Tuvaluan People's Explanations of Pacific Underutilisation of Mental Health Services
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This doctoral study explored Pacific underutilisation of mental health services in New Zealand, in addition to the associated consequences of late presentations in acute care or forensic service provisions. According to available literature, there are visible patterns showing multiple barriers that influence help-seeking behaviours amongst Pacific people for the treatment of mental disorders/illnesses. Current interest in this issue in New Zealand by government, academic, medical and even public discourses has been immense. However, sufficient research has not been forthcoming which may account for the slow progress in improving Pacific use and access of mental health services. The aim of this research was to explore explanations of underutilisation in relation to Tuvaluan mental health needs, the extent and types of assistance received, and whether these were adequately sought and received. The theoretical conceptual framework that guided this doctoral study, Bronfenbrenner’s Ecological Systems Theory (1992), was combined with a qualitative descriptive research framework that unearthed Tuvaluans explanations of their experiences and attitudes towards mental health services in New Zealand. The research question What are Tuvaluan’s explanations for the underutilisation of mental health services in New Zealand was answered via qualitative research data collection methods of focus groups and semistructured interviews. A sample of seventeen Tuvaluan participants were involved, the participants were recruited from four groups of stakeholders; mental health consumers, relatives, mental health professionals and community representatives. The thematic analysis revealed influential factors particularly the unexpected finding of homeland factors that were scarcely located in other studies’ findings as a barrier. The findings additionally reiterated the global literature of barrier factors that include: lack of mental health knowledge, apathy and stigma found in the way ethnic minorities explain low use of mental health services, despite differences in race and contextual circumstances. Similarities in the patterns of journeys towards the use of mental health services in line with research based on other ethnic minorities was also identified in this study. These findings contribute to an understanding of the reasons of low use of mental health services and the journeys towards the use of mental health services by Tuvaluans, Pacific and other minority populations living in New Zealand and in other western countries.