"There are still broken or fragmented systems": Qualitative assessment of needs to strengthen adolescent mental health services in American Samoa.
Emma J Mew, Vanessa Blas, Julia Winschel and 15 others
PMID 37691318WHAT IT FOUND
Community leaders and clinicians in American Samoa report a high burden of adolescent depression and suicide, with no specialists in adolescent mental health.
They identified gaps in school screening, confidentiality concerns, and a lack of coordinated care pathways as primary barriers to treatment.
Key findings
01Participants reported that there are only four doctoral-level clinicians serving the entire territory and none specialize in adolescent mental health.
02Barriers to care included adolescents' unawareness of symptoms, fears about confidentiality in a small community, and a lack of trained first responders.
03Key informants suggested task-shifting duties to school counsellors and training community members as gatekeepers to identify distress.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Findings come from adult perspectives and were not validated by adolescents themselves. The sample was small and purposefully recruited, limiting generalizability to other populations. Data collection occurred during the COVID-19 pandemic and shortly after a cluster of suicides, which may have heightened emotional responses. Demographic details were withheld to protect confidentiality, limiting insight into participant diversity.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not interpret these reported high rates of suicide and depression as statistically measured prevalence from this study. These are perceptions from a small group of adults in a specific crisis period, not objective epidemiological data.