The program has resulted in a major boost to regional expertise and leadership in mood disorders. Furthermore, it has made an important contribution to the implementation of individual country mental health policies, one which strengthens the regional mental health network and builds new connections with Australian institutions. Success was based on a collaborative approach, high levels of institutional and individual commitment, and careful attention to both content and process issues. Sustainability will be enhanced through ongoing collaborative in-country and regional activities.

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Background To facilitate decentralisation and scale-up of mental health services, Fiji’s Ministry of Health and Medical Services committed to implementing the World Health Organization’s mental health Gap Action Programme (mhGAP). mhGAP training has been prolific; however, it remains unclear, beyond this, how successfully Fiji’s national mental health program has been implemented. We aim to evaluate Fiji’s mental health program to inform Fiji’s national mental health program and to develop an evidence-base for best practice. Methods The study design was guided by the National Implementation Research Network and adhered to the Consolidated Framework for Implementation Research. CFIR constructs were selected to reflect the objectives of this study and were adapted where contextually necessary. A mixed-methods design utilised a series of instruments designed to collect data from healthworkers who had undertaken mhGAP training, senior management staff, health facilities and administrative data. Results A total of 66 participants were included in this study. Positive findings include that mhGAP was considered valuable and easy to use, and that health workers who deliver mental health services had a reasonable level of knowledge and willingness to change. Identified weaknesses and opportunities for implementation and system strengthening included the need for improved planning and leadership. Conclusion This evaluation has unpacked the various implementation processes associated with mhGAP and has simultaneously identified targets for change within the broader mental health system. Notably, the creation of an enabling context is crucial. If Fiji acts upon the findings of this evaluation, it has the opportunity to not only develop effective mental health services in Fiji but to be a role model for other countries in how to successfully implement mhGAP.

Fiji is one of the largest island nations in the South Pacific.

Objectives:To describe the development of a postgraduate clinical training programme in mental health for the Pacific region by the Fiji National University (FNU), the challenges and benefits. Conclusions: The establishment of FNU's one-year full-time postgraduate diploma in mental health (PGDMH) has resulted in graduates across the Pacific in all three main regions of Oceania trained as frontline practitioners in mental health. Most of the graduates hold key mental health positions in their respective countries. The PGDMH provides culturally relevant and sensitive training in settings and with resources similar to the graduates' homelands. Challenges relate mainly to the sustainability of the programme, selection of candidates, addressing the needs of stakeholders and teaching in an evolving, under-resourced mental health service. The ongoing challenge continues to be the maintenance of a symbiotic co-existence that results in mutual benefits for both the University and stakeholders without jeopardizing the integrity of the programme or the independence of the University.