Sir Collin said the research has found the prevalence of mental health distress in Samoa and Tonga. Photo: RNZ
Research by Auckland University has highlighted an urgent need to improve mental health services in the Pacific.
University of Auckland Professor Sir Collin Tukuitonga said that surveys done in 2023 offer the first comprehensive national data on mental health in Samoa and Tonga.
Working alongside Pacific health and research professionals in Samoa and Tonga, Sir Collin co-led research involving about 1000 participants across four villages in both countries.
Levels of psychological distress were significantly higher there than among Pacific peoples in Aotearoa.
RNZ Pacific spoke with Sir Collin.
(The transcript has been edited for brevity and clarity.)
Don Wiseman: You and your team from Auckland University, you've been looking at this state of mental health wellness in the Pacific. What have you found?
Collin Tukuitonga: We're doing the study in six Polynesian countries. We've completed Samoa and Tonga, and in these two countries, [we have found] some important findings. The first is that severe mental health disorders like psychosis and schizophrenia, are actually not any more common. What is new and interesting is the prevalence of mental health distress. One might say these are not severe, but clearly [are] affecting people, such conditions such as anxiety, some of it related to climate change, depression, suicide ideation, thinking about suicide. So anxiety disorders and depression appear to be quite common.
DW: Is it unusual? I mean, are you surprised by these results?
CT: Oh, it's not unusual. I suppose what is new is the fact that we've been able to quantify it. I think everyone has pretty much had an idea that these are conditions that are occurring in different communities. But there's never been an objective and formal assessment of the extent of these conditions. And we've been able, for example, to find out, in a bit more detail, without work, appear to be most affected by the anxiety disorders. It's particularly more common in women. I guess the other thing to say is the fact that it's never been measured, it's never been reported, so people don't get access to services. Service availability is not where it needs to be, and so people tend to fend for themselves, do the best they can with their families and churches and communities.
DW: How significant do you think climate change is in terms of raising levels of anxiety?
CT: Our study and studies before clearly show that climate change is a significant trigger for many of these communities. People concerned about having to leave their villages, their homes and to move further away from the coast, concerns about sea level rise, concerns about displacement and having to find somewhere else to live. It's a significant cause of anxiety among these communities.
DW: Now, the research showed, I think, that there's lower alcohol use among Polynesians in Polynesia compared with in New Zealand, but that there are quite severe levels of alcohol abuse within a small minority there. Just how bad is it?
Photo: Elise Manahan/ University of Auckland
CT: Certainly in men in particular, they don't to drink on a regular basis, but when they consume alcohol, it tends to be in quite harmful amounts. It's uncommon in women, particularly in Tonga, to consume alcohol. Very low levels of alcohol use in women, but the smaller proportion of the population, as I say, usually young men, they consume a significant amount of alcohol, not very often, but usually connected to when they get paid or when they have money, so harmful practices, harmful drinking patterns, all sorts of social problems related to that - accidents, violence and so on.
DW: You did a comparison with Polynesian residents in New Zealand, and you found generally lower levels; that the levels of anxiety and mental distress were higher in the islands. Are you mystified by that?
CT: Not really. As I say, we've always suspected that to be the case, but this is the first time we've been able to measure it. I wouldn't make too much of a fine point on it, Don, because the last survey that was done here was 1986 I think it was, and the methodology is not the same. So yes, significant levels of anxiety disorders, depression in the islands, not so prominent here. Not quite sure what that means. It's probably partly methodological.
DW: As you say, the survey is funded by MFAT. What will come of it? What will it lead to?
CT: Well, we hope, in fact, in terms of our support and contribution to development in Islands, and the Islands governments themselves and communities will respond to the findings. That was the second part of the study, when the study was done, firstly to look at the occurrence of these disorders, and then planning and thinking about how best to respond an immediate one that's occurred is, is just the sheer shortage of trained mental health workers in the islands. No great surprise but that's a issue that's come up, and we've clearly made some recommendations on that.
DW: Well, you've done the first two countries, Samoa and Tonga, but you're doing six. What are the other four?
CT: So, Tokelau is next [and] Niue after that. We're not sure what will happen with Tuvalu. It was clearly identified in the mix, but we haven't progressed any details with Tuvalu. The Cook Islands, there was a survey done there already, so we didn't really want to repeat what was already done.
