A Tongan talanoa about conceptualisations, constructions and understandings of mental illness : a thesis presented in fulfilment of the requirements for the degree of Doctor of Philosophy in Nursing at Massey University, Albany, Auckland, New Zealand

Abstract

The New Zealand Mental Health Survey, Te Rau Hinengaro (Oakley-Browne, Wells, & Scott, 2006), reported that Tongan people have high prevalence rates of mental illness, do not utilise mental health services, and the risks of mental illnesses were different between Tongan people born in Tonga and those who were born in New Zealand. The risks were higher for those who were born in Aotearoa New Zealand (A/NZ). The overall aim of this research is to explore the meaning of mental illness for Tongan people in A/NZ, and the research question is, what is the meaning of mental illness for Tongan people in A/NZ? The Tongan cultural framework talanoa was used as a conceptual framework to inform this research and also as a method for collecting the data. Using talanoa engaged this research in the circular and collective ideologies of Tongan people. Tongan cultural contexts are used to strengthen this engagement and the collection of data, and Tongan concepts are used to discuss the findings. Thematic analysis was utilised to analyse the data. These Tongan concepts construct (tufunga) mental illness from Tongan perspectives and interpretations. This research found that Tongans in New Zealand perceive and interpret mental illness in three ways: through traditional Tongan interpretations, through Western and biomedical influences, and also through an intersection of Tongan interpretations and Western/ biomedical influences. These interpretations are presented as themes. These themes were tufunga faka-Tonga (Tongan constructions of mental distress); tufunga faka-paiōsaikosōsiolo (biopsychosocial constructions of mental distress), and the tufunga fepaki mo e fetaulaki he vaha‘a ‘o e tufunga faka-paiōsaikosōsiolo mo e tufunga faka-Tonga (intersections between biopsychosocial and Tongan constructions of mental distress). The research findings, therefore, highlight challenges associated with applying a biomedical linear, individually focused Western mental health system to a traditional Tongan, circular, and collective community in A/NZ.