Fighting mental health stigma across the Pacific

Samoa Seiuliali’i’s only psychiatrist, Dr George Tuitama, says there is still a stigma surrounding mental health in Samoa.
Photograph: RNZ Pacific/Caleb Fotheringham

Mental health continues to be a stigma in the Pacific, but there may be good news coming from the Cook Islands.

Around 600 doctors, nurses and healthcare professionals traveled across the region to take part in the Pasifika Medical Association Conference in Rarotonga, which began last Wednesday local time.

One of the main items on the agenda was mental health.

Dr George Tuitama of Seiuliali’i, who runs mental health services in Samoa and is the country’s only psychiatrist, said there was ignorance surrounding mental health.

“There is always stigma and discrimination towards mental health patients,” Tuitama said.

“I don’t think it’s something that’s going to go away anytime soon; mental health disorders are a kind of [seen as] cursed beliefs.

“But when you start crying and being isolated and drinking too much, they don’t think it’s a health problem – they don’t think they need to go to the hospital because of it.”

Last week, Samoa’s Ministry of Health announced the formal creation of the National Mental Health Committee, to respond to growing concerns about mental health issues in Samoa.

The Director-General of the Ministry of Health, Aiono Dr. Alec Ekeroma, said mental health is a critical aspect of healthcare.

In the Cook Islands, a unique study on mental health interviewed around 10% of the country’s population.

Dr Sam Manuela, who led the study, found that Cook Islanders born in the Pacific have better outcomes than those born in New Zealand.

“So there is something happening here in the Cook Islands that is good for our mental health,” said Manuela.

Dr Sam Manuela interviewed around 10% of the Cook Islands population for a mental health study.

Dr Sam Manuela interviewed around 10% of the Cook Islands population for a mental health study.
Photograph: RNZ Pacific/Caleb Fotheringham

He said there were fewer people living in the Cook Islands with severe symptoms of depression compared to New Zealand.

But there was an increase in young people in the Cook Islands reporting symptoms of anxiety and depression – which was in line with global trends.

“A lot of the feedback we got from administering the survey across the islands was that people felt there is stigma here in the Cook Islands around mental health, but they are happy that people are also talking about it more,” he said.

“It’s a good sign that people are getting a little more comfortable talking about mental health issues.”

Dr Jimmy Obed, Vanuatu’s first and still only psychiatrist, said people continue to deal with the stress caused by back-to-back intense tropical cyclones that arrived within days of each other in March.

Now they have to think about the fast-approaching next cyclone season.

“We’re going into the cyclone season very soon, towards the end of this year, from November to April next year, so that’s something we also have in mind – how do we recover, as we recover from the twin cyclones now gearing up for this season of cyclones.”

Dr Sione Vaka from the University of Waikato led a session on supporting people with dementia.

Vaka said Pacific people need to see themselves in mental health services.

He said current services in New Zealand and some in the region are based on a foreign framework rather than indigenous ways of thinking.

“We are very collective and circular in the way we think; we look like a circle in terms of movement, whereas our healthcare systems are very individual and linear,” said Vaka.

Vaka said a Pacific-based healthcare system focuses on building a relationship and then asking questions about illnesses.

“You get to know them, where they come from, what their relationships are.

“For us, I need to get to know you, before I tell you what’s inside my heart, and if I don’t know you, I don’t trust you and I’m not going to tell you what’s bothering me,” he said.

Dr George Tuitama of Seiuliali’i said cultural and traditional beliefs need to be integrated into mental health treatment.

“Spiritual, traditional and cultural aspects must be taken into consideration,” said Tuitama.

“We cannot fully treat patients with mental disorders and mental illnesses without encompassing their entire cultural background.”

The Pasifika Medical Association Conference ends on Monday local time in Aitutaki, Cook Islands.

Pasifika Medical Association 2023 conference begins

Pasifika Medical Association 2023 conference begins
Photograph: Pasifika Medical Association Group

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