A major mental health study has found a worryingly large proportion of surveyed Cook Islands adolescents experience high to very high levels of anxiety and other mental health issues.

The study was compiled by Metua Daniel-Atutolu, Evangelene Daniela-Wong, Neti-Tamarua Herman, Christine Porio, Jacquie Bay, and Mark Vickers for Te Marae Ora and Ministry of Education.

It surveyed 57 Year 9 -10 students across three schools representing the main island (Rarotonga) and outer islands (Aitutaki and Atiu) in the middle of last year.

The Strengths and Difficulties Questionnaire (SDQ) was used – this is a validated self-report questionnaire designed for children and adolescents. 

The SDQ contains 25 questions and impact statements and a focus group was held to help contextualise the SDQ for use in Cook Island adolescents. 

SDQ scores were scored across 5 elements related to emotional symptoms, conduct problems, hyperactivity-inattention, peer relationship problems, and prosocial behaviour.

A summary of the study was released to Cook Islands News in January. 

Cook Islands News has given the organising committee more than a month to respond, but Education Secretary Danielle Cochrane, who is part of the committee, said on Wednesday: “a statement will be shared on this matter when it is both appropriate for our partners and those who participated in the survey.  We will not be responding in haste on such an important matter as it includes our children and their families, without their blessing and input”.

The study found that of those surveyed, 38 per cent of all students presented SDQ scores in the high-very high category compared to an expected prevalence of 10 per cent. Students identified at potential risk were followed up by the Health Hub team at the Ministry of Health. 

The study says adolescent mental health is an underestimated risk factor for Non-Communicable Diseases (NCDs), and there were “complex” links between mental health and wellbeing and the main NCDs that are targeted including diabetes and heart disease.

“Adolescent mental health has yet to evaluated in a Cook Island school-based setting,” it says. 

“This pilot study aimed to undertake the first baseline assessment of mental health in Cook Island adolescents.”

The study says international evidence has highlighted the impact of Covid-19 on adolescent SDQ scores. 

“Since this is the first time a baseline survey has been undertaken in the Cook Islands only future cohorts will help ascertain such impacts,” it says.  

“Nonetheless, this pilot study has highlighted a current significant mental health burden in Cook Island adolescents and an urgent need to develop scaffolded resources to support these students, their families, the schools and wider community.”

Wong said workshops with the Ministries of Health and Education were held to discuss the data and develop a draft plan around the “scaffolded” resources required to support those adolescents identified across each SDQ score category. 

Mereana Taikoko, the director of Te Kainga O Pa Taunga, the Cook Islands mental health organisation, said the results did not surprise her.

“We see it when we visit schools all the time,” Taikoko said.

“Adolescents face all sorts of pressures, whether it be in their relationships, or drug and alcohol use, or even the lack of support from parents.”

She said they were hoping to get more resources to run more school programmes.

“We find it easier to engage with schools in the outer islands for some reason,” Taikoko said.

“Adolescents are definitely affected by peer pressure, and that drives anxiety levels. We’ve seen it get worse since Covid-19.”

NZAC counsellor Mark Henderson has worked extensively with local youth, with the Ministry of Education and local NGO Cook Islands Family Welfare Association. 

He said the results surprised him a bit. 

"That said, I think the small group of professionals working with local youth have been aware of the increase in mental health issues on the island, but probably not the scale,” Henderson said. 

“The results should be of concern to educators, employers and of course, families - anyone wanting to see their children thrive in life. It's very hard to study, apply yourself, even sit through a class, when you're mentally unwell."

Henderson said many youths experience mental health issues in isolation. 

“Some reach out to a friend. Many suffer alone. The stigma around mental health still exists and is problematic,” he said. 

“That, plus, a reluctance to reach out to adults for help, and a lack of trained professionals and easy, private access to professional support.”

Henderson said people’s environment often affects their mental health.

“When you look at a plant that's not thriving, a look at its environment can give you some clues to what's causing the plant to be unwell," he said. 

"If we apply that idea to young people who may be struggling mentally and looked at their environment, what would we see? How has Covid-19 affected them and their whanau, their friends, their future prospects? 

Henderson advised parents and educators to “ask and listen, carefully, without judgement or blame". 

"A lot of young people support each other with mental health issues. Some of the issues they're dealing with are extreme. I like that they look out for each other, but it's concerning that they need to," he said. 

"We can do more. As adults, we can provide more support to young people who may be struggling. We need to, especially if we want to support the next generation to grow and thrive."

This was not the only major mental health study that was conducted in the Cook Islands last year.

A study, which interviewed more than 850 people in Rarotonga and Aitutaki aged 16 and over about mental health issues, was conducted in the middle of last year. Wong said it was likely that the results of it should be released soon.