FAYETTEVILLE -- Talking about and treating mental illness, already a challenge among the general population, can be especially difficult among the Marshallese and other Pacific Islanders in Northwest Arkansas and elsewhere, health care experts said Tuesday.
But just as Pacific Islanders' histories and cultures can create unique puzzles in promoting mental health, that shared heritage can also provide the ways to solve them, the experts said.
At a glance
For more information about the University of Arkansas for Medical Sciences’ Center for Pacific Islander Health, go to northwestcampus.uam…, or call (479) 713-8673 for co-director Nia Aitaoto or (479) 713-8680 for co-director Pearl McElfish.
Source: Staff report
A few dozen researchers, health care providers and advocates gathered Tuesday afternoon for presentations and discussion on mental health and well-being. The talks specifically centered around Marshallese, native Hawaiians and other migrants from the Pacific that number more than 11,000 in Northwest Arkansas, according to an estimate from the University of Arkansas for Medical Sciences, which hosted the event.
The stigma of being diagnosed with mental illnesses, lack of education and other common issues that hamper mental health treatment are amplified among Pacific Islanders, said Nia Aitaoto, co-director of the university's Center for Pacific Islander Health.
The islands' collectivist cultures teach people to conceive of themselves in terms of their relationships with, and duties toward, their families and communities, which can drive them to try to ignore or conceal depression, anxiety, suicidal thoughts and other mental health issues, said Andy Subica, a clinical psychologist and researcher at the University of California's Riverside School of Medicine who participated in the event.
"You bear it -- you kind of just power through," said Subica, who studies treatment for Hawaiians and other Pacific groups. "The automatic perspective is, what does everybody want."
Pacific Islanders' other health issues, including exceptionally high rates of obesity, diabetes and related ailments, add stress, worry, even hopelessness to the mix, Aitaoto said. American nuclear tests in the Marshall islands decades ago decimated local sources of food, leaving mostly high-salt, high-fat processed food as the main alternative.
"That means we attend funerals almost every week," Aitaoto said. "Imagine facing death like that."
An agreement between the U.S. and the Marshall Islands allows island residents to travel and work in the U.S. without a visa.
The Western understanding of psychology, with its professional therapists and counselors who focus on individual clients and ask direct questions about their emotions, can be a foreign perspective for people used to traditional and religion-based healing, Subica and Aitaoto said.
And finally, the groups' history of trauma and colonization by the U.S. and other countries is carried generation to generation and never truly fades away, Subica said. Native Americans, New Zealand's Maori and other indigenous people show the same effect, he said.
"These are real, long-term historical issues," he said.
Treatment can become successful if it takes all of these factors into account, they said, and framing mental health care as restoring relationships and the natural rhythm of life.
"There's very little they won't do when it comes to protecting the family," Subica said.
Subica pointed to treatment programs in Hawaii providing a safe space for a kind of group therapy and helped with issues as serious as child abuse and rejoining society after prison. Another approach that put people to work in taro fields, touching on the cultural importance and pride of living off of the land, also provided a kind of psychological rehabilitation, he said.
Reaching out to church pastors is a great way to plant the seed of seeking help when it's needed as well, Aitaoto said.
"The other thing about that -- it can become a dialogue," she said, as pastors can give advice for tweaking treatments and programs and so on. "That can be something the center can do, facilitate that conversation."
Pearl McElfish, co-director of the health center, called on health care providers to hire Pacific Islander staff members and translators. Aitaoto also urged governments to put more time and resources into health services before mental illness leads to a crisis, such as an arrest or a suicide attempt.
Nancy Kahanak of the Judicial Equality for Mental Illness Coalition of Northwest Arkansas, which pushes local governments to send people with mental illnesses to treatment instead of jails, seconded the sentiment.
"Why don't we prevent rather than make do with the problems," she said, adding the conference was the first time she learned about Pacific Islanders' specific challenges.
Leigh Wade, a social worker at the university's Family Medical Center, said she'd encountered Pacific Islanders only "here and there" in her work. Events such as Tuesday's can teach her and others to help those people more effectively, and perhaps encourage more of them to come in, she said.
"We can utilize the tools we understand and collaborate with the tools they understand," she said. "And I need that."
NW News on 07/27/2016