South Pacific, Suva, Fiji Dr Xiangdong Wang, Regional Adviser for Mental Health, WHO Regional Office for the Western Pacific, Manila, Philippines (WHO proMIND): Cook Islands Potential partners interested in finding out more about mental health in the Cook Islands should also contact project partners based in-country (contact details on page 8). WHO proMIND Potential partners and donors interested in supporting or funding WHO proMIND projects should contact Dr Michelle Funk ([email protected]), Coordinator, Mental Health Policy and Service Development, Department of Mental Health and Substance Abuse, WHO, Geneva, Switzerland. More information about WHO MIND and WHO proMIND projects is available on the website: http://www.who.int/mental_health/policy/en/ The WHO Pacific Islands Mental Health Network (PIMHNet) The idea to establish the Pacific Islands Mental Health Network (WHO PIMHNet) came about at a meeting of Ministers of Health for the Pacific Island Countries (Samoa, 2005) during which the idea of a Pacific network as a means of overcoming geographical and resource constraints in the field of mental health was discussed. There was unanimous support among countries of the Pacific Region to establish the network, and with the support of New Zealand’s Ministry of Health, the World Health Organization initiated process to establish PIMHNet. The network was officially launched during the Pacific Island Meeting of Health Ministers in Vanuatu in 2007. PIMHNet currently counts 20 member countries, each with an officially appointed focal point: American Samoa, Australia, Commonwealth of the Northern Mariana Islands, Cook Islands, Federated States of Micronesia, Fiji, Guam, Kiribati, Marshall Islands, Nauru, New Zealand, Niue, Palau, Papua New Guinea, Samoa, Solomon Islands, Tokelau, Tonga, Tuvalu and Vanuatu. The key aim of the Pacific Island Mental Health Network is to enable Island countries to work together and draw on their collective experience, knowledge and resources in order to establish mental health systems that can provide effective treatment and care. In consultation with countries, PIMHNet has identified a number of priority areas of work, including advocacy; human resources and training; mental health policy, planning, legislation and service development; and access to psychotropic drugs; and research and information. Network countries meet on an annual basis to develop workplans outlining major areas for action to address these priorities, to be officially endorsed by their ministers of health. PIMHNet has also been successful in forging strategic partnerships with NGOs and other agencies working in the Pacific Region in order to reduce the existing fragmentation of mental health activities and to build more coordinated and effective strategies to address the treatment gap, to improve mental health care and put an end to stigma, discrimination and human rights violations against people with mental disorders. PIMHNet is funded by the New Zealand Ministry of Foreign Affairs and Trade through the New Zealand Aid Programme. THE PROJECT "The provision of an integrated community-based mental health service that addresses the needs of all persons with mental disorders." WHOproMIND: Cook Islands | 1 KEY ACHIEVEMENTS FOR MENTAL HEALTH IN THE COOK ISLANDS A mental health policy and plan has been drafted. A detailed human resource and training plan has been developed. Training has been conducted for a range of stakeholders in mental health. The undergraduate curriculum of the school of nursing has been reviewed and a mental health component has been added. A new Youth Line was created to provide mental health advice to young people. The Te Kainga Centre was awarded the Excellence in Developing Community Mental Health services by the Asian Federation of Psychiatric Associations for its work in the Cook Islands. A rehabilitation programme for clients with mental disorders and the elderly with chronic medical conditions and dementia. Atypical antipsychotics (Olanzapine) on the Essential Medicines List. NEXT STEPS FOR THE COOK ISLANDS Increase the number of community-based mental health programs, including counseling services and substance abuse services. Finalize the national mental health policy and plan. Develop and implement legislation to protect the rights of people with mental illness. Develop open learning opportunities, collaboration and work-related visitation with countries such as New Zealand, Australia, Samoa and Cuba. Provide mental health care attachments/training in New Zealand and/or Fiji for nurses and support workers. Build the capacity of primary care workforce to provide mental health services, including assessment and treatment. WHOproMIND: Cook Islands | 2 OVERVIEW The status of mental health care services in the Cook Islands has been slowly improving, but there remains much to be done to ensure that the country reaches its goal – to address the needs of all persons struggling with mental disabilities. Currently, there are not nearly enough medical