Rising admissions at St Giles Hospital spur push for early treatment and new rehab facilities in Fiji
The country’s only dedicated psychiatric hospital, St Giles in Suva, is grappling with growing patient admissions linked to mental health conditions and substance use. Acting Medical Superintendent Dr. Kiran Gaikwad has urged Fijians to seek help early and to stay consistent with prescribed medications, warning that many patients present only after their condition has worsened.
Mental illnesses such as schizophrenia and bipolar disorder remain among the leading causes of admission at St Giles. Dr. Gaikwad emphasized that early diagnosis and continuous treatment are crucial for managing these chronic conditions, noting that stopping medication after feeling better often leads to relapse and a gradual deterioration of health. “These illnesses start at young ages,” he said, typically coming to light in the late teens to mid-30s, and community awareness remains essential to reduce stigma and delay.
Context and supporting data from recent reporting highlight the broader pressures facing St Giles and Fiji’s mental health system:
– Admissions at St Giles are projected to surpass 1,000 by year’s end, up from about 570 in 2021 and 886 last year.
– About 68% of patients are readmitted, indicating relapses and ongoing challenges in sustaining recovery.
– Around 70% of admissions are related to substance use, with commonly abused substances including marijuana, methamphetamine, glue, and benzene; many patients use multiple drugs.
– In the past year, 57 young people tested positive for HIV, underscoring the intertwined nature of substance abuse and broader public health concerns.
– A notable share of long-stay patients are clinically well enough to be discharged but remain in hospital because relatives have not claimed or not provided a reliable home situation. Estimates suggest 10–15% of inpatients could live in the community with support but remain in hospital due to a lack of family reintegration.
– Families and caregivers have been urged to update contact information and collaborate with the hospital’s community treatment team to facilitate discharge and follow-up care.
Government and community responses are coalescing around the need for dedicated rehabilitation infrastructure and expanded services. Health officials acknowledge capacity and infrastructure constraints at St Giles and are pursuing partnerships and donor support to develop a modern facility. Plans discussed include expansion into addiction treatment, child and adolescent psychiatry, and geriatric psychiatry, as well as broader therapeutic options. The government has signaled plans to establish drug rehabilitation centers and is exploring collaborations with development partners and NGOs to accelerate action. The Foundation for a Drug Free World has been involved in awareness and community initiatives aimed at prevention and support.
Commentators and health professionals say the situation presents both a challenge and an opportunity: with stronger community-based supports, clear pathways from hospital to home, and targeted prevention and early intervention, Fiji can reduce relapse, shorten hospital stays, and improve outcomes for people living with mental health and substance use disorders. Reconnecting families, scaling up community treatment teams, and delivering dedicated addiction services could help relieve hospital congestion and build a more humane, community-centered mental health system.
Summary and hopeful note:
While admissions at St Giles reflect a deeper public health issue, the convergence of clinical guidance, policy commitments, and community partnerships points toward meaningful progress. If families, health services, NGOs, and government actors align resources and implement rehabilitation and early intervention strategies, Fiji can move toward a stronger, more integrated approach to mental health and addiction care—reducing relapses, supporting recovery, and restoring dignity for patients and their families.
Additional value and considerations for readers:
– Early treatment and medication adherence are repeatedly identified as key levers for better outcomes; public education campaigns could help reduce stigma and encourage timely help-seeking.
– Investment in a modern facility and integrated services could create a more efficient care continuum, from crisis intervention to community-based follow-up.
– Strengthening family engagement and ensuring reliable discharge planning are essential to freeing beds for acute care while supporting sustained recovery.
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