Date of Award

January 2023

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

Nicola Hawley


Despite reports of mental health concerns among adolescents in American Samoa, little is known about the current mental health burden. Furthermore, previous literature has identified mental illness-related stigma as a significant barrier to mental health care access and treatment. By gathering various perspectives of adult stakeholders and adolescent participants, this community-partnered qualitative study aimed to describe the perceived stigmatization of mental health in American Samoa.

This study stems from a larger qualitative project on adolescent mental health in American Samoa. Employing the Fa’afaletui research framework, 28 adult informants of differing professions, ages, and gender participated in semi-structured, in-depth virtual interviews from October 2020 to February 2021. During June 2022, adolescent stakeholders were split into five focus groups on Zoom to validate themes gathered from the adult interviews. After duplicate coding of transcripts, the research team adopted a deductive approach to identify themes and levels of mental health stigmatization before mapping them on to a socio-ecological model.

Participants described multiple levels of mental health stigma that an adolescent struggling with mental health challenges may encounter. Although there has been progress in mobilizing services and educational resources to address various mental health needs, the perceived structural, social, interpersonal, and self-stigma of mental illness may prevent an adolescent in American Samoa from seeking social support and utilizing mental health services.Current and future interventions promoting adolescent mental wellness in American Samoa should also focus on addressing the multi-level aspects of mental health stigma in the community.


This is an Open Access Thesis.

Open Access

This Article is Open Access