Mental Health in the Smaller Pacific States

Abstract

This chapter traces changing patterns of mental health and its provision within the smaller Pacific Islands. Although small and distant from Europe, some people living within precolonial Pacific cultures suffered from stress and mental illness. This chapter emphasizes indigenous conceptions of Pacific minds and mental health and the entanglement with Western biomedicine, psychiatry and global mental health structures. The smaller nations in the Pacific are covered—American Samoa, Cook Islands, Federated States of Micronesia, French Polynesia, Kiribati, Marshall Islands, Nauru, NewHawai Caledonia, Niue, Northern Mariana Islands, Palau, Tokelau, Tonga Tuvalu, Samoa, Solomon Islands, Vanuatu, Wallis and Futuna—but not Fiji, Papua New Guinea and Hawai‘i. This chapter begins with the discussion of indigenous conceptions and treatment of mental illness within the Pacific Islands. We then examine the introduction of mental health infrastructure and biomedicine into the region. The Islands also attracted researchers who offered divergent interpretations of mental health epidemiology among Pacific cultures. The second half of this chapter focuses on contemporary health provision in the Pacific. Global mental health structures have been directed through the Pacific Islands Mental Health Network (PIMHnet), launched in 2007. Despite this, mental health within the small islands of the Pacific region continues to receive low priority, competes for scarce resources, faces problems of isolation and struggles to be recognized at all levels of government and society. Indigenous communities still rely heavily upon traditional treatments and support—offering some resilience but also presenting challenges for contemporary health initiatives.