Dealing with stigma, discrimination and be kind

Samoa's only registered Psychiatrist and the Head of the Mental Health Unit, Seiuliali'i Dr. George Tuitama, is encouraging people to show a kind spirit and caring heart to help friends or family members going through a hard time.

Seuliali'i makes the call ahead of the International Mental Health Day on Saturday, where professionals from the Ministry of Health, Goshen Trust, Fa'ataua le Ola, Teen Challenge and the Salvation Army urge people to listen to each other, and if needed, visit them for help.

“A simple thing is how are you, are you okay?" Seiulialii said.  "A simple question like that can actually help someone because that person will never go out asking for help when it comes to mental health issues. The reason they won’t is because of the stigma, the discrimination." 

This year’s Mental Health week theme is “Be Kind.” 

Seiulialii said it is so important to always be kind, because you may not know what someone is experiencing behind closed doors.

“You may be smiling but deep down inside you may be having issues with your family you don’t want to talk about," he said. 

"And you would never share it unless you see someone actually cares to listen to you and ask, is everything okay.”

He said family and friends should not feel they need to be qualified counsellors in order to talk to their loved ones, but to listen closely and ask open ended questions that allow their loved one to figure out what is bothering them.

More often than not, a person struggling will have all the answers to their own problems, but they need a chance to work that out.

“I am not here to solve your issues, I am here to help you solve your own issues,” Seiulialii said. “I don’t need to know the issue in order to help a person be a little bit better than they are.”

Family should also be aware of the warning signs that someone might be a risk to themselves or others, and can encourage them to contact one of the services available, or go with them too, which is why the group are so eager to advertise their services to Samoans. 

Counsellor and board member of Faataua le Ola, the 24 hour helpline for suicide prevention, Lise Taeoali'i said when you having a hard conversation, it is okay to admit you don’t have all the answers.

“You can acknowledge your humanness, that you don’t know everything, even if you are trained. You can say, I really don’t have the answer right now, but tell me more.”

All Samoa’s mental health services work in close collaboration, which mean no matter who you turn to in a time of need, you should get the help you need, says Salvation Army clinician, Natalie Leger.

“We’ve worked to establish relationships across the services so that any door is the right door for anybody, and we’ll be able to screen and identify which service is going to be most appropriate,” she said.

That goes for working with the affected person’s family and their wider community too in order to help them as best as possible.

In 2007, Samoa passed its first Mental Health Bill, which focused on providing care, support and protection of people with mental disorders, and reduce restrictions on their freedoms. 

Seiulialii says there are around 700 people on the Mental Health Unit books who require ongoing treatment for their mental illnesses, caused by either mood disorders, thought disorders or substance abuse.

At any given time, between 10 and 15 of those patients live at the Goshen Residence in Moamoa, when they are between needing hospitalisation and being able to return to their homes.

At least 120 people come and go from the Goshen services, Chief Executive Officer, Naomi Eshraghi said.

She said she hopes with more awareness, the community can come to understand just how normal mental health difficulties can be, at any level of seriousness.

 “Samoans need to understand that it is part of being human, the mental side of things. It isn’t separate,” Ms. Eshraghi said.

“It’s good to start with ourselves, that whatever mood we are in is okay but we need to talk about it. It should be our priority to be an open society that can talk about things.”

Substance abuse can be a troublesome prelude to serious mental disorders, and the Salvation Army’s addiction services have shown how much of a problem could be bubbling beneath the surface.

Ms. Leger said the programme has had much more demand than originally anticipated. 

“Clearly, that indicates we do have a real need here in Samoa. Addiction and mental health go hand in hand, so what we are here to do is provide and specialised service for those identified with a substance abuse disorder.”

While majority of their clients – numbering 670 since August 2018 – are referred to their programmes by the courts, a growing number of people are referring themselves or their family members to give the service a go.

Ms. Leger said she is encouraged to see that women are coming forth too.

“That is an area we have been worried about. We know women are often the victims, they may be abusing substances but they are not appearing before the court. 

“It doesn’t mean they don’t have an issue. Talking about substance abuse and mental health is not an easy thing to do so we are just letting people know that we are here, we are free and confidential and it’s a place where people can come and talk.”

Another organisation working with the courts to help young people who enter the justice system is Teen Challenge, which has around 762 members between 13 and 35 years getting treatment, counselling and improving their lives, mostly after having a run in with the law.

Programme Manager, Teatuolo Mabel Toilolo, said the programme is especially good for helping young people identify the issues in their lives or in themselves that have led them to abuse alcohol or drugs, and maybe even commit a crime.

Young people often find it hard to confide in someone about their problems, but if she persists and proves to them that she is interested, and cares about them, they do begin to open up. 

“Somebody said people don’t care how much you know unless they know how much you care," she said.

“The hard ones are the ones who answer with one word. How are you? Fine. You spend a little more time and find a way to dig in, and gradually, they open up – they just want to see if you are really real or not, how genuine our kindness is.” 

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