The bottom of the pit

I assessed Ofato in the visitor section of Silverwater jail in Sydney's western suburbs. Anxious, expectant relatives were directed, by stern guards, towards a large room filled with plastic chairs and tables, where they waited for their precious minutes with loved ones lost to the criminal justice system.

I was there at the request of a lawyer who had discovered his Samoan-born client had prior contact with mental health services. Ofato is not tall, but like many with his heritage, he is muscular and has an intimidating presence. He has black curly hair, a flat nose and partially Mongoloid eyes. He sat dressed in his green jumper and tracksuit pants, the correctional centre's uniform for inmates, across a battered, chipped office table. He bowed his head, avoided eye contact and answered my questions softly, but with never more than a few words, with a Kiwi accent. He smiles only when talking about a visit from his parents and five siblings the day before.

He was charged with 'break and enter' with three other men of Samoan heritage. Unusually for a case involving young men and crime, there were no drugs involved. I read through the pile of legal documents and noticed a shoplifting offence years earlier. This was his first time in jail.

A week earlier in a hospital I assessed Eli, a nineteen-year-old boy of Samoan heritage living in Mt Druitt, who had become withdrawn and mute. He had previously worked at a Woolworths distribution centre, but felt pressure to stay home with a sick grandmother when his father and uncle left to take jobs as fruit pickers. He had completed his school certificate but further study didn't interest him. Eli was difficult to diagnose, offering the briefest of answers to my questions. I discovered he liked rap music. Fifty Cent and Kanye West were his favorite artists. His presentation was consistent with the criteria for depression – laboured speech, disengaged manner, slowed memory and concentration – yet was also culturally appropriate.

Ofato and Eli are two of an emerging community of Pacific Islanders increasingly falling through the cracks of respectable, prosperous Australian society, most commonly from Samoa, Tonga and Fiji. Pacific Islanders have been described as statistically invisible in Australia, because most have migrated either through or from New Zealand, and are identified as New Zealanders. Ancestry data from the 2011 Census is more accurate and tallies 85,000 people with Pacific Islander ancestry, a 15 per cent increase since 2006.

In January, riots in Logan, on the southern outskirts of Brisbane, between Pacific Islanders and Aboriginal teenagers, drew attention to this group and their growing representation among the deprived and disenfranchised.

'They're competing over not wanting to be bottom of the pit,' says Gail Ker, CEO of Access Community Services in Logan, who explains that some Aboriginal and Torres Strait Islander residents in the area feel African refugees and Pacific Islanders are competing with them for subsidised housing and welfare. Pacific Islanders often lacked access to resources such as HECS and the disability pension. 'We are denigrating them to an underclass,' she says.

Pacific Islanders are increasingly over-represented in juvenile justice system, they are more likely to drop out of the educational system and be unemployed. In Victoria Pacific Islanders make up just 0.1 per cent of the population, but 8.5 per cent of young people in youth detention centres. NSW, Queensland and Victorian correctional services have special advice booklets about dealing with Pacific Islanders for workers in the juvenile justice system, acknowledgement of their over-representation and specific cultural context.

In Mt Druitt, long synonymous with deprivation in Sydney, a boisterous church for Samoans meets every Sunday. My patient Eli used to attend regularly, playing keyboard in accompaniment with the church choir. The congregation of several hundred people echoes the missionary history and strong Christian traditions of the Pacific. Speeches are short and performances are long, with passionate choirs taking their cues from American gospel singers.

Young people attend with their older relatives. The men dress formally in shirts and trousers, the curvaceous women favour floral dresses. Traces of their external life are visible, from baseball caps to headphones attached to mobile phones. I watch several elders chide their children playing with their smartphones.

At church the cracks in the community elsewhere are not obvious.

A legal assessment in jail allows for only one encounter, but Ofato becomes more comfortable as the interview progresses. He is guarded about his prior interaction with mental health services but eager to please his lawyer too. He first used marijuana a year ago, and it made him paranoid. Convinced he was being persecuted by Sudanese and Aboriginal youth, he hid behind crates at a local shop. Police were called and he was taken to emergency and later diagnosed with drug-induced psychosis. He was discharged a day later, but didn't return for follow up. He says he has not tried drugs again. I found no evidence of any underlying psychiatric abnormalities during my interview.