By Indira Stewart, RNZ
Read RNZ’s full investigation into Pasifika mental health here: http://shorthand.radionz.co.nz/together-alone/index.html
Mental health will become the most important issue for Pacific people in New Zealand over the next decade, a South Auckland psychiatrist says.
Dr Siale Foliaki says self-harm and suicide attempts are growing issues in the Counties-Manukau district, which has the country's largest Pacific population.
"They sometimes end up in an intensive care unit. We see all sorts of self-harm, the sort of self-harm that would frighten you if you saw them, so some serious trauma. And you've got to ask yourself [what] the state of mind of a young person has to be able to inflict that level of trauma,” he says.
"It's alarming, for the Pacific community in particular, I don't think it's going to get better anytime soon and even the suicide rate itself… for the Pacific community continues to climb, where it has stabilised for other parts of New Zealand society, so there's an enormous amount of work that needs to be done but it's a really complex issue."
Pacific people are already known to have higher rates of psychological distress than any ethnic group in the country.
Pacific youth are particularly at risk. A 2017 study revealed Pacific youth had higher rates of depressive symptoms and suicide attempts than any other ethnic group, and more than half had self-harmed in the past 12 months.
Risk factors for mental disorder and suicide include poverty, over-crowded housing, physical and sexual abuse, experiencing loss and being between the ages of 15 and 24. Statistics show Pasifika experience these risk factors at higher rates than others.
Yet Pacific people access publicly-funded mental health help at lower rates than other New Zealanders, according to government reports.
The Mental Health Inquiry report, released last week, found Pacific people thought the current system was "hostile, coercive, culturally incompetent, individualistic, cold and clinical".
They wanted the system transformed to incorporate “Pacific ways” into treatment.
Dr Karlo Mila works in the area of Pacific health, research and policy, and says Pasifika struggle to feel comfortable in Palagi institutions.
"When you're in mental health crisis, you tend to be feeling the most vulnerable and desperate that you've ever felt before. So to engage with an institution where you don't understand how it works is kind of frightening and [especially] if you've had poor experiences of other institutions like Immigration."
Change can't come quick enough for Niuean dad Jay Williams. He’s experienced mental illness and watched loved ones struggle.
"Mental distress for me has meant isolation. It's meant fear. It's paralyzing me because if you ask for help, you're weak.
"I lost my two best friends, both had taken their lives about six months apart from each other. And then there was a suicide-murder that happened in my own family."
The government is yet to announce what action it will take on the back of the mental health inquiry.
For now, Karla Milo says it's important Pacific youth, in particular, feel valued by their communities.
"The challenge for us is to collectively create an environment that is worthy of our young people, that's accepting and loving.
"It's a hard time to grow up for our Pacific young people, and accept them, kind of come as you are, who you are, and just try and create loving relationships, that's the best suicide prevention that's available really."
*This story was made possible by the RNZ/NZ On Air Innovation Fund and the Mental Health Foundation of New Zealand's Like Minds, Like Mine programme.
Top image of Jay Williams by RNZ/Derek Henderson