Asian Together’s Month May 2024: Pacific Islander Mental Health

By Faizan A. Rakin

Diverse and vibrant, Pacific Islander communities span a vast expanse of the world's largest ocean, each with its own unique culture, traditions, and languages. From the serene shores of Polynesia to the turquoise oceans surrounding Melanesia and the scattered islands of Micronesia, these communities are united by rich histories and deep-rooted tradition. Pacific Islander countries include Fiji, Samoa, Papua New Guinea and various other islandic nations. However, within this diversity lies a pressing need for understanding mental health concerns in Asian/Pacific Islander communities. In 2019, more young Native Hawaiians/Pacific Islanders aged 15-24 died from suicide than from any other cause. Additionally, in the same year, statistics show that Native Hawaiians/Pacific Islanders were three times less likely than non-Hispanic whites to get help for mental health issues or to get prescribed medications for mental health treatment. Another study indicates Asian Americans and Pacific Islanders are the least likely ethnic group to seek mental health services. Recognizing these intricacies is vital for fostering culturally appropriate support systems and promoting holistic well-being within these resilient communities.
Present Problems

In the current world, conflicts and natural disasters and pandemics have become very common occurings and the Pacific islander nations are not exempt from the scars inflicted through such tragedies.

Vanuatu

Vanuatu faces frequent natural disasters, including tropical cyclones and volcanic eruptions. For instance, Tropical Cyclones Judy and Kevin in 2023 and Cyclone Lola in October 2023 caused significant destruction, leading to a revision of Vanuatu's GDP growth forecast from 3.6% to 3.0% and total recovery needs estimated at $773 million. The cumulative effect of these events undermines the community's mental resilience, leading to long-term psychological impacts.

Solomon Islands

The Solomon Islands are prone to cyclones, flash floods, and earthquakes due to their location along the Pacific tectonic plates. Recent events include Tropical Cyclones Lola and Harold and significant flash floods in 2020. Additionally, civil unrest, such as the political disturbances in February 2023, exacerbates the mental strain on the population.

Fiji

Fiji has experienced multiple tropical cyclones, including Cyclones Yasa and Ana in 2020-2021, and frequent flash floods. These disasters disrupt daily life, damage infrastructure, and create economic burdens. Fiji's tourism sector, crucial for its economy, suffered a massive blow during the COVID-19 pandemic, with 115,000 workers losing their jobs. This economic downturn, coupled with the physical destruction from natural disasters, leads to severe depreciation in mental health.

Samoa

Samoa faces threats from cyclones, flash floods, and health crises such as the 2019 measles outbreak, which claimed over 70 lives. The economic impact of these events, coupled with high unemployment rates due to the pandemic, contributes to significant mental health challenges.

Tonga

Tonga deals with the impacts of cyclones and volcanic eruptions, such as the 2022 eruption that led to a consequential tsunami. These disasters result in physical destruction, displacement, and loss of life, profoundly affecting the mental well-being of Tongans.
Kiribati and Tuvalu

These nations face severe droughts, particularly challenging in 2022-2023. Drought conditions lead to water scarcity, food insecurity, and adverse health effects. The uncertainty and stress of living in such vulnerable conditions exacerbate mental health issues.

The frequent and intense disasters lead to displacement, loss of property, and disruption of livelihoods, contributing to widespread mental health issues such as anxiety, depression, PTSD, and chronic stress. The compounded effect of these events requires robust mental health support systems and community resilience-building initiatives to mitigate the psychological toll on these populations.

Mental Health Services & Awareness

The Pacific Island countries are grappling with a unique set of challenges that profoundly impact mental health. In response, ministries of health across 21 Pacific Island countries have adopted a multifaceted approach, integrating mental health services into primary care, leveraging community involvement, and enhancing healthcare workers' capabilities through specialized training. 

Community Involvement & Education

Engaging and educating local communities are critical for improving mental health services. In Kiribati, community leaders gather in traditional meeting houses to discuss mental health, where primary health care workers facilitate discussions to raise awareness, reduce stigma, and educate on mental health prevention and well-being. This approach leverages traditional community dialogue for effective grassroots communication and support.

Skill Development & Capacity Building

WHO enhances local health professionals' skills through the mental health gap action programme (mhGAP). Training of Trainers courses have enabled mental health professionals in Kiribati to train nearly 200 additional health workers. This decentralized approach allows communities to manage mental health issues locally, reducing the burden on central hospitals. As a result, improved early identification and intervention have been achieved through these initiatives.

Responding to COVID-19 

COVID-19 disrupted mental health services, especially for vulnerable populations. WHO responded by transitioning to online support, including video training workshops and self-directed online courses. Monthly webinars for mental health focal points have been introduced to facilitate information sharing and peer support. These adaptations ensure the continuity of mental health care during the pandemic.
Environmental & Economic Challenges

Pacific Island countries face significant environmental and economic stressors, exacerbated by COVID-19. In Kiribati, climate change has led to food and water shortages, causing overcrowding and economic hardship. To mitigate these stressors' psychological impact, community resilience-building activities and the integration of mental health into public health and disaster response strategies are being implemented.

Global Support & Cooperation

WHO's Universal Health Coverage (UHC) Partnership supports mental health service strengthening in 21 Pacific Island countries. The partnership provides technical expertise, funding, and international cooperation for universal health coverage and primary health care. Sustaining these initiatives relies heavily on support from international donors, and multi-agency collaboration ensures a comprehensive approach to mental health support.

