The new Te Puna Tiaki – Wellness Unit at the Rarotonga Hospital will help alleviate some of the pressures on the mental health system in the island. Cook Islands News journalist Matthew Littlewood speaks to Te Marae Ora clinical psychologist Dr Evangelene Daniela-Wong about why it’s so important.

It’s been years in the making, and it could save lives. The $1.2 million Te Puna Tiaki Wellness Centre, which was unveiled on Friday, represents a gamechanger in mental health services in the Cook Islands.

“It’s a new beginning,” Daniela-Wong tells Cook Islands News.

Daniela-Wong says there were several designs over several years before they reached something that was conceptually and economically suitable.

“When I saw the final design (by design and project officer Sally Hosking-Naea), I was blown away,” she says.

“It represented everything that we were hoping for. It’s been in the pipeline for many, many years.”

Daniela-Wong says there were several different designs according to different budgets.

Te Marae Ora Ministry for Health staff at the opening of Te Puna Tiaki – Wellness Unit at the Rarotonga Hospital. LOSIRENE LACANIVALU/23050588

“It was about finding designs that fit the various budget, but also meet our needs,” she says.

“We started off on a budget of about $200,000, but it grew as we discovered the aspects it needed to cover. A lot of the fittings and doors are quite specialised for an in-patient unit. It meets international requirements.

“It’s light, it’s open, but it’s got all the features required for looking after those with acute mental health issues,” Daniela-Wong says.

Daniela-Wong says it became increasingly necessary for such a centre in Rarotonga.

“Prior to this, we were putting people with serious mental health issues in the prison, because there was nowhere else that they could go, and this is just not a conducive environment for wellness,” she says.

“There were a few examples where we had some people in prison who never should have been there.”

The wellness centre features four rooms for patients, and there are plans to use part of the building to allow patients’ families or caregivers to stay.

“It’s not going to replace social housing, the idea is to have people staying at the centre for up to six weeks,” Daniela-Wong says.

“We don’t want this to be a hospital centre, we want it to be fully integrated with the community.”

One of the rooms at the new Te Puna Tiaki – Wellness Unit at the Rarotonga Hospital. LOSIRENE LACANIVALU/23050589

Wong says they were hoping to use the garden near the wellness centre as an opportunity for patients to participate in activities while they undergo treatment.

“At the moment, we’re not opening for respite, but we’re working towards it. It’s a wonderful building, but it needs the culture to match. I’m thinking of gardening opportunities or arts and crafts, music for the patients, just something that will help them in their wellness journey,” she says.

Daniela-Wong says over time, the goal would be for the centre to specialise in preventative care.

“It would be great to create a real place where respite can happen,” she says.

Daniela-Wong says the stigma towards mental health has declined in the Cook Islands.

“Before we didn’t talk about it at all as a community, and we heavily stigmatised it. Now we’re seeing the conversations happen in the community,” she says.

“You still get people coming into the clinics, especially men, who feel embarrassed about having to talk about their mental health, but overall people are much more receptive to the idea of treatment.”

Daniela-Wong says she was pleased with the Government’s recent approach to mental health policy and funding.

“It’s a big commitment on behalf of the government. Mental health has previously been on the backburner, it’s never had that much funding. Now we have a new building, and a new team, and it’s really exciting,” she says.

Daniela-Wong says that in order for mental health care to be most effective, there needs to be a “whole of person” approach taken.

“We talk about Non-Communicable Diseases (NCDs), but it’s lifestyle that creates those diseases, so you’ve got to look at the whole person. It’s the same with mental health, you get much better outcomes dealing with it holistically, rather than just prescribing medication. Healthcare is about treating the body, the mind, and the person,” she says.

Daniela-Wong says she was impressed with the way that the Cook Islands Investment Corporation (CIIC) and the government sourced the necessary funding for the centre.

Funding for this project was provided by the Cook Islands Government and totalled $1.2 million over three consecutive financial years. Funding for the IT Building and Pharmacy Extension, which together cost $700,000, was delivered separately through Covid-19 national pandemic funding streams. The two buildings were also unveiled yesterday.

“That was a huge help to us, for them to eventually understand why this centre was so important, and why it needed the funding was really gratifying,” Daniela-Wong says.

“It has been a long work in progress. When we had a few high-risk incidents in prison, I think authorities became more receptive to the idea of this centre.”

And now it’s open, Daniela-Wong can’t wait to see the results.

“It’s in a perfect location, and it’s just so accommodating. It’s going to be a great place for recovery,” Daniela-Wong says.

The opening ceremony was also attended by Minister of Health, Vainetutai Rose Toki Brown, Minister for CIIC Albert Nicholas and Secretary of Health Bob Williams, senior government officials, community leaders, and a range of NGOs in the health, mental health, and social services sectors.

Minister Brown said: “Te Puna Tiaki is a much-needed mental health facility with the capacity to accommodate up to four inpatients at one time and a larger number of outpatients. The design allows for future expansion, should the need arise. It has been designed and constructed specifically to allow TMO to appropriately care for patients with a range of mental health disorders. Key therapeutic features embedded in the design include internal and external courtyards, natural lighting, and landscape views with safe and comfortable resting areas.”

Minister Nicholas thanked Landholdings and Andersons for the construction of Te Puna Tiaki Wellness building. Nikao Beach Sheetmetal and Mann Short were thanked for their work constructing the pharmacy warehouse extension and TMO’s IT building, as well as acknowledging the efforts of all TMO and CIIC staff involved in the planning, design, construction and outfitting of the new facility. Special mentions were afforded to Dr Daniela-Wong and CIIC design and project officer Sally Hosking-Naea, key architects for the project.

A Memorandum of Understanding (MOU) between CIIC and TMO was also signed at the opening, outlining responsibility for the management and operation of Te Puna Tiaki now being handed over to TMO, with CIIC retaining ownership of the building and providing support and maintenance, facility advice and resources if needed.

Secretary of Health, Bob Williams remarked how his staff are eager to move in and start providing services in this new fit for purpose facility. Following the handover of the building, he expects his staff will progressively start offering the full suite of mental health services, commencing in the next week or two.