Welcome to BPJ 28, “He Hauora Wairua” our third journal focused on Māori Health
E te rau o tītapu, e te rau o Huna
To our distinguished readers
Nei ko te reo maioha e tangi atu ki a koutou i runga i te au o aumihi.
This is the voice of welcome, calling out to you a greeting.
Ko te hunga wehiwehi kua mene ki te pō, kua rau atu ki te pūtahi nui o Rēhua, moe mai okioki mai. Ko tātou o te ao kikokiko, o te ao hurihuri tēnā tātou.
To our loved ones who have gathered in the night, rest now. To the living in this, the physical world, the ever-changing world, greetings.
Ki tēnei putanga o te tuhinga hauora nei ka aro atu ki te hauora o te wairua, te wairua kua mau i te whakaaro keka, kua waroa e te waipiro, e te tarukino, e te taumaha o mataporehu rānei. He take kua hora whānui ki te iwi, ahungarua mai, pakeke mai, taitamariki mai.
This edition of the Best Practice Journal focuses on mental health, an issue that affects us all in some way, from the elderly to the young child.
Mokori anō te tuku mihi ki ngā tautōhito, ngā matanga nā rātou i tuku kokomo hei kai mā tātou.
Thanks must also go to our knowledgeable contributors.
Koutou mā te ihu o te waka hauora e wāwāhi ana ngā ngaru o te moana kia tau ai te waka ki uta.
And also to you, the prow of the canoe that cuts through the waves of the sea, so that the canoe may land safely ashore.
Tēnā koutou
Greetings
This edition aims to provide an overview of some important issues surrounding Māori mental health. For Māori, a person’s mental health can be considered in terms of the health of their wairua (spirit). Hence the title “He Hauora Wairua” – the health and wellbeing of the spirit.
Evidence shows that disparities in mental health care are significant and there is a continuing unmet need for Māori.
Primary care practitioners can make a significant contribution to lessening these disparities. A framework for the management of mental health problems in Māori is provided along with a focus on more specific topics of particular importance, including:
Youth suicide
Alcohol addiction
Cannabis misuse
Problem gambling
Some indicators from the PHO performance programme have also been included to show gains that have been achieved over the past few years. However, there is still further progress to be made to reduce disparities and achieve targets.
A holistic approach is important in all areas of medicine however it is vitally important when dealing with people with mental health problems, and is especially important for Māori. A secure cultural identity can assist in recovery from mental health problems.
Whānau ora is the aim – Māori families supported to achieve their maximum health and wellbeing.
Tīhei mauri ora!
Glossary
Hinengaro
Psychological
Iwi
Tribe
Karakia
Prayer, incantation
Kaumātua
Elder
Kaupapa
Principle
Marae
Traditional meeting place
Mauri
Life force
Mihi
Greeting
Mirimiri
Massage
Rongoā
Traditional Māori healing including medicines produced from native trees and plants
Tangata whaiora
Mental health patient
Tangi
Funeral, to cry
Te Reo Māori
Maori language
Tikanga
Customs, right way of doing something
Tinana
Body, physical
Tohunga
Skilled person, expert
Waiata
Song
Wairua
Spirit
Whakamomori
Suicide
Whakapapa
Genealogy
Whānau
Family
Whānaungatanga
Relationships, kinship
Recognising and managing mental health problems in Māori
Mental health problems are common in Māori, yet there is an unmet need for receiving treatment. Identifying mental health problems and providing early intervention for Māori is a key priority. The unique perspective of Māori culture should be acknowledged in order to provide the most effective level of care. Recognising that Māori might perceive and deal with mental health problems in different ways is an important first step.
It is estimated that substance misuse and other addictions are experienced by over one quarter of Māori in their lifetime. Every opportunity should be taken to discuss substance misuse and addiction, which is also often associated with other mental health problems. It is important that issues are understood and treatment is delivered in a culturally appropriate manner. Here we focus on the principles of care for Māori with substance misuse or addiction problems, and the specific issues of alcohol and cannabis misuse and problem gambling.
The rate of suicide in young Māori males is higher than in any other population group in New Zealand. Mental health disorder is strongly associated with suicide but is not the only risk factor. Assessing wellbeing at every opportunity, providing culturally appropriate care and identifying risk early are key factors in suicide prevention.
PHO Performance Programme – high needs populations
The PHO Performance Programme recognises the increased health needs of Māori, Pacific peoples and those living in lower socioeconomic areas. The Programme focuses on indicators which are measured to identify target levels of care. These indicators include services such as cervical and breast screening, immunisations, cardiovascular risk assessment and diabetes detection and follow-up. While there have been positive gains achieved over the past few years, there is still further progress to be made to reduce disparities and achieve targets.