Coordinated Efforts

In January 2020, WHO established the COVID-19 Pacific Joint Incident Management Team to coordinate health responses, including mental health support. The Mental Health and Psychosocial Support cell helps Ministries of Health prepare for and respond to COVID-19's mental health impacts by creating and distributing mental health guidance and materials, enhancing coordination and effectiveness.

Supporting Healthcare Workers

Supporting healthcare workers is crucial for the success of mental health initiatives. WHO provided online training on basic psychosocial support and self-care to healthcare staff. In Fiji, approximately 300 primary health care practitioners received training in psychological first aid. This training helps staff offer psychosocial support during the pandemic and prepares them for future health emergencies.
These efforts towards developing Pacific Islander mental health have already started showing results. Health workers across the Pacific report greater awareness and understanding of mental health issues among community members, leading to increased referrals and access to care. However even with all these measures in place, mental health problems seem to prevail throughout the vast Pacific Islands.

Barriers Against Mental Health

Despite current initiatives for mental health support among Native Hawaiians and Pacific Islanders (NHPI), several social and economic barriers hinder their access to care. Only 24% of NHPI adults in California report needing mental health support, yet among those who sought care, 42% faced challenges such as high costs, lack of insurance, and limited awareness of available services. Notably, 9.4% of Pacific Islanders do not have health insurance, which exacerbates these access issues. Cultural stigma is a significant barrier, with mental health often misunderstood or associated with spiritual issues rather than medical conditions. Additionally, historical trauma from colonization and resettlement adds layers of complexity to their mental health struggles.

Discrimination and the rising threat of hate crimes contribute to mental health issues. Nearly half of NHPI adults reported frequent experiences with discrimination, and 45% expressed concerns about gun violence, a worry exacerbated by recent mass shootings targeting Asian communities. Language barriers also pose a significant obstacle, particularly in regions with diverse dialects and a shortage of bilingual mental health providers. For instance, more than 100 languages and dialects are spoken in the Philippines, complicating access to services without adequate linguistic support. As a result, a significant portion of the population remains untreated; 73.1% of Asian American and Pacific Islander adults with a mental illness did not receive treatment, compared to 56.7% of the overall population.

Thinking Ahead

Improving mental health in Pacific Islander nations needs both personal and community efforts to tackle cultural and systemic barriers. Individuals can help by talking openly about mental health to reduce stigma, practicing self-care, and supporting each other in recognizing mental health issues early. They can also spread awareness throughout their communities about the significance of stable mental health by organizing campaigns, writings, art or any medium. Communities can enhance mental health by training local professionals, making mental health services more affordable and culturally appropriate, and running awareness campaigns. In Kiribati, for example, the Ministry of Health, with WHO's support, trained nearly 200 local workers in mental health care, creating a stronger support network.

Organizations like WHO, UNICEF, and NAAPIMHA are vital in these efforts. NAAPIMHA specifically focuses on improving mental health for Asian American, Native Hawaiian, and Pacific Islander people through training, programs, and advocacy. Their goal is to reduce stigma and ensure these communities can access the care they need. Community-based activities like school programs and caregiver support are essential for reaching vulnerable groups. By focusing on culturally sensitive and accessible care, Pacific Islander nations can build stronger, more resilient communities and counter all mental health issues.




Works Cited

“Asian American / Pacific Islander Communities and Mental Health.” Mental Health America, https://www.mhanational.org/issues/asian-american-pacific-islander-communities-and-mental-health. Accessed 21 May 2024.

The Communications Department at UCLA CHPR. “Blog What prevents more Native Hawaiian, Pacific Islanders, and Asian Americans from seeking mental health care?” UCLA Center for Health Policy Research, 29 February 2024, https://healthpolicy.ucla.edu/newsroom/blog/aanhpi-mental-health-care-needs. Accessed 21 May 2024.

“Mental and Behavioral Health - Native Hawaiians/Pacific Islanders.” Office of Minority Health, https://minorityhealth.hhs.gov/mental-and-behavioral-health-native-hawaiianspacific-islanders. Accessed 20 May 2024.

Murphy, Sherry L., et al. “National Vital Statistics Reports Volume 69, Number 13 January 12, 2021.” CDC, 12 January 2021, https://www.cdc.gov/nchs/data/nvsr/nvsr69/nvsr69-13-508.pdf. Accessed 20 May 2024.

“The National Asian American Pacific Islander Mental Health Association.” National Asian American Pacific Islander Mental Health Association (NAAPIMHA), https://www.naapimha.org/. Accessed 21 May 2024.

O'Connor, Lauren, et al. “UNSDG | Strengthening mental health services in the Pacific during COVID-19 and beyond.” United Nations Sustainable Development Group, 12 July 2022, https://unsdg.un.org/latest/stories/strengthening-mental-health-services-pacific-during-covid-19-and-beyond. Accessed 21 May 2024.

“Pacific Islands.” Humanitarian Action, 8 December 2023, https://humanitarianaction.info/document/global-humanitarian-overview-2024/article/pacific-islands-0. Accessed 20 May 2024.

“Strengthening mental health services in the Pacific during COVID-19 and beyond | Universal Health Coverage Partnership.” WHO/OMS: Extranet Systems, 23 February 2022, https://extranet.who.int/uhcpartnership/story/strengthening-mental-health-services-pacific-during-covid-19-and-beyond. Accessed 20 May 2024.

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