A ‘St Giles case’: negotiating mental illness, treatment and the adverse impact of stigma in Suva, Fiji

This thesis explores the role and impact of stigma on mentally ill individuals and the provision of mental health services within Fiji. Fiji is home to a multi-ethnic, multi-religious and multi-cultural population, which is currently undergoing rapid social change that is changing everyday life within Fiji. As a result there is a very diverse understanding around mental illness and how mentally ill individuals should be treated, therapeutically and socially. Therefore this thesis first explores the different etiologies of mental illness that exist within Fiji. I also investigate the relationship between understandings of mental illness and help seeking behaviours, and the resulting treatment choices of Fijians in Suva. Finally, this thesis discusses how the subjectivity of the mentally ill individual is impacted in response to the intersubjective process of stigma, which is a prevalent issue within Fiji. This research project was based in Suva, Fiji’s capital city. A mixed method approach was utilized to meet research objectivities. Primary participant observation was engaged in over multiple sites: St Giles Psychiatric Hospital, Stress Management Ward, and the Community Rehabilitation Outreach Program. Additionally I attended outpatient clinics, home visits and mental health stakeholder meetings. In complement to participant observation, unstructured interviews (n=49) and focus groups (n=4) were conducted with inpatients, ex-patients, carers, mental health professionals and various NGO employees working in the area of mental health.