Why Pacific Islanders in Utah have trouble connecting with mental health care

Story and photo by ALEXANDRA OGILVIE

Most Pacific Islanders live in a clan-based family society, where the family unit as a whole is viewed as more important than the individual, said Susi Feltch-Malohifo’ou, the executive director of Pacific Island Knowledge 2 Action Resources (PIK2AR) in Salt Lake City. Family is so important that many Pacific Island languages don’t distinguish between “brother” and “cousin.”

However, this family-based support system often prevents Pacific Islanders from getting professional help with mental illnesses and domestic abuse.

Karson Kinikini, a Pacific Islander and a licensed professional counselor of mental health, said in an email interview, “As a tribal/family based culture, they may more naturally seek support from within their family system in non-clinical ways. Often times, the concept of counseling (going to talk to a stranger about personal things) seems like a foreign concept to a people who have learned to rely on each other. Polynesians are often LDS in Utah, and so they have another support system of the Church, who they will often talk to before reaching out to a stranger.”

While having a strong support system is key to good mental health, family members and clergy often aren’t trained to give mental health advice. This is generally OK when the problems are about having an unrequited crush, but can become problematic when a family member has an undiagnosed serious mental illness, Kinikini said.

One example of mental illness is depression. Depression can present in many ways other than feeling sad all of the time. In men, it can often show itself as aggression. “All types of mental health problems were positively associated with aggression perpetration,” according to a study in the Journal of Family Violence.

This is certainly not unique to the Polynesian community, but the Organisation for Economic Co-operation and Development reports that Polynesian women are at the same risk for spousal abuse as are women in Somalia and Afghanistan.

Line drawing of sad people

A bipolar woman’s visual description of her illness. Used with permission.

One of the programs that PIK2AR offers is an anti-domestic abuse Pacific Island initiative. Feltch-Malohifo’ou said domestic abuse doesn’t end when families leave the islands and come to Utah. She said the family clan system also contributes to women not seeking help. “Women are expected to carry their share of the family burden.”

According to the Office of the Surgeon General, racism is a major barrier when it comes to getting mental health help. “Ethnic and racial minorities in the United States face a social and economic environment of inequality that includes greater exposure to racism and discrimination, violence, and poverty, all of which take a toll on mental health,” it stated. And for good reason, the office reported, “Their concerns are reinforced by evidence, both direct and indirect, of clinician bias and stereotyping.”

Along with overt racism, racial minorities tend to occupy the lower socio-economic echelons. Kaati Tarr, a Pacific Islander who is a licensed clinical social worker in Salt Lake City, said in an email interview, “In my opinion, it’s a combination of culture and socioeconomic status. Having insurance coverage helps, but still, the co-pay might be considered excessive, especially if paid weekly. $25 x 4 visits a month is $100 dollars that could be used to pay for food and higher priority basic needs.”

According to The Utah Health Department, “16.3% of PIs (Pacific Islanders) reported that someone in their household had been unable to receive needed medical care, tests, or treatments during the past year, usually due to financial barriers.”

Kinikini, the counselor of mental health, said money isn’t the only missing resource — mental health professionals often don’t have translators. “Services available in a native Polynesian language is very difficult to find access to. I, for example, am of Tongan descent but I do not speak Tongan. I have struggled to find native language speaking therapists to refer native language speaking clients to. Consequently, often the solution is to have a family member or friend translate. This can limit the effectiveness of the counseling process.”

Studies have been done on bridging this gap for other racial minorities, such as Latino and black communities. But, few data exist on Pacific Islander communities, so many families and mental health professionals are left on their own to determine best practices.

“The overall rates of mental disorder for many smaller racial and ethnic groups, most notably American Indians, Alaska Natives, Asian Americans and Pacific Islanders are not sufficiently studied to permit definitive conclusions,” the NIH reports.

Tarr, the local clinical social worker, said, “Unfortunately, I don’t have any additional resources to provide you with … that’s part of the issue, I think.”

But local Pacific Islanders like Kinikini and Feltch-Malohifo’ou are working toward closing that gap.

Empowering cultures in Pacific Islands community in Utah

Story and photo by DAYNA BAE

Utah has the largest Pacific Islander population in the United States per capita. Approximately 38,000 Pacific Islanders are currently living in the state. However, stereotypes against Pacific Islanders are considered a significant obstacle in constructing their own cultural identities.

Susi Feltch-Malohifo’ou is having an interview at the University of Utah.

“Our first, second and third generation, they are floating around with lost identity,” said Susi Feltch-Malohifo’ou, the executive director of Pacific Island Knowledge 2 Action Resources (PIK2AR). “When they are in their home, they are Americans, when they leave, it’s not how we perceive ourselves, it’s about how you perceive me.”

Pacific Islanders often face stereotypes related to their physical strength. They are commonly thought of as athletes due to their physicality. Consequently, many Pacific Islander figures in mass media and pop culture are typically portrayed as security guards or athletes.

In addition, many Americans tend to view different Pacific Islander cultures as one identical culture. This creates yet another stereotype.

In fact, Pacific Islanders consist of Polynesians, Micronesians and Melanesians divided into three different regions. Polynesia includes Hawaiian Islands, New Zealand, Easter Island and the Samoan Islands. Micronesia incorporates the islands of Kiribati, Nauru, the Marianas such as Guam, Fiji, Norfolk Islands and other small islands. Lastly, Melanesia is comprised of the island of New Guinea, Papua New Guinea, the Solomon Islands, New Caledonia, Fiji and few other smaller islands. Since each region has different geographic, historical and weather conditions, there are obvious differences among the Pacific Islanders.

Jacob Fitisemanu Jr., a clinical manager with the Utah Department of Health and an associate instructor of ethnic studies at the University of Utah, said, “Literally hundreds and hundreds of different languages are spoken throughout the Pacific, accompanied by myriad worldviews, artistic perspectives, governance systems, subsistence patterns, etc.”

Despite diverse Pacific Island cultures, a misconception as perceiving them as one group pervades in everyday life.

“When I went to the hula dance class, the instructor told me that she thought every Polynesian knows how to do a hula dance,” Feltch-Malohifo’ou said.

To correct pervading misunderstandings, PIK2AR focuses on emphasizing dissimilarities and cultures of various Pacific Islands communities. The organization offers educational and cultural programs such as the Utah Pacific Island Heritage Month, an annual festival held in August. Regarding the missions of PIK2AR, Feltch-Malohifo’ou said, “To educate outside of our community of similarity between all of our countries, but also some differences.”

Feltch-Malohifo’ou shared what she had witnessed in East Palo Alto, California. “Pacific Island kids were coming to know how to go to college.” She was helping them with filling out the documents. “There was a missing bridge between culture and resources,” she said.

According to NBC News report, many Pacific Islander students have experienced a lack of academic support and information. Some students were frustrated by filling out Free Application for Federal Student Aid (FAFSA) documents. The others did not feel confident about signing up for scholarships.

Although Pacific Islander students are willing to go to college or university, many of them do not have access to adequate information due to lack of appropriate support. Lack of academic resources leads to unfortunate statistics. Empowering Pacific Islander Communities, a nonprofit organization, announced that only 18 percent of Pacific Islander adults have a bachelor’s degree.

Biased perspectives also hinder Pacific Islander students from building cultural identities.

Feltch-Malohifo’ou said, “It feels like they need to uphold stereotypes and they are pigeonholed by everybody around them that they have to be this way.” One of the common stereotypes is that Pacific Islander students play in a football team at school. “How about if they don’t want to be a football player?” she said.

Putting them into a pigeonhole not only influences their school life but also has negative effects in their life.

Although PIK2AR has not yet quantified the depression rate among Pacific Islander teenagers, the suicide rate has increased in Utah and a 12-year-old committed a suicide in 2017, according to Feltch-Malohifo’ou.

As a response, PIK2AR prioritizes children and young students from Pacific Island communities who are suffering from intertwined identity and stereotypes as primary targets.

“We try to educate and reach out to youngsters,” Feltch-Malohifo’ou said.

One of PIK2AR’s cultural preservation education programs is using cultural objects of Pacific Islands communities. They use the objects to educate young students. Kava bowls and tapa cloth are the examples. “A kava bowl, maybe it’s different, but everybody can recognize that it comes from the Pacific Islands community,” Feltch-Malohifo’ou said. With the objects, PIK2AR tries to find cultural commonalities and builds meaning around it. Teaching about shared culture helps young children to differentiate dissimilarities between Pacific Islands cultures as well as the common features. “We teach the history and teach about the objects. Because it still has value,” she said.

Fitisemanu shared his idea about another effective method of cultural preservation. “Teaching and developing literacy and fluency in heritage languages is another important piece, and this process involves updating language with new words to reflect modern contexts that our ancestors never encountered,” he said.

Fitisemanu also suggested that documenting oral histories and perpetuating ceremonies, customs, language and performing arts are all necessary to preserve culture. “But more importantly, to me, is demonstrating the value of these practices and values for contemporary Pacific Island generations, who will ultimately decide what cultural traits to maintain and transmit to future generations,” he said.

A community can also provide a useful way of preserving culture.

Fitisemanu lives in West Valley City, which has the largest Pacific Islander population in Utah. He said that his daughter is involved in many cultural aspects by attending school, participating in cultural dance classes and speaking Samoan language in the community. He said, “Preserving a sense of Pacific Islands identity and culture is facilitated here, whereas it would be very difficult for my family to maintain cultural and language connections if we lived, say, in Sevier County,” he said.

Young Pacific Islander students are currently living in American multicultural and bilingual settings. Within the mixed Pacific Islands culture and American culture, students need help and support to develop their own unique identity.

Fitisemanu said, “We should encourage children to be versed in English and their heritage languages. That kind of upbringing teaches children to be very observant situational learners who pick up on social cues and learn to code switch and see through different perspective lenses.”

Local universities and colleges also put efforts to work with Pacific Island communities. The University of Utah has the Pacific Islander Student Association (PISA), which is a student-run organization within the Center for Ethnic Student Affairs (CESA). The student group enhances learning experiences and provides off-campus opportunities to serve Pacific Islands communities. In addition, the Pacific Islands Studies Initiative (PISI) is an academic collective that makes the U as a premier institution for Pacific Islands studies.

Utah has the largest population of Pacific Islanders per capita in the nation, and it also has numerous organizations and communities to support them. Pacific Islander organizations such as PIK2AR and PISA aim to provide cultural preservation, economic support, domestic violence education and other useful programs for Pacific Islanders in Utah. 

Utah advocates to stop domestic violence among Pacific Islanders

Story and photos by WOO SANG KIM

Statistics on domestic violence are appallingly high among Pacific Islanders. But a Utah nonprofit is offering seminars to educate men and women about domestic violence and provide information for disrupting the cycle.

According to a 2017 study, “Domestic Violence and Sexual Assault in the Pacific Islander Community,” “With regard to domestic violence and sexual assault, UN Women estimates that 60-80 percent of Pacific Islander women and girls experience physical or sexual violence by a partner or other in their lifetimes. The rate is higher than any other region in the world. Few countries in the Pacific Islands have laws against violence against women.”

What is the cause? Erin Thomas, a researcher at American University and author of the study, wrote, “The effects of climate change often emphasize gender disparities and result in greater violence against women. Additionally, political turmoil, violence, and poverty in many areas of the Pacific Islands increase the prevalence of gender-based violence.”

Oreta Tupola, community health specialist at the Utah Public Health Association, said, “The culture also prevents women from taking action.” Most Pacific Islander women take care of the household while the men earn income. She said women rely on men for financial support. Victims’ relatives do not meddle in the family business and let the family resolve the issue. The religious orthodoxy does not encourage people to challenge traditional family roles. In short, Tupola said women are left helpless and uneducated on how to stop the abuse.

Tupola 1
Tupola serves as an advocate assisting and advising women in danger to avert domestic violence.

Pacific Island Knowledge 2 Action Resources (PIK2AR), founded in 2015 by Susi Feltch-Malohifo’ou, Simi Poteki and Cencira Te’o, is a group of activists who speak up to inform the community about the domestic violence, cultural preservation, and economic impact. The mission of the organization is to provide resources, opportunities and services to Utah’s Pacific Islanders by bridging communities.

PIK2AR’s domestic violence program focuses on unique messages for men and women. The Pacific Island Women’s Empowerment (PIWE), seminar featuring workshops and group discussions created by PIK2AR for women, hosts two weekly sessions for both Pacific Islanders and non-Pacific Islanders at the Sorenson Unity Center at 1383 S. 900 West in Salt Lake City. The seminar lasts about 90 minutes and has about 17 participants.

Feltch-Malohifo’ou, PIK2AR’s executive director, said, “We teach how to pay the bill, raise the credit score, and what domestic violence is by definition, which starts way before the first punch.”

Susi 1
Feltch-Malohifo’ou (left) is executive director of PIK2AR,  which provides safe passageways for women who are victims of domestic violence to liberate from their husbands.

Tupola said the PIWE offers a curriculum that gives therapy, group sessions on empowerment and strength, how to remove children safely, where to find shelter, how to have a safety plan, how to detach emotionally from a spouse, and how to prepare for separation. The PIWE also rotates speakers specialized in social work and behavioral psychology weekly, too. Every seminar, the speaker prepares different topics as requested by the guests and answers questions that are taboo in the Pacific Islander culture. Tupola said such are sex, drugs, and personal lifestyle.

Women at the varying stages of victimization are aided. “They don’t just come because they are just trying to run away. They have not decided if they want to leave but come in for therapies and advices,” said Matapuna Levenson, lead guide at the Salt Lake Area Family Justice Center. “We have a wide range of stages. They generally come to get a civil protective order. The protective order forbids abusers from contacting victims. Upon contact, police arrests them (abusers). Victims are surprised by the vast resources and helps out there,” Levenson said.

Levenson 1
Matapna Levenson provides resources, connections and advice for women who seek aid.

Although the door is always open for all victims, the aim of the PIWE is to teach women to be independent. “We don’t want people keep coming back to us for help,” Feltch-Malohifo’ou said. “We want to empower and teach so that they can help themselves.”

Levenson said, “Those able to sustain themselves and prevent themselves from abuse become advocates in issuing protective order, supporting other victims in healing, and speaking in domestic violence conferences.”

The PIWE shapes women to liberate and take actions from their husbands, Tupola said.

PIK2AR also offers a seminar, Kommitment Against Violence Altogether (KAVA) Talks, for men. The monthly seminar is held at the Oish Barber Shop in 4330 3500 South in West Valley City. It also lasts for 90 minutes and has about 13 participants.

Tupola said men are taught that “everyone has a right to be free of harm, domestic violence is against the law, respecting personal boundary is crucial, and that violence is not a discipline.”

She also said men were often unaware of this country’s culture and laws, and that their actions could result in deportation. Many have family history of domestic violence and have accepted it as a norm.

This upbringing combined with stressors of living in a new environment, not finding a job, comparing their wife to other wives, and not having enough money prompts men to perpetuate the crime,” Tupola said. “The Western influence of spanking to discipline also reshaped men, too.”

What can we do? “Appealing to priests, bishops, and governors, becoming allies, and maximizing faith and family relationships is key to connecting the Pacific Islander community. Violence has nothing to do with culture and race. It crosses socioeconomic groups,” Levenson said.


From confusion to confidence: search for self-acceptance as a transracial adoptee

Story and photo by MARISSA SITTLER

Through childhood, adolescent and adult memories, the first transracial adoptee from Tonga recalls the feeling of never being able to fit in within her Tongan heritage, or the white culture that she was raised in. And, how she was able to turn this insecurity into one of her greatest strengths.  

Susi Feltch-Malohifo’ou turns 55 in 2018. But she was 3 years old when a white couple legally adopted her. She left the staff quarters where she lived with her biological mother and moved into the main house on the plantation estate.

It was the first day that Feltch-Malohifo’ou started living with her adoptive parents that her Tongan grandfather said to her, “So from here on out you don’t speak Tongan. I don’t ever want to hear you speak Tongan again before I cut your tongue out.” Feltch-Malohifo’ou is able to speak a little Tongan, but cites her grandfather’s admonishment as a reason why she has never truly been able to pick up the language.

Before moving to America when she was 12, Feltch-Malohifo’ou lived where there was lots of diversity and was never taught to be aware of skin color. She adds that she never heard the terminology “black” before, or that people had to be different skin colors, or be labeled at all.

Feltch-Malohifo’ou first experienced racial tension in Vernal, a town about 170 miles from Salt Lake City that she described as predominantly white and Mormon. She recalls, “I remember kids said, ‘Where are your parents?’ and I would say, ‘Right there.’ The kids would say, ‘You’re black, and they’re white.’ And I’d be like, ‘I’m black?’”

In high school, Feltch-Malohifo’ou remembers how she never dated, because of the way that the boys at her high school viewed her: as a brown girl. She says, “I was best friends with guys that I played sports with, but I wasn’t someone that they dared asked out, even though I knew they wanted to.” This feeling of being romantically undesired is one of the ways that her self-confidence was negatively impacted.

She also recalls, “I was really a follower. I just wanted to be accepted.” She says she never really felt part of the majority in her high school, partially because she was never able to fit into the same clothes or shoes as other girls in school. She felt “different.”

Growing up with her adoptive white family, Feltch-Malohifo’ou remembers that her brothers and sisters never recognized that she looked differently than they did, other than the variation of their hair colors. She says, “But [my family] never talked about skin color. So I didn’t recognize that I was a different color. I had never thought about being different, because in my family I was the same as my siblings.”

Angela Tucker, a transracial adoptee, creator of the website The Adopted Life and advocate for adoptee rights, believes in the importance of parents talking comfortably to their transracially adopted children about some topics that may be uncomfortable to discuss, such as racism. Tucker said in a phone interview, “It’s hard for a transracial adoptee to have a high intact self-esteem if the parents aren’t able to talk about racism.”

Kathy Searle, Utah director of program for the Adoption Exchange and parent of transracial adoptees, also believes that how parents choose to be involved in resources for their transracially adopted children can further strengthen the relationship between parent and child.

In an email interview, Searle said, “I also think that it’s important for adoptive parents to join communities that are the same race as their children. They need to cultivate relationships that can help them to better understand what their children face.”

It was when Feltch-Malohifo’ou played volleyball at a Northern California community college that she was around a lot of Pacific Islanders for the first time. She says, “My world was so different. So I did a lot of observing, I did a lot of watching, and trying to fit in.” She went from wanting to be accepted in “this white world,” to wanting to be accepted by the people who looked like her. It was only when she attended college that she discovered what the word racism meant.

Despite her desire to belong, she still was not accepted. “I was still different. I didn’t fit here, I didn’t fit there,” she says. Feltch-Malohifo’ou believes it was her upbringing in a white household that truly set her apart from her similarly looking peers.

In a clear moment of self-reflection, Feltch-Malohifo’ou says, “I’ve had problems just, like, figuring out where do I fit in this world. And so I went way this way, way that way, just trying to figure out where it is that I actually I fit in. Till I just started finding my own voice and realizing that everybody has value, everybody has privilege.”

While Feltch-Malohifo’ou says it has taken her many years to be comfortable and confident in herself, she has learned to love her unique “hybrid” background. Her perspective and understanding of white and Pacific Islander culture allows her to successfully be the executive director of Pacific Island Knowledge 2 Action Resources (PIK2AR), a community resource group.

PIK2AR’s mission “is to help Utah’s Pacific Islander communities flourish through providing culturally-relevant resources, opportunities and services to help build alliances, bridge communities, and provide opportunities.”

Feltch-Malohifo’ou believes she has finally found her place with PIK2AR. Before, she felt like an outsider, but “now I have a whole group of people who have been struggling like me trying to figure it out.” She hopes that her work with PIK2AR will be able to create a space for the generations of Pacific Islanders that follow, without facing similar struggles that Feltch-Malohifo’ou did herself.

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Susi Feltch-Malohifo’ou before meeting with a women’s resource group that is organized by PIK2AR.