Content area
Full Text
Abstract
Health and illness have been largely defined and categorised using biomedical perspectives which do not capture the categories and concepts which Tongan people employ to construct and understand mental illness. This article explores conventional definitions of health and mental illness and then compares these with Tongan constructions of mental distress. This article explores the significance of Tongan people's conceptions of mental illness for design and delivery of mental health services for Tongans in Aotearoa New Zealand.
A qualitative research programme, based on Health Research Council funded doctoral research at Massey University, found that Tongan people identify three types of mental distress, tufunga faka-Tonga (Tongan constructions); tufunga faka-paiosaikososiolo (biopsychosocial constructions of mental distress), and the tufunga fepaki (intersections between biopsychosocial and Tongan constructions of mental distress).
A Tongan model of care, based on a communal fishing technique called uloa, that can capture these Tongan interpretations and constructions of mental distress, is proposed here as a model of practice which may produce more successful treatment outcomes for both health practitioners and Tongan service users.
Keywords: üloa, mental illness, mental distress, Tonga.
Definitions of Health
In 1946, the World Health Organization (WHO) defined health as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity" (World Health Organization, 1946: 100). This definition has been heavily criticised on numerous grounds. For instance, the inclusion of the word "complete", as the requirement for complete health would leave most people defined as unhealthy (Capstick, Norris, Sopoaga, & Tobata, 2009; Huber et al., 2011). This focus on 'complete health', including social well-being, shifted the focus to medicalised health, a consequence of the dominant influence of biomedical science, and may be a danger when the "nature of a problem is seen to be medical, its cause is said to be medical, and a medical solution is looked for, rather than any other type of solution" (Boddington & Räisänen, 2009: 54).
As social well-being is often overlooked in service provision, the WHO definition leaves unanswered questions about the direct relationship between poor mental health and high levels of social needs and therefore the service boundaries of health, illness, disease and well-being. The Mental Health Commission (2011) reported 80% of people with long term mental...