Contents lists available at ScienceDirect International Journal of Disaster Risk Reduction journal homepage: www.elsevier.com/locate/ijdrr General and post-disaster mental health servicing in Vanuatu: A qualitative analysis Nathan Dawes a,∗ , Richard .C. Franklin a , Lachlan McIver b , Jimmy Obed c a College of Public Health, Medical and Veterinary Sciences, James Cook University, Australia b Rocketship Pacific Ltd., Australia c Mind Care Unit, Vila Central Hospital, Port Vila, Vanuatu ARTICLEINFO Keywords: Mental health Disaster Pacifc islands Mental healthcare ABSTRACT Background: Natural disasters contribute to the burden of mental illness, increased poverty and environmental degradation in developing Pacifc countries. The aim of this study was to review the attitudes and opinions in relation to the delivery of post-disaster and general mental healthcare in Vanuatu. Method: This qualitative study design applied semi-structured interviews to collect data from key informants. A total of 11 participants were involved in 11 interviews. The sample group consisted of; i) four government health representatives; ii) four non-government participants with knowledge of mental healthcare in Vanuatu; and iii) three community members from the village of Emua, Efate Island. NVivo qualitative data processing software assisted with thematic analysis of the transcribed data. Results: The key fndings of this study were associated with mental healthcare in Vanuatu and exhibited themes including: i) low levels of mental health literacy; ii) a defciency of general and post-disaster mental health services; iii) the increased prevalence of mental health disorders following a disaster; and iv) strategies to im- prove general and post-disaster mental healthcare. Conclusion: Findings indicate a range of challenges impeding the provision of mental healthcare in Vanuatu. Future actions should aim to: i) enhance levels of mental health literacy to diminish the stigma associated with mental illness; and ii) facilitate decentralised mental healthcare to enable the development of community based services. Increased levels of mental health literacy and improved access to community services will assist the identifcation and treatment of mental health disorders in Vanuatu. 1. Introduction Natural disasters contribute to the burden of mental illness, in- creased poverty and environmental degradation in developing coun- tries [1]. Disaster can be defned as a sudden, calamitous event that seriously disrupts the functioning of a community or society and out- strips the resources available to respond [2]. Destruction elicited by natural disasters can signifcantly afect the health of a community [3]. Hydro-meteorological disasters including foods [4], droughts and tro- pical cyclones are infuenced by the efects of global climate change. Heightened exposure to the consequences of climate change are ex- pected to enhance the burden of mental illness throughout the Pacifc region, as the occurrence of Hydro-meteorological disasters increase [5]. In most instances it is not feasible to completely avoid the efects of a disaster given the rapid and often unpredictable formation of events [6]. As a result developing and developed countries should defne sufcient approaches to respond, recover and,re-integrate populations that have been exposed to some form of devastation or large scale crisis [6]. Improved levels of mental health literacy are necessary to ensure the quality of post-disaster mental healthcare in developing countries [7]. Mental health literacy can be described as an individual's knowl- edge or understanding relating to mental illness which may aid their recognition, management or prevention [8]. The concept involves techniques to prevent mental illness, the recognition of signs associated with mental health disorders, familiarity of the services available to treat mental illness and the knowledge of efective self-help strategies to address milder mental health concerns [9]. Unrecognised mental health disorders increase an individual's risk of physical illness, restricts aca- demic achievement, disrupts social functioning and can contribute to premature mortality [10]. Furthermore, insufcient mental health lit- eracy levels have been found to impede the psychological processing of https://doi.org/10.1016/j.ijdrr.2019.101256 Received 26 October 2018; Received in revised form 3 July 2019; Accepted 24 July 2019 ∗ Corresponding author. E-mail address: nathan.dawes@jcu.edu.au (N. Dawes). International Journal of Disaster Risk Reduction 40 (2019) 101256 Available online 27 July 2019 2212-4209/ © 2019 Elsevier Ltd. All rights reserved. T