The growing number of Cook Islands patients with mental illness returning from overseas without adequate local support systems presents a significant challenge for frontline healthcare workers and volunteers in the Pa Enua.

This issue was highlighted at the Primary Care Psychiatry Course for Frontliners and Volunteers organised by Te Kainga O Pa Taunga (TKOT), the leading provider of mental health care in the Cook Islands, at the Sinai Hall this week.

More than 50 participants, including police, Te Marae Ora Ministry of Health nurses and health workers from the Pa Enua, are attending the training which began yesterday.

The initiative aims to strengthen frontline mental health care, reduce stigma, and build essential skills among healthcare professionals and volunteers.

Mereana Taikoko, director of Te Kainga, said, “There’s always been a shortage of people working in this field.”

“There’s a stigma that mental health is about ‘crazy people,’ but a lot of our work focuses on prevention, helping people manage stress before it becomes overwhelming and leads to emotional illness.”

Taikoko highlighted that while only about seven per cent of mental health cases are hospitalised, the vast majority – 93 per cent – live in the community, “many of whom are suffering in silence”.

“Some are too ashamed to seek help, or their symptoms are not recognised or treated,” she explained.

“The aim of this course is to help participants understand the signs that someone may need support – and to know that mental illness is nothing to be ashamed of. It’s an illness like any other.”

Health professionals in the Pa Enua raised concerns about the growing number of Cook Islands patients with mental illness being sent back from New Zealand and Australia without the necessary support systems in place.

According to frontline nurses, these patients often diagnosed and treated overseas, are being returned to their home islands alone, where resources are scarce.

In Atiu, nurse Teinakore Windy shared her concerns. Among their current mental health cases is a 25-year-old man sent from Australia last year, as well as a brother and sister, both diagnosed with schizophrenia in New Zealand, who were also relocated to the island.

Windy also reported three elderly patients suffering from dementia, one male on medication, another who refuses treatment, and a female in her 70s.

Aitutaki charge nurse Lee Marie highlighted the challenges her team faces, noting that while the island has a population of approximately 2000, around 280 are elderly.

“Mental illness is invisible but real, and it can happen to anyone,” said Marie.

Aitutaki currently has 18 diagnosed mental health patients, 10 women and eight men.

The training is being co-facilitated by Dr Sione Vaka, Associate Professor and Associate Dean Pacific at the University of Waikato. Dr Vaka is a passionate advocate for culturally integrated mental health care around the Pacific.

Participants engaged in a variety of learning methods, including group discussions, role-playing exercises, practical skill development and the use of PowerPoint presentations.

The course emphasises the importance of early intervention and community support in addressing the growing mental health needs of the Cook Islands.

The course objectives are:

• Strengthen the capacity of mental health professionals in the Cook Islands.
• Offer foundational knowledge about health, mental health, and mental illness, including key concepts, causes, and common emotional challenges encountered in primary care.
• Build initial skills in identifying signs and symptoms of frequently seen mental health conditions in primary care settings.
• Introduce participants to basic management approaches for mental illness, such as commonly used medications, basic counselling techniques, relaxation methods, and how to handle mental health emergencies.
• Provide insight into emotional and mental health issues specific to children, adolescents, women, and the elderly, and how to manage these within primary care.
• Explore mental health challenges and care system limitations in the Cook Islands, encouraging participants to suggest and discuss practical strategies for improving local services.