A School of Public Health study was one of the first to delve into the intricacies of mental health problems among young people in American Samoa; The findings will help create a framework on how to improve mental health services and infrastructure in the community.
Jessica Kasamoto
Journalist
Tim Tai
In a recent study, School of Public Health researchers found that despite successful local efforts to improve mental health infrastructure, more action needs to be taken to combat mental illness among adolescents in American Samoa.
The study was primarily led by Emma Mew GRD ’25, a doctoral student studying the epidemiology of chronic diseases, in tandem with her faculty advisor Nicola Hawley, associate professor of epidemiology and affiliated faculty member at the Yale Institute for global health. Mew and Hawley worked in collaboration with Jueta McCutchan-Tofaeono, a clinical psychologist in American Samoa.
McCutchan-Tofaeono praised the study for its cultural sensitivity to American Samoan culture.
“As a U.S.-trained Samoan mental health professional, I have always been struck by the extremely limited disaggregated data on Pacific Islanders,” McCutchan-Tofaeono wrote in an email to the News. “Even articles that included the term “Pacific Islanders” did little or nothing to enumerate the unique needs of Native Hawaiians/Pacific Islanders…Rather than taking traditional Western models, normalized to Western values, and Trying to adapt them, this research allows us to start from scratch, to truly understand the unique needs of our own people.
“To our knowledge, this is the first published scientific study on youth mental health in a Samoan context,” Mew wrote in an email to the News.. “This study took a community approach that gathered the views of local leaders… (and) showed that mental health is a major health problem among young people – including a suspected high prevalence of suicidal tendencies, depression , anxiety, trauma and stress-related disorders. »
Hawley, whose research lab is called the Samoan Study Group on Obesity, Lifestyle and Genetic Adaptations, has been researching American Samoa topics for more than a decade. Although his research generally focuses on the treatment and prevention of obesity and diabetes in resource-poor, low-income populations, the idea for this particular study grew out of the realization that effective interventions against obesity Diabetes and obesity also require a fundamental understanding of population mental health. .
When conducting the study, the researchers followed a Samoan research framework called Fa’afaletuiwhich researchers at the University of Auckland have translated as “the means of” (fa’a) “weaving together” (tui) the deliberations of different groups or “houses” (fale). »
This research framework is intended to be more culturally sensitive than many North American and Anglo-European research models, allowing researchers to hear the perspectives of different groups in society of interest in order to minimize their own biases cultural before drawing final conclusions.
With Fa’afaletui’s ideas in mind, researchers conducted 28 in-depth interviews with adults living in American Samoa. Each interview began with the same question: “Can you share with me your opinion on the state of mental health among adolescents in American Samoa?” » Conversations often revolved around common mental health issues seen among young people in American Samoa, including depression and anxiety, as well as stress-related psychiatric disorders.
Researchers recognized that although most teens appeared to excel in their work, faith and community, many still struggled with mental health issues, including suicidal ideation. Additionally, many participants noted that mood disorders, substance use, and non-suicidal injuries are also common.
Additionally, many interviewees expressed frustration with existing services that address adolescent mental health issues. In response, researchers have identified several common needs and policy proposals that need to be addressed.
Researchers recommended adding more mental health professionals and strengthening case identification to strengthen existing mental health services, reducing barriers for adolescents needing treatment and maintaining consistent funding to increase the sustainability of the project. Ultimately, the researchers called for increased collaboration and communication among local leaders on adolescent mental health issues.
Hawley acknowledged that the most difficult part of the study was hearing about how a community she cares about so deeply is affected by mental health issues. Nonetheless, Hawley praised the American Samoan community for its efforts and dedication to improving mental health services for adolescents.
“(T)he biggest takeaway for me is the incredible strengths that reside in the community organizations that support mental health in American Samoa,” Hawley wrote in an email to the News. “They are already accomplishing remarkable things with very few resources, but with continued funding and political support, (they) could do much more.” »
Pew also noted that it was difficult to ensure the study adequately captured residents’ voices, given the newspaper’s limited word count. Nonetheless, she said the process of conducting these interviews was extremely rewarding, as it allowed her to hear many different perspectives and form diverse connections with members of the American Samoan community.
Sarah Lowe, clinical psychologist and associate professor of public health in social and behavioral sciences, helped develop mental health-related interview questions and interpret interview data. Lowe hopes the themes gleaned from the interviews will encourage other researchers and policymakers to think about mental health treatment models.
“We have studied existing interventions and have concluded that none fully meet the needs of the community,” Lowe wrote to the News. “We therefore hope to culturally adapt an intervention that would include parents and children, with the aim of improving family well-being and decreasing youth mental health symptoms.”
According to United States Census Bureau in 2020American Samoa has a population of 49,170.
February 12 update: The article has been updated to include quotes from Jueta Mccutchan-Tofaeono.
