A Unique Tongan Mental Health Service

Rising demands on the Tongan Health Society’s mental health service have resulted in an innovative way to meet those demands within budget. 

Image: Dr. Staverton (Tony) Kautoke, Psychiatrist

For more than a decade the service consisted of a mental health nurse who primarily focused on patients to ensure they were taking their medications as prescribed, medication side effects monitoring, as well as dealing with non-clinical issues such as housing and benefits. But CEO and Medical Director Dr Glenn Doherty saw the need to provide a wider range of mental health services.

“There has been an increasing emphasis within the sector to have more community based mental health services,” he says.

“We had a look at our contract with our DHB (Auckland District Health Board), to see if we could add value to it by broadening the skillsets that we presently offer.”

The newly proposed model of care involves bringing in specialists from the mental health sector, including a mental health nurse specialist, a psychiatrist, clinical psychologist and a mental health social worker.

So instead of the budget going into one fulltime worker with a specialist skillset, it will be split to achieve a multifaceted ‘stepped care model’ of service delivery.

The team is overseen by Dr Siale Foliaki, the only Tongan psychiatrist in NewZealand, and Glenn is confident they will be able to deliver a more efficient and effective service. 

“We’re doing more at a community level where mental health is best placed,” he says.

The service is free, locally accessible and has a wider focus on non-clinical matters that underpin the ‘stepped’ model of care.

“These days it’s very hard to get mental health patients to attend their appointments, especially in hospitals and outpatient clinics,” says Glenn.

“Their first thoughts when they’re given an appointment to attend are How are they going to get there, will they be able to get parking, how much will that parking cost and can they afford it?”

There is a large focus on youth and adolescent mental health issues, and the team now consists of registered nurse Makoni Havea, Dr Siale Foliaki, Dr Staverton Kautoke and Pauline Tupouniua-Taufa. Salome Finau is the social worker affiliated with the service.

Glenn says the fact that all four are Tongan and committed to improving the wellbeing of the Tongan community that they’re part of is significant.

“Our Tongan-specific mental health service is unique. It’s autonomous, but has the benefit of being able to integrate with other parts of the practice such as our clinic, integrated outcomes unit and other services which we’re contracted to run. It is the only comprehensive Tongan specific mental health service of its kind in the world, based in the community.”