# Voices of the Pacific: Pacific Peoples’ Conceptualisations of Anxiety in Aotearoa New Zealand—Findings from a Cross-Sectional Survey

## TL;DR

This study explores how Pacific peoples in New Zealand understand anxiety, revealing their holistic and relational approaches to mental health.

## Contribution

The study provides new insights into Pacific peoples' conceptualisations of anxiety, challenging deficit-based assumptions about their mental health literacy.

## Key findings

- Anxiety is seen as a transient, everyday experience rather than a prolonged mental health condition.
- Participants prefer informal relational support over professional help for managing anxiety.
- Anxiety is understood through a holistic lens, with causes attributed to experiential, contextual, and health-related factors.

## Abstract

Public health relevance—How does this work relate to a public health issue?
Pacific peoples experience disproportionately higher rates of anxiety, alongside low engagement with formal mental health services.The study goes beyond prevalence research to explore how Pacific peoples understand and conceptualise anxiety.

Pacific peoples experience disproportionately higher rates of anxiety, alongside low engagement with formal mental health services.

The study goes beyond prevalence research to explore how Pacific peoples understand and conceptualise anxiety.

Public health significance—Why is this work of significance to public health?
Understanding how Pacific peoples conceptualise anxiety is essential for improving cultural congruence within mental health service provision.The findings challenge deficit-based assumptions about Pacific peoples’ mental health literacy by demonstrating their nuanced understandings of anxiety.

Understanding how Pacific peoples conceptualise anxiety is essential for improving cultural congruence within mental health service provision.

The findings challenge deficit-based assumptions about Pacific peoples’ mental health literacy by demonstrating their nuanced understandings of anxiety.

Public health implications—What are the key implications or messages for practitioners, policy makers and/or researchers in public health?
Mental health services and policies must move beyond Western, symptom-based models and embed Pacific-led, culturally responsive approaches to mental health care.Pacific peoples’ underutilisation of mental health services is not necessarily due to a lack of knowledge, but indicative of structural and practical barriers to care.

Mental health services and policies must move beyond Western, symptom-based models and embed Pacific-led, culturally responsive approaches to mental health care.

Pacific peoples’ underutilisation of mental health services is not necessarily due to a lack of knowledge, but indicative of structural and practical barriers to care.

Pacific peoples in Aotearoa New Zealand (Aotearoa is the Indigenous Te Reo Māori name of New Zealand) experience disproportionately higher rates of anxiety than the general population. However, while informal relational support is strongly utilised, formal or professional help-seeking remains comparatively low. Understanding how Pacific peoples conceptualise anxiety is critical for addressing this disparity. This study provides a snapshot of Pacific peoples’ understandings of anxiety in Aotearoa NZ. A total of 548 Pacific peoples aged 16 to 83 years who resided in Aotearoa NZ completed the Pasifika Mental Health in Aotearoa (PMHA) survey between 2018 and 2019, which included questions about anxiety. Inductive Content Analysis (CA) grounded by Pacific epistemologies was used to categorise open-ended responses, and participants’ response frequencies were analysed. The findings suggest that anxiety was understood as a transient, everyday experience, rather than a prolonged mental health condition. Informal relational support networks were strongly preferred in addressing or managing anxiety, followed by professional support. Perceived causes of anxiety were complex and evenly attributed to experiential, contextual, and health-related risk factors, highlighting the centrality of holism in Pacific worldviews. These findings suggest a nuanced understanding of anxiety that challenges deficit-based assumptions about Pacific peoples’ Mental Health Literacy (MHL), and emphasises the ongoing need for more culturally responsive, community-based, relational, and holistic mental health support.