First in-depth study of mental health issues in Cook Islands

Dr Sam Manuela will lead a project to conduct a survey across the island of Rarotonga to identify experiences and history of mental illness, prevalence of diagnosis, and prevalence of symptoms for mental illness.

He has been awarded $249,512 by the Health Research Council’s Emerging Researcher First Grants programme.

“There has never been a comprehensive population survey of mental health issues in the Cook Islands and available information is limited to WHO estimates and the annual National Health Bulletin released by Te Marae Ora – the Cook Islands Ministry of Health,” Dr Manuela says.

“We anticipate that we will see an increase in the prevalence of mental health problems in the Cook Islands as a result of our work but we expect this will be a reflection of more accurate data rather than increasing rates.”

All researchers on the project are Cook Island and it’s hoped their connections with the land and families will help with data collection. A team of Cook Islands-based data collectors will be recruited and it’s hoped this will contribute to growing the mental health workforce in a small way.

The research will be guided by Tivaevae, a Cook Islands research framework, so that the approach is centred on the needs, values, and priorities of Cook Islands people. The survey will be developed in consultation with an advisory board of Cook Islands mental health experts, advocates, service users, and community members.

Additional pressures on the mental health and wellbeing of Cook Islands people will likely include the ongoing impacts of climate change, and the newer impacts of COVID-19, particularly as the Cook Islands economy is heavily dependent on tourism, Dr Manuela says.

“Our approach will use advertising and village-based meetings so everyone knows the purpose and intent of the study and feel comfortable about contributing even though we will be discussing potentially sensitive issues.”

Existing information within the Cook Islands health system indicates gender and age differences in the prevalence of mental health problems, including problems associated with alcohol use and other substances.

Internet in the Cook Islands is expensive and Wi-Fi connectivity can be temperamental, so a team of data collectors will be recruited and trained to conduct offline computer assisted personal interviews.