Comparing and contrasting Tongan youth and service users’ interpretations of mental distress

Vaka, Sione; Holroyd, Eleanor; Neville, Stephen; Cammock, Radilaite

doi:10.1080/09638237.2020.1818193

Cited by 6 publications

(6 citation statements)

References 5 publications

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“…According to the key informants in this study, the fear of being stigmatized for experiencing mental unwellness poses a significant barrier for Pasifika and their families in accessing and using services. In line with traditional Pacific perspectives (e.g., Lui & Schwenke, 2003;Tamasese et al, 2005;Vaka et al, 2009), mental health problems lead to stigma and shame related to being perceived by other Pasifika as facing the consequences of breaching spiritual and social taboos. Further, as a result of this, some Pasifika service-users felt that they were letting family down and bringing shame to the family by being unwell and by not being able to solve their problems within the family.…”

Section: Discussionmentioning

confidence: 86%

“…Mental unwellness may be viewed by Pasifika as originating either in traditional Pacific cosmologies or as "introduced" by outsiders, such as Europeans (Vaka et al, 2009). Mental unwellness is traditionally not considered to originate entirely from within a person (Bathgate & Pulotu-Endemann, 1997).…”

Section: Traditional Pacific Worldviews and Perspectives On Mental He...mentioning

confidence: 99%

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Barriers and Supports Experienced by Pacific Peoples in Aotearoa New Zealand’s Mental Health Services

Fa’alogo-Lilo

Cartwright

2021

Journal of Cross-Cultural Psychology

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As with minority groups internationally, Pacific peoples in New Zealand (Pasifika) experience higher rates of mental health problems than the general population, and are less likely to access mental health services. This study investigated the barriers and supports for Pasifika accessing and using mental health services with participation of 25 Pasifika (10 service-providers, 11 ex-service-users, and 4 ex-service-users/providers) in order to gain their key informant perspectives. A Pasifika-appropriate Talanoa approach was used to guide the data-collection process and the qualitative data were analyzed using thematic analysis. Barriers included stigma among Pasifika regarding mental health problems, commitment to finding solutions within the family, and both mistrust and lack of knowledge of services. Within the services, non-Pasifika providers often lacked understanding of the collectivist cultural values and practices of Pasifika, including spiritual beliefs. They were more likely to use services if the providers were respectful of Pasifika practices and paid attention to developing relationships in a culturally appropriate way. This included involvement of the Pasifika family, when possible. Service-users often benefited from contact with Pasifika providers within mainstream services. These results support previous cross-cultural research that indicates the importance of offering evaluation and intervention services grounded in an understanding and respect for the cultural significance and meaning of mental health problems for the person, the family, and their community. While efforts are made to address these issues in New Zealand, change is slow and ongoing cultural training for service-providers along with psychoeducation for Pasifika about mental health services is strongly desirable.

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Section: Discussionmentioning

confidence: 86%

Section: Traditional Pacific Worldviews and Perspectives On Mental He...mentioning

confidence: 99%

Barriers and Supports Experienced by Pacific Peoples in Aotearoa New Zealand’s Mental Health Services

Fa’alogo-Lilo

Cartwright

2021

Journal of Cross-Cultural Psychology

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“…The findings of the present study provide further evidence to support more Pasifika centred approaches to improving access to mental health services, especially for those in areas of highest deprivation. Such approaches may include assisting in increasing health literacy to support knowledge of where to get support for mental health, 4,23,30 and addressing practical issues such as lack of transport and language barriers known to contribute to low utilisation of healthcare services and under-diagnosis of some conditions. 31 Finally, it may be related to perceived stigma or other inhibitions towards help seeking behaviours.…”

Section: Discussionmentioning

confidence: 99%

“…29 Opportunities clearly exist to cultivate the rich cultural life that is inherent in Pasifika communities within mental health services, to bridge the gap between Pasifika communities and these services, and to reduce stigma. 30,34 The key strength of this study is the use of a national dataset to examine mental health conditions at a population level. There are few datasets that include large enough numbers of Pasifika people to allow for comparison with people of other ethnicities.…”

