Pacific adults experience disproportionately higher rates of psychological distress than non-Māori, non-Pacific adults in Aotearoa New Zealand, new Otago research has found.
The study by researchers from the University of Otago, Wellington – Ōtākou Whakaihu Waka, Pōneke, has been published in Kōtuitui: New Zealand Journal of Social Sciences Online.
It found high rates of psychological distress but lower rates of diagnosed mood and anxiety disorders in Pacific adults. This is consistent with literature on mental health service use in Pacific adults, and suggests ongoing barriers to mental health care need to be addressed for Pacific Peoples.
Lead author Joanna Ataera-Minster, who is completing her PhD in the Department of Psychological Medicine, says mental health varies within the Pacific population.
“When we compared different groups of Pacific adults, the rates of diagnosed mood and anxiety disorders were higher among those born in Aotearoa New Zealand (NZ-born) than overseas-born Pacific, with rates appearing to increase as time spent in Aotearoa New Zealand increased.
“When we looked at Pacific adults affiliated with multiple ethnic groups (multi-ethnic Pacific), the risk of diagnosed mood and anxiety disorders was almost three times higher than in sole-Pacific adults.”
Joanna Ataera-Minster
The research team examined five consecutive years of data from the annual New Zealand Health Survey (NZHS), spanning 2014/15 – 2018/19.
Data from 4,335 Pacific adults and more than 50,000 non-Māori, non-Pacific (nMnP) adults were compared.
The mental health inequities and within-Pacific differences persisted even after the researchers accounted for various socioeconomic and demographic explanatory factors in their analysis, Ms Ataera-Minster says.
“It isn’t clear from our research why these differences exist, but we can surmise from related studies that the social and cultural determinants of mental health are likely contributing factors.
“These socio-cultural determinants include things such as: exposure to racism, challenges surrounding one’s cultural and ethnic identity, stressors associated with migration and acculturation, and the ongoing impacts of colonisation.”
This study is the first in a two-part cross-disciplinary research project with co-authors and supervisors Jesse Kokaua, Ruth Cunningham and Susanna Every-Palmer.
The second part involves using General Social Survey data to explore whether identity – a significant socio-cultural determinant of mental health – protects the psychological wellbeing of Pacific adults.
Ms Ataera-Minster says although this first study did not encompass the 2023/24 NZHS released last month, the latest survey results are consistent with her research, as were the previous 2022/23 survey results.
“The new results show Pacific adults are 1.3 times as likely to have experienced psychological distress as non-Māori and non-Pacific adults.”
Aotearoa needs to continue to build a sustainable Pacific mental health workforce and equip non-Pacific mental health workers to deliver culturally safe care to address health inequities for Pacific adults, but mental health promotion also needs to be approached more broadly, she says.
“For example, strengthening cultural connectedness through programmes that build knowledge of Pacific cultural customs and traditions, language skills, ancestry, and connections with extended kin.”
“This is especially important since many of these seem to be protective of mental health in various global Indigenous and migrant population groups.”
Ms Ataera-Minster says another nationally representative mental health survey with structured diagnostic interviews based on clinical criteria is needed.
“Ideally there would be routine monitoring of national mental health through a survey like this every 10 years.
“This is resource and time intensive, but yields valuable information on mental health conditions in population groups, and can help us identify subpopulations with higher needs.”
The last survey of this nature was Te Rau Hinengaro (NZ Mental Health Survey) which was run in 2002/03 – more than 20 years ago, she says.