Much of the mental health legislation in the Pacific region is archaic, pays no attention to the rights of mental health consumers and is long overdue for reform. A small number of countries in the Pacific has recently undertaken such reform. This work analyses the provisions of past and present mental health statutes in selected Pacific countries to establish, firstly, whether the new legislation has prima facie created or improved pathways for access to justice for mental health consumers and, secondly, whether these pathways offer any practical benefit for those subject to involuntary detention. The research is based on field work involving interviews and correspondences with mental health professionals, court officials, law reformers, lawyers and other professionals in the Pacific region.