Samoan clinical psychologist Muliagasisila Dr Fa’afetai Fa’aleava is urging greater investment and less stigma around mental illness.

He said Samoa has very limited mental health services, with just one psychiatrist serving a population of more than 225,000 people.

Speaking on ABC Radio Australia’s Pacific Pulse programme, Dr Fa’aleava said the shortage of specialists leaves families carrying much of the burden when relatives become unwell.

“There’s a big gap in providers,” he said. 

“There’s not really an in-depth treatment happening. A lot of the monitoring falls on families.”

Fa’aleava said Samoa’s limited mental health infrastructure means patients experiencing severe psychosis are sometimes temporarily housed in jail cells when hospital beds are unavailable.

He said stigma is still a big problem, with many people seeing mental illness as a spiritual issue rather than a health condition.

“A lot of times we perceive mental illness as a spiritual issue, a demonic attack,” he said.

“Prayer is important, but in addition to that, we need services.”

Fa’aleava said mental health is a spectrum. 

“It’s not just ‘crazy.’ It’s anything that impacts your daily functioning.”

His advice to families and communities is simple: “Be kind. You don’t know what someone is going through.”

Fa’aleava is one of only six Samoan psychologists trained in the United States and is helping build networks among Samoan clinicians abroad to support communities back home.

He works in an inpatient forensic unit at a California state prison, and in his current role, he treats inmates in crisis, stabilising them before returning them to their home prisons. 

He said working in prisons has reinforced the importance of compassion.

“The label ‘inmate’ can distract you from realising these are still humans,” he said. “You never know what someone’s going through.”

Fa’aleava hopes more Samoan professionals overseas will eventually return or contribute expertise to strengthen services in Samoa. Until then, he said communities can start by shifting attitudes.