The effectiveness of ūloa as a model supporting Tongan people experiencing mental distress

Abstract

This article is based on a larger research project, which investigates the effectiveness of a culturally appropriate model, namely uloa, when working with Tongan people. Uloa is a communal method of fishing in Tonga, which includes all members of the community. A previous paper described the three phases of uloa: presenting the concept to health providers and community groups; phase two amended the model based on phase one. This paper reports on phase three and findings related to the increased awareness of uloa model within the mental health services and to raise awareness of how to work with Pacific people and adjust the health service to suit the needs of this population to test its effectiveness. Using reflexive thematic analysis, results highlighted a number of patterns both across the groups, described as napanapangam alie (harmony, balance), ng aue fakataha (working together/oneness), and toutai (fisher). These findings continue to support that the conventional biomedical approach employed in the mental health services overlooks elements of Tongan constructions of mental illness and the intersections between Tongan and biopsychosocial themes. Care that is based only on the 'medicine' rather than bringing the spiritual aspect into care planning (fake leaves) will not serve the needs of the Tongan community.

Using Fa'afaletui to explore Samoan consumers' experience and interpretation of mental health person‐centred care in Aotearoa, New Zealand

“…2009). Such as, Te Vaka Atafaga, a holistic mental health assessment model for Tokelau peoples in NZ (Kupa 2009); Uloa, a MH practice model for Tongans (Vaka 2016); and Fonofale Model, a Samoan health and wellbeing model (Ioane & Tudor 2017; Suaalii‐Sauni et al . 2009).…”

“…Indeed, our results again endorse Pacific models of care as the blueprint to achieve equity for Pacific (Bush et al 2009;Samu & Suaalii-Sauni 2009;Suaalii-Sauni et al 2009). Such as, Te Vaka Atafaga, a holistic mental health assessment model for Tokelau peoples in NZ (Kupa 2009); Uloa, a MH practice model for Tongans (Vaka 2016); and Fonofale Model, a Samoan health and wellbeing model (Ioane & Tudor 2017;Suaalii-Sauni et al 2009).…”

‘They tried to evil me’: An explanatory model for Black Africans' mental health challenges

“…Understandings of mental health challenges vary widely across cultures. However, the Eurocentric perspective, which emphasises individual pathology and pays little attention to cultural and social values, has traditionally influenced these conceptualisations (Rogge, 2011; Vaka, 2016). The Eurocentric understanding of mental health challenges is based on the medical model, which is characterised using diagnostic criteria and treatment typically involving medication, therapy or a combination of both (American Psychiatric Association, 2013).…”

“…When biomedical definitions of mental health challenges are applied to people from different cultures, there is a potential for conflict. Vaka (2016) argues that the Western approach to mental health challenges may not consider cultural subtleties, which could lead to misdiagnosis and inappropriate treatment.…”

“…However, there is variation in how mental health challenges are conceptualised across Pacific subcultures. For example, Samoans generally view it as an altered state of mind, behaviour and emotions (Leckie & Hughes, 2017), while Tongans generally conceptualise mental health challenges in three ways: Tongan constructions, biopsychosocial constructions and intersections between biopsychosocial and Tongan constructions (Vaka, 2016). Also, there is evidence that Tongan youth are inclined to emphasise on biopsychosocial perspectives (Vaka et al, 2022).…”