https://doi.org/10.1177/1039856219895186 Australasian Psychiatry 1–3 © The Royal Australian and New Zealand College of Psychiatrists 2019 Article reuse guidelines: sagepub.com/journals-permissions DOI: 10.1177/1039856219895186 journals.sagepub.com/home/apy 1 AUSTRALASIAN PSYCHIATRY V anuatu is a Pacific nation in which over 65 islands support a population of more than 277,000 of whom 98% are indigenous. There are more than 100 ni-Vanuatu languages with Bislama, English and French being the three official languages. Mental health services are limited (funded psychotropic medications consist of amitriptyline, haloperidol, chlorpromazine, fluphenazine and diazepam) but have recently been identified as a government priority. 1 The development of the Vanuatu Psychiatry Mentorship Programme (VPMP) has been described elsewhere. 2 This article presents the case of ‘Tamauri’ and the involve- ment he and his family had with the mental health ser- vice in Port Vila, as a practical illustration of the VPMP mentoring process and an example of the learning expe- riences for all participants. Presentation and early management Tamauri, a 22-year-old ni-Vanuatu man, was brought to Vila Central Hospital (VCH) by family members concerned about changed behaviour. He had been studying in New Zealand and the family had flown him home four weeks earlier as he had withdrawn to his room in his student flat, appeared highly anxious and unable to give any explanation. When seen with his family at VCH, he was in a wheelchair and gave no response to questions. He was assessed by the mental health doctor JO as suffering from a psychotic illness and prescribed a low dose of halo- peridol. Within two weeks, he was reviewed with his family by JO together with VPMP mentors (AB and SS). JO carried out the interview in Bislama and acted as translator for Vanuatu Psychiatry Mentorship Programme: a case illustrating cultural and clinical considerations Jimmy Obed Vila Central Hospital, Vanuatu Allister Bush Pasifika Child and Adolescent Mental Health Service, Capital Coast District Health Board, New Zealand Stephen Stathis Child and Youth Mental Health Service, Children’s Health Queensland Hospital and Health Service, Australia, and; Faculty of Medicine, University of Queensland, Australia Ernest Hunter The Cairns Institute, James Cook University, Australia Abstract Objectives: The objectives of this article are to describe a case highlighting challenges in managing an acute psy- chiatric presentation, the process of mentorship and the significance of cultural matters influencing family engage- ment in Vanuatu. Method: Case description. Results: This case highlights resourcing constraints facing a small mental health team in the Pacific, the clinical significance of the concept of tabu in a ni-Vanuatu context and the importance of family decision making processes in ni-Vanuatu culture. Conclusion: A structured mentoring programme to foster mental health capacity development in Vanuatu can support psychiatric decision-making in complex cases, reflection on the role of culture in formulation and family engagement, and mutual learning. Keywords: Vanuatu, psychiatry, mentoring, indigenous Corresponding author: Allister Bush, Child and Adolescent Psychiatrist, Pasifika Child and Adolescent Mental Health Service, Capital Coast District Health Board, PO Box 50233, Porirua, Wellington, New Zealand. Email: allister.bush@ccdhb.org.nz 895186APY Australasian PsychiatryObed et al. Invited Article