issue 1 09 - APS Member Groups - Australian Psychological Society

States of Micronesia111intensified, with the foremost mental healthissues being schizophrenia (Hezel, 1993) andsuicide (Rubenstein, 2002). In addition,excessive alcohol and growing drug use,especially marijuana and ‘ice’, are beingdocumented in the region (Saleh, 1994; Storr,Arria, Workman, & Anthony, 2004).Much of the research presented in thispaper is based on the limited studies available,some of which are becoming dated. However,more recent presentations (e.g., Gonzaga-Optaia, 2006) and the authors’communications with local authorities suggestthat these issues continue to worsen. It is alsonoteworthy that almost all of the studiesreviewed here discuss cultural change to someextent and relate it to the problems experiencedin Micronesia. This presents a much neededdirection for research on mitigating thesenegative effects.In addition, there is still a need forresearch to confirm the prevalence ofsubstance abuse and mental illnesses on a morecomprehensive scale. The knowledge baseregarding the correlates of substance abuse andmental health among Micronesians is also stillin its infancy. While many argue thatWesternization is contributing substantially tothese problems, almost no theoretical modelsor studies were found examining therelationships among substance use, mentalillness, and their precursors withinMicronesian society. Research on culturallycompatible treatment and prevention programsis also lacking for this population, and previousefforts to adequately assess and address theseproblems have been minimal and ineffective(Robillard, 1987).Substance abuseBesides kava, a root-based drink oftenconsumed together with the community duringsignificant events, alcohol, tobacco, and otherdrugs have been unknown in much of theregion until foreign contact. Tobacco may havebeen one of the first to be introduced to theislands through Spanish trading networksaround the mid-19 th century (Marshall, 1990).Likewise, alcohol was unknown until foreigncontact (Marshall, 1993), although Nason(1975) argued that sakau (general term fordrinks containing alcohol) and achi(fermented coconut toddy) were presentbefore Western contact. Marshall andMarshall (1975) discovered that some islandsof Micronesia learned about the coconutvariety from Filipinos. Estimates of whenwhisky, wine, and beer made theirappearance range from the early to late1800’s (Marshall & Marshall, 1975; Nason,1975). It is argued that marijuana wasintroduced in the late 1960s by Peace Corpsvolunteers (Marshall, 1990), although localsdid not begin using until the mid 1970s(Larson, 1987). Today, all of these substancesare used frequently in FSM. Althoughtobacco use is undoubtedly a concern(Marshall, 1997), more research is availableon the use of alcohol and other drugs.Therefore it is the latter two that will befocused on.Marshall conducted an ethnographicstudy of alcohol and drunken behaviour inMoen in 1976 and followed up this researchon the same island in 1985 with a morecomprehensive study of alcohol, tobacco andmarijuana using multiple methods (Marshall,1990). Marshall’s study found that a majorityof men drink (85% were current or formerdrinkers), especially those between their midteensand mid-30s, while a majority ofwomen did not drink (2.3% were current orformer drinkers). Gender was the greatestpredictor of alcohol, tobacco, and marijuanause. Of current drinkers, consumption wasfound to be heavy, with 77.6% having morethan four drinks per session and 50.6%having more than 10 drinks per session. Noassociation was found between alcohol useand the biographical characteristics ofreligious affiliation, marital status,educational level, employment status, orcommunity of origin. Also, alcohol use wassignificantly correlated with tobacco andmarijuana use. Despite the high use ofThe Australian Community Psychologist Volume 21 No 1 June 2009