Kapua Awatea Maori Mental Health Services

Auckland District Health Board; 11 Sutherland Road, Point Chevalier

Monday 9 October 2006; 10am

Mental Health Awareness Week Public Launch

Tariana Turia, Co-leader, Maori Party

Tēnā koutou e whakarauika nei i tēnei ra. Nga mihi, mai i tēnei o te awa o Whanganui ki nga uri o Ngati Whatua, tēnā tātou katoa.

I’m really taken with the theme of Mental Health Awareness Week:

Ko te whanaungatanga te maioha

Accept, Belong, Connect.

The concept of ‘Maioha’ particularly stands out. Maioha - a token of regard, a treasure, to remind us relationships are valuable. Te Ahukaramü Royal refers to maioha as the precious words of one’s ancestors - giving sustenance to the spiritual well-being of iwi.

The theme for how we view mental well-ness is thus beautifully captured in these words which convey a sense of belonging and connectedness.

He maioha te whanaungatanga - the treasure, indeed, of whanau.

For we can not look at the issue of mental health and well-being without considering the impact of our kuia, koroua, pakeke, rangatahi, tamariki as the very source of our strength.

The concept of drawing upon our collective strength is a universal concept, a value that has passed down the generations and across the continents.

You may recall the lyrics of a civil rights activist of the sixties, Mexican folk singer, Joan Baez who, herself, drew on the words of a classic meditation by 16th century English poet John Donne:

No man is an island,
No man stands alone,
Each man's joy is joy to me,
Each man's grief is my own.
We need one another.

For tangata whenua, this universal truth reflects in the fact that whanau are the key to unleashing our potential.

Whanau are at the absolute centre - providing the guidance, support, advocacy, security, stability and strength to ensure well-being.

You’re probably all aware of the findings of Te Rau Hinengaro: The New Zealand Mental Health Survey, published just last month. The survey revealed that 29.5% of Maori, compared to 19.3% of others experience mental illness in a twelve-month period.

The most common lifetime disorders amongst Maori were anxiety disorders, substance use and mood disorders. 19% of Maori with any disorder, had three or more disorders at the same time.

It is important to know these facts - but it is even more important to know what to do with them.

For a diagnosis of mental illness has a ripple effect on all those who love or live or connect to tangata whaiora.

How do whanau deal with such facts in Te Ao Hurihuri, the ever-changing world? What are the tools which assist whanau to understand the challenges of mental health, and live positively?

The reality is that mental disorder is more usual than it is unusual; 47% of the population are predicted to meet criteria for a disorder at some point in their lives. And yet, studies show that only with a minority of people with a mental disorder obtain professional help.

And with the de-institutionalisation of the mental health sector - and the Government’s failure to provide sufficient investment in community care - it is going to be even more critical that whanau are equipped to know how to support.

De-institutionalisation has created huge pressure on both community care and whanau. And it is not over. In a publication by the Mental Health Commission in April this year, Mary O’Regan advised, that a “wider range of community and home-based recovery-focused acute mental health services needs to be high on everyone’s agenda”.

O’Regan states that the acute mental health services of this country, often fail to respond well to people in acute crises, because many of these services are themselves in crisis. She reports that people admitted to hospital-based acute services, often find them frightening, impersonal and untherapeutic. Rangatahi can find acute inpatient units particularly traumatising.

It’s the clear challenge that this report issues - that our acute services are failing the nation - that reinforce the value of the Mental Health Commission - and which is why I was so pleased at yesterday’s announcement confirming their continuing role.

To respond to the acute crisis, O’Regan suggests a shift from maintenance to recovery; from segregation to social inclusion. Self-determination is a worthy aspiration, alongside more holistic approaches to health. Whanau ora is pivotal to these goals.

What, therefore, does it take for whanau ora to work? What is the cultural competency we all need to care for our own?

Cultural competency includes the notions of cultural knowledge, cultural awareness and cultural sensitivity. But the difference lies in not just knowing and being aware of the cultural basis, but actually living and operating in it.

And this, I think, is a far harder challenge for our whanau than studying up about the various disorders or states of mind.

For there is no doubt - whether it is te whare tapa wha, Te Wheke, Te Rau Matatini, Te Rau Puawai, Te Korowai Oranga - Maori structures and frameworks have proven to be consistently helpful in supporting Maori aspirations for the attainment of whanau ora.

But the crunch comes in actually applying kaupapa and tikanga Maori to the recovery process, the source for restoring the spirit.

The diagnosis of a mental health condition of a family member, can be devastating for whanau. We see fathers in tears, mