Pacific Islanders refers to the indigenous people of the Polynesian, Micronesian, and Melanesian islands. Polynesia refers to the islands settled by Polynesians, which includes (but is not limited to) Tahiti, Hawai’i, American and Western Samoa, Tonga, Rapanui (Easter Island), the Cook Islands, and French Polynesia. Micronesia refers to the islands in the Western Pacific with its main islands being the Carolina Islands (including Federated States of Micronesia and Palau), the Gilbert Islands, and the Mariana Islands (including Guam). The Chamorros are native to Guam and the Northern Marianas. The islands of Melanesia consist of Papua New Guinea, Solomon Islands, Vanuatu, New Caledonia, and Fiji. The history of the three divisions of the Pacific Islands is tied to the colonization process of the Pacific (also referred to as Oceania) and is related to the geographic locations of these islands rather than commonalities of culture and language. However, two areas of commonalities exist across these island cultures: (1) commitment to cultural values such as the emphasis on family, interdependence, holism, and harmony with nature; and (2) historical trauma due to colonization and the current challenges facing many Pacific cultures to maintain their cultural identity, lands, and traditions. To be consistent with the language of the U.S. Census, Pacific Islander will be referred to as a racial category.
In the field of counseling, there is some debate in terms of the distinction between race, ethnicity, and culture, yet no conclusion has been made indicating whether Pacific Islander is a racial or ethnic category.
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Each island has unique cultural aspects that may be similar to or different from those of other nearby islands; therefore, generalizations about chains of islands should be interpreted with caution given the heterogeneity within the Pacific Islands’ cultures and their respective native inhabitants.
The 2000 U.S. Census was the first census to have Pacific Islander as a distinct racial category separate from Asian for all 50 states. The 2000 Census included three specific Pacific Islander groups—Native Hawaiian, Samoan, and Guamanian or Chamorro—as well as a separate Other Pacific Islander response category for people to write in their Pacific ancestry. Other Pacific Islander groups living in the United States are Tahitian, Tokelauan, Mariana Islander, Saipanese, Palauan, Carolinian, Kosraean, Pohnpeian, Chuukese, Yapese, Marshallese, I-Kiribati, Fijian, Papua New Guinean, Solomon Islander, and Ni-Vanuatu. In the 2000 U.S. Census, the total number of individuals who identified as fully or partially Pacific Islander was 874,414 people (0.3% of the total U.S. population), with 398,835 reporting solely as Pacific Islander and 475,579 as Pacific Islander in combination with one or more races. The increase in Pacific Islanders (who indicated only one racial category) living in the United States was 9% from 1990 to 2000, while the increase of Pacific Islanders who indicated one or more races increased 140% within this same time period. The Pacific Islander racial category consists of more than 20 different groups with the 4 largest accounting for slightly over three fourths (76%) of this racial group: Hawaiians (n = 401,162; 45.9%) constituted the largest cluster of Pacific Islanders, followed by the Samoans (n = 133,281; 15.2%), the Chamorros or Guamanians (n = 92,611; 10.6%), and the Tongans (n = 36,840; 4.2%). The other Pacific Islander ethnicity categories ranged from a total of 18 (Ni-Vanuatu) to 12,581 (Fijian) people living in the United States.
Pacific Islanders also reported the highest concentration of individuals who recorded as being of more than one race in comparison with all other races in the United States and the only race that had a higher number of people indicating multiple racial categories than a sole racial category. Pacific Islanders are becoming increasingly a multiracial and multiethnic population. Pacific Islanders live throughout the United States, with nearly three quarters (73%) living on the West Coast of the continental United States and Hawai’i.
History of Pacific Islanders and the United States
The United States is the colonial landlord of more than 2,300 islands in the Pacific (excluding Hawai’i). The only Pacific island that officially became a state of the United States was Hawai’i, in 1959. Guam, American Samoa, and Northern Mariana Islands are U.S. territories, and the Republic of the Marshall Islands, Federated States of Micronesia, and the Republic of Palau are considered freely associated states. Guam is considered an unincorporated territory of the United States because not all provisions of the U.S. Constitution apply to this territory; however, the government was organized based on the U.S. Constitution, including an elected representative to Congress.
Status of Pacific Islanders in the United States
Pacific Islanders, in general, have lower median earnings (for both men and women), have lower family income, and are less likely to hold management and professional positions in comparison with the total U.S. population. In addition, Pacific Islanders have higher rates of poverty (17.7%) in comparison with Caucasians (11.5%) and Asian Americans (9.4%). Pacific Islanders have a high prevalence rate of high school graduates: 78% (compared with 90% for Caucasians and Asian Americans) but are concentrated in the lower percentage of persons having completed a bachelor’s degree (14% compared with 24% of the total U.S. population) and graduate degrees (4% for Pacific Islanders and 10% for Caucasian Americans).
Pacific Islanders have higher prevalence rates of smoking, alcohol consumption, and obesity, while having a lower survival rate for cancer, in comparison with Caucasians and other racial and ethnic groups. Unfortunately, knowledge about the prevalence rates of mental health issues and the needs of Pacific Islanders is limited given the low numbers of Pacific Islander participants in epidemiological studies. However, studies on Native Hawaiians have found Pacific Islanders to be at risk for depression, anxiety, substance abuse disorders, and suicide. Many indigenous populations in the Pacific are facing similar challenges and health risk factors.
Research on Pacific Islanders
The proliferation of empirical research on counseling, treatment, and mental health issues among Asian Americans in the past 25 years has masked the paucity of research among Pacific Islanders. Furthermore, research on cultural values, norms, beliefs, attitudes, and family dynamics in Pacific Islander cultures have been advanced through ethnography and anthropology investigations leaving psychological theories and interventions without a solid culturally appropriate foundation upon which to build a body of knowledge. The emergence of stereotypes from ethnographic research of Pacific Islander cultures has resulted in appropriate concern about the value of extant knowledge in guiding psychology and clinical interventions. Without over-dramatizing the limitations of past anthropological studies, an example may be found in the classic work of Margaret Mead, who portrayed Samoans as warm, easygoing, pleasant, happy people with playful and open sexual relationships living in a society lacking competition, aggression, and hierarchy. Results from ethnographic studies were used as evidence to support the stereotype of the Pacific Islander as lazy, promiscuous, happy, easygoing, and nonassertive. These stereotypes have been further perpetuated and maintained by the tourism industry and the media. Further research has found Pacific Islanders and their respective cultures to be much more complex than these initial anthropological studies demonstrated, with heterogeneity within and between cultural groups within the Pacific Islander community. Generalizations need to be interpreted with caution given the varying degree of Western contact and influence, interracial relationships, migration, and heterogeneity among the various peoples and cultures of the Pacific Islands.
Pacific Islander communities have come together to reclaim their identity, their land, their cultural values, and their spiritual beliefs to strengthen themselves and their families after years of colonization. The movement of “indigenous ways of knowing” and re-embracing cultural strengths to help heal past historical injustices can be seen in multiple Pacific Islander communities, including the Native Hawaiians, Tongans, and the aboriginal peoples of Australia and New Zealand. This cultural renaissance of ethnic beliefs, values, customs, expectations, and practices has also created a sense of pride and strength to help empower indigenous groups to create their own empirical investigations about their own people.
At the center of Pacific Islander culture is the family system, that is, the network of interpersonal relationships that shape the processes by which cultural practices and values are transmitted, maintained, and affirmed. The network of relationships is at the piko (Hawaiian for “center”) of health and healing processes and can be a strong source of support and identity in Pacific Islander culture. A person’s family can consist of extended family and informal relationships such as friends and family members of friends. The Pacific Islander’s concept of self is tied to the view that the individual, society, and nature are inseparable and key to psychological and physical health. Such relational and emotional bonds that shape the individual, family, and community have implications for psychological functioning and well-being.
Mental health symptoms may be related to disharmony or dysfunction within the family or collective unit. A conflict within this network of social relationships can lead to mental illness such as depression, substance abuse, anxiety, alienation, and isolation. The etiology of mental illnesses and its respective symptoms can be seen as related to disharmony or discord within social relationships. Therefore, treatment of mental health issues using indigenous health practices may focus on treating social relationships rather than the individual.
Another critical component to understanding Pacific Islanders is the concept of a sense of place in connection to one’s identity. Place is the source of one’s worldview, genealogy, and existential foundation. The connection to a place or land is also embedded with responsibility and obligation to the land, the place itself, and one’s kin. Space in contrast to place refers to where a person is living or dwelling; however, it may not be the origin of one’s identity. A person’s space may be dictated by circumstances in his or her life, such as living on the continental United States for educational or work opportunities.
One of the most common misunderstandings about Pacific Islanders is the assumption that by either living away from one’s island or being born elsewhere somehow means that person is less “native” or “indigenous” to the islands. Mental health professionals may make an erroneous claim that if Pacific Islanders are not living in their “place,” they have forfeited their identity as indigenous or native Pacific Islanders. However, this need to “legitimize” or “authenticate” a Pacific Islander’s identity and cultural heritage can feel like negating this person’s sense of identity and the essence of his or her mana (Hawaiian for “life force”). Another misconception about Pacific Islanders is the idea of migration as being one way toward another place, such as the continental United States, rather than circular migration. Circular migration occurs when people may live away from the islands but return home for long visits or move back in later stages of their lives (e.g., after having children or after retiring).
Another similar feature among Pacific Islanders is the emphasis and importance placed on one’s cultural identity. The importance of knowing one’s ancestral heritage and its respective connection to the land can be viewed as a key element in developing a coherent sense of self. There are terms within the language such as Fa’a Samoan (“the Samoan way of life” or “the Samoan way”) or anga fakatonga (“the Tongan way”) that indicate this connection between one’s culture, heritage, the land, and cultural identity. However, this importance placed on cultural identity and the influence of Western individualism and capitalism has had an effect of the definition and development of Pacific Islanders’ cultural identity.
Psychological Issues Facing Pacific Islanders
The issues facing Pacific Islanders are also embedded in the events in history and similar challenges faced by other groups of color living in the United States. These issues include acculturation, ethnic identity, the effects of colonization and annexation, and the effects of racism, discrimination, and oppression. Charles Darwin indicated that “wherever the European has trod, death seems to pursue the aboriginal.” One issue that Native Hawaiians and Chamorros have had to face is the cultural genocide of the indigenous peoples of the islands. Explorers who came to the Pacific Islands brought with them many foreign diseases for which the native populations had no immunity; the results were death and infertility among the native people. In addition, contact with foreigners also led to warfare, thus increasing the death toll of the indigenous peoples of the islands. The colonization process and cultural genocide of Pacific Islanders, such as Native Hawaiians, has been noted as a major contributor to the prevalence of depression, anxiety, and despair among these indigenous people. Missionaries in the 1820s came to the Pacific Islands to help save souls of the native inhabitants. Along with Christian doctrine, Western cultural norms were also transmitted as the ideal to these indigenous cultures. The result was the emphasis on native people to conform and assimilate to Western values. This included Western notions of economic and sociopolitical development, such as private ownership of land and the restructuring of hierarchy and privilege based on wealth rather than on genealogy. These radical shifts and changes in the social, political, economic, and religious structures within these indigenous communities resulted at times in ethnocide, that is, the destruction of the Pacific Islanders’ way of life.
The study of the psychological impact of Western contact resulting in colonization and annexation of Pacific Islanders is in the early stages of development in research. Models and theories have indicated that the accumulation of losses—including land, language, culture, ancestors, and kin—can lead to depression, anxiety, drug and alcohol abuse, deviant behavior, and suicide. The stressors associated with colonization can include historical trauma and the effects of the multiple losses and the ripple effects throughout indigenous peoples’ daily lives and significant life events. The need to perpetuate one’s culture after such significant loss is a responsibility felt by many indigenous peoples; this need can influence life decisions such as choice in a partner or spouse, where to live, the pursuit of higher education, career choice, and child-rearing practices.
Decolonization has been greatly discussed in Pacific Islander communities politically, economically, and psychologically. Decolonization refers to the process where a colonized group of people develop a consciousness based on the remnants of the traditional culture and redefine and reassert their identity and unique qualities that historically guided their existence. This may entail sovereignty, the reacquisition of land, and the rediscovering and reaffirming of indigenous epistemology to guide one’s life in understanding the past, present, and future. An example of this renewed identity is the reemergence of traditional and indigenous healing practices, which is being researched by mental health professionals. Indigenous healing practices can be helpful in treating symptoms of psychological distress while also empowering Pacific Islanders in maintaining traditional customs and practices. The colonization process associated with the acquisition of Pacific Islands was accompanied by the institutionalization of ethnic categories as formal social entities used to dictate rights and privileges within a society. This socialization process has raised the importance of cultural identity to a new level. Not only is cultural identity important to the well-being of the Pacific Islanders, but it has been empowered to be a critical source of political power and economic influence.
These latent issues, which have both historical and current influence on the psychological and social well-being of the Pacific Islander peoples, ultimately shape their cultural identity. The postcolonization struggles, including the need to maintain their cultural identity, are a prevalent theme across many Pacific Islander communities, including Samoan, Tongan, Chamorro, Hawaiian, and aboriginal Australian communities. Pacific Islander literature reflects this struggle in stories of indigenous people living on the margins in order to express their identity finishing their lives in isolation, madness, and suicide. These stories demonstrate that the Western notion of “functioning” may in fact be inherently pathological for Pacific Islanders.
A testimony of resilience of Pacific Islanders is the circular migration pattern of indigenous peoples returning to their homelands, revitalizing their native cultures, affirming their sense of place and cultural identity, and utilizing their “Western” knowledge to help their communities to become self-sufficient and to heal from the detrimental effects of previous colonization. The efforts to maintain one’s language, spirituality, cultural healing practices, and customs have resulted in feelings of pride, strength, renewal of spirit, and hope for the future of Pacific Islanders. The reclaiming of one’s culture, land, and identity can be empowering and healing. The social process in Western communities to quantify and essentialize racial groups in order for those groups to receive benefits from the government (e.g., land acquisition by blood quantum) has implications for Pacific Islander communities. The Western socialization process of legitimizing or authenticating who is to be considered “native” to the islands has led to fractions within Pacific Islander communities. It has also created a social class system within Pacific Islander groups with a social elite class defining who is “native” or “indigenous” and who has access to resources such as education, land acquisition, and economic opportunities.
Counseling Pacific Islanders
As a group, Pacific Islanders have not received much attention in studies of racial and ethnic groups in counseling. One of the main reasons for this lack of attention is the trend of combining Asian American and Pacific Islander groups together, which has led to a paucity of counseling literature focused on this racial group as a separate entity. This aggregation of the data for Asian American and Pacific Islanders has led to Pacific Islanders being invisible or misrepresented in public policy and the mental health field. The ramifications of this collapsing of these racial/ethnic groups have been the failure to understand the health needs of Pacific Islanders, the impact of social history on assessment of mental health factors, undercounting of Pacific Islanders in general, and a limited awareness of the poverty, discrimination, and the adjustment of these indigenous groups in the United States. Also, by combining Pacific Islanders with Asian Americans, there has been a lack of knowledge by clinicians and mental health professionals about the historical similarities of these indigenous groups in the Pacific to other Native Americans living in the United States.
It is important to note that the social norms found in Western models of counseling—such as individualism and the need to separate from one’s family of origin after a certain age—may not be applicable to Pacific Islanders. In fact, these Western norms may be viewed by Pacific Islanders as pathological and detrimental to their social network. In addition, symptoms of distress, such as depression, anxiety, or suicidal ideation, should be viewed within the historical context of the Pacific Islander and understood that it may be a reflection of an unhealthy society rather than a problem that lies within the individual.
Asian Americans and Pacific Islanders have limited availability and access to mental health services and tend to underutilize counseling services. Possible explanations for this underutilization are the lack of trained healthcare professionals who are fluent in Pacific Islander languages and lack of understanding of Pacific Islanders’ history and worldviews. Counselors that have been trained in working with culturally diverse clients may be applying Asian American values that do not fit for Pacific Islanders, which may lead to early termination. For example, despite assertions that Asian Americans and Pacific Islanders express more somatic symptoms and that shame and stigma may be related to the lack of utilization of mental health services, there is no empirical research to support this claim with Pacific Islander samples. In addition, given that 17% of Pacific Islanders are below the poverty level, they may lack health insurance to pay for mental health services. Access to mental health providers and their respective services may also be problematic because of the remote and rural locations where Pacific Islanders reside.
With the emphasis on family as the social unit and the need to maintain harmony within one’s extended kin, family therapy based on the values of the Pacific Islander group may be an effective invention that is culturally congruent with the values and beliefs of this population. For example, ho’opono’pono, a Native Hawaiian indigenous healing practice, focuses on “setting right” family issues or conflict to maintain harmony with one’s family, community, and ancestors in the spiritual world. Similarities within this practice exist when compared with other Western family therapy models, but its uniqueness lies in (a) the goals of the ho’opono’pono (seeking family harmony through confession and the seeking of forgiveness within the group rather than within oneself), and (b) the spiritual focus (including prayer and seeking help from the spiritual world, for example, from a higher power or ancestors that have passed on) of the sessions.
Given the paucity of research about the mental health needs of Pacific Islanders within the United States, more research is needed focusing on Pacific Islanders and the groups within this racial category. Future research of Pacific Islanders should include (a) the prevalence rates of mental health issues; (b) the availability, accessibility, and utilization of counseling services within this population; (c) culturally competent therapies, prevention, and intervention strategies; (d) cultural factors that help promote well-being and protect against mental illnesses; and (e) help-seeking behavior, including indigenous health practices and Western models of therapy.
The literature on indigenous communities reveals links between sovereignty issues and health, with economic and political freedom being key to the well-being of native peoples. It has been proposed that the restoration of the rights and privileges of these communities—including self-governance, the freedom to cultivate and practice the cultural traditions of ancestors, and having a relationship with the environment— will help promote the psychological well-being of Pacific Islanders. In light of the history of colonization and oppression of Pacific Islanders, it is understandable that political factors such as self-governance would be linked with the promotion of physical and mental health.
Predictably, Pacific Islanders have a place in counseling and psychology in spite of the limitations of extant research. Pacific Islanders have a history of being invisible or marginalized within the field of psychology, and this is being remedied accordingly. Yet the indigenous people of these islands have been a part of social changes and resurgence of their cultures, the migration of cultures, and the adaptation of their people. With the importance of multicultural competence in counseling, researchers have taken on the challenge of understanding these unique populations of people and their mental health needs. Future research on Pacific Islanders and counseling should be designed to improve upon the ability to serve these populations with full understanding of their histories and the strengths and resilience of their cultures.
- Andrade, N. N., Hishinuma, E. S., McDermott, J. F., Johnson, R. C., Goebert, D. A., Makini, G. K., et al. (2006). The National Center on Indigenous Hawaiian Behavioral Health study of prevalence of psychiatric disorders in native Hawaiian adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 45(1), 26-36.
- Grieco, E. M. (2001, December). The Native Hawaiian and Other U.S. Pacific Islander population: 2000 (Census 2000 Brief No. C2KBR/01-14). U.S. Census Bureau. Retrieved from https://www.census.gov/prod/2001pubs/c2kbr01-14.pdf
- McCubbin, H., & McCubbin, L. (1997). Hawaiian American families. In M. K. DeGenova (Ed.), Families in a cultural context. Mountain View, CA: Mayfield.
- Office of Minority Health. (2006). [Native Hawaiian/Other Pacific Islander profile]. Retrieved May 21, 2006, from http://minorityhealth.hhs.gov/omh/browse.aspx?lvl=3&lvlid=65
- U.S. Department of Health and Human Services. (2001). Mental health: Culture, race, and ethnicity: A supplement to mental health: A report of the surgeon general. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services.