1. Mental Health in Pacific Mothers Sara Weeks Lotofale Pacific Island Mental Health Service Auckland District Health Board

2. How big is the problem?  Suicide is the leading single cause of maternal death in NZ and several other Western countries  Rates of PND appear to be higher in Pacific women in NZ  Lasting effects on children

3. Post partum illness world wide  Described historically  Culture bound syndromes  Failelegau  Kita  Post partum psychosis – 0.5%  Post natal depression – 10-20%  Third day blues – 80%

4. Contributing factors  Sexual or reproductive trauma  Lack of social support  Family relationships  Traditional practices

5. Outcomes  Impact on mother  Suicide  Infanticide  Quality of life  Impact on children  Cognitive  Behavioural  Emotional  Impact on family

6. What can we do?  Awareness  destigmatisation  Screening?  EPDS  Medication  Support and psychoeducation  groups

7. Lotofale Samoan Mothers’ Group  Slow open group  Two facilitators – both grandmothers  Confidentiality  Education and destigmatisation  Emotional distress and coping strategies  Infant mental health  Looking after yourself