Section: Discussionmentioning

confidence: 99%

Identification of mental health and substance use-related conditions among Pasifika young people in Aotearoa New Zealand - a national cross-sectional study using the Integrated Data Infrastructure (IDI)

Ruhe

Bowden²,

Theodore³

et al. 2022

PacHealthDialog

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Introduction: Pasifika young people of Aotearoa New Zealand are known to experience higher rates of mental health and addiction conditions (especially anxiety and depression), compared with young non-Māori/non-Pasifika (NMNP). However, there is little information about how well these issues are identified by mental health services. Aim: We compared rates of diagnosis of common mental health and substance use-related conditions between Pasifika and NMNP young people (aged 10-24 years) and examined how these diagnoses varied with deprivation. Method: This national, cross-sectional study was undertaken using 2017/18 fiscal year data from a national database known as the Integrated Data Infrastructure. Specialist mental health service use, hospitalisations and pharmaceutical dispensing for any mental health condition, emotional condition (depression and/or anxiety), substance use-related conditions, and self-harm were examined. Results: A total of 982,305 young people (12.4%, Pasifika and 63.9%, NMNP) were identified. Compared with NMNP, Pasifika young people were significantly less likely to be diagnosed by specialist mental health services with any mental health condition (adjusted Risk Ratio (aRR) = 0.77, 95% CI = 0.75 to 0.78); any emotional condition (aRR= 0.44, 95% Confidence Interval (CI) = 0.43 to 0.45); or to be hospitalised for self-harm (aRR = 0.88, 95% CI = 0.82 to 0.94). However, they were significantly more likely than NMNP to be diagnosed with substance use-related conditions (aRR = 1.68, 95% CI = 1.63 to 1.74). Although the overall rate of mental health issues remained relatively stable across deprivation levels, emotional conditions were much less frequently diagnosed in those with greater deprivation. Discussion: Discrepancies between expected and identified rates of diagnoses of common mental health and substance use-related conditions might indicate different patterns of service access by Pasifika young people, or they may reflect the bias of an inequitable and less than culturally appropriate health system.

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“…Talanoa captures Pacific ways of knowing and doing and provides a platform for tala (conversation/talking) and ability to reach into people's noa (hearts, souls) (Vaka, Holroyd, et al . 2020, Vaka, Neville, et al . 2020).…”

Section: Methodsmentioning

confidence: 99%

The effectiveness of ūloa as a model supporting Tongan people experiencing mental distress

Vaka

Hamer²,

Mesui‐Henry

2022

Int J Mental Health Nurs

Self Cite

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This article is based on a larger research project, which investigates the effectiveness of a culturally appropriate model, namely uloa, when working with Tongan people. Uloa is a communal method of fishing in Tonga, which includes all members of the community. A previous paper described the three phases of uloa: presenting the concept to health providers and community groups; phase two amended the model based on phase one. This paper reports on phase three and findings related to the increased awareness of uloa model within the mental health services and to raise awareness of how to work with Pacific people and adjust the health service to suit the needs of this population to test its effectiveness. Using reflexive thematic analysis, results highlighted a number of patterns both across the groups, described as napanapangam alie (harmony, balance), ng aue fakataha (working together/oneness), and toutai (fisher). These findings continue to support that the conventional biomedical approach employed in the mental health services overlooks elements of Tongan constructions of mental illness and the intersections between Tongan and biopsychosocial themes. Care that is based only on the 'medicine' rather than bringing the spiritual aspect into care planning (fake leaves) will not serve the needs of the Tongan community.

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Comparing and contrasting Tongan youth and service users’ interpretations of mental distress

Cited by 6 publications

References 5 publications

Barriers and Supports Experienced by Pacific Peoples in Aotearoa New Zealand’s Mental Health Services

Barriers and Supports Experienced by Pacific Peoples in Aotearoa New Zealand’s Mental Health Services

Identification of mental health and substance use-related conditions among Pasifika young people in Aotearoa New Zealand - a national cross-sectional study using the Integrated Data Infrastructure (IDI)

The effectiveness of ūloa as a model supporting Tongan people experiencing mental distress

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