Health
Schizophrenia Hits Western Micronesia
Mental Health Picture May Worsen
Although outbreaks of dengue and cholera grab headlines in the Pacific, many have become increasingly aware of the burden of serious mental illness. For example, between 1960 and 1990 the number of suicides in Micronesia increased by 700 percent.
Schizophrenia is a debilitating chronic condition that affects approximately one percent of the world’s population, but Micronesia is an isolated ‘pocket’ of higher prevalence. It appears to increase on an east to west gradient, with the highest rates documented in Yap and Palau. Research in Palau has demonstrated the importance of complex genetic inheritance patterns in schizophrenia. Isolated populations that happen to carry multiple genes for schizophrenia may pass it on to later generations at a higher concentration than the outside world. Both Yap and Palau experienced significant population decreases in the early 20th century, which may have affected the schizophrenia genetic load. But genes are not the whole picture.
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Yap and Palau have had some of the Pacific’s highest rates of drug use over the past 20 years. Fr. Francis Hezel of the Micronesian Seminar and A.M. Wylie of the University of Guam reported that per capita spending on alcohol shows the same east to west gradient as the distribution of schizophrenia.
Research has begun to link the changes in male social and economic roles with the violence, drug and alcohol abuse seen in Western Micronesia, along with mental illness. Traditional male occupations have been supplanted by a cash-based economy, to a greater degree than female occupations, and the lack of opportunity may be particularly hard on young men. A Kosrae study shows that men are diagnosed with schizophrenia at dramatically higher rates than women.
Residents throughout the FSM and Palau are fortunate as mental health services have been relatively accessible and staffed by competent local professionals. However, community organizations have a valuable role to play in bringing mental health out of the realm of hospitals, preventing alcohol, drug abuse and suicide, and ensuring that people with mental illness receive stable support and a place in society.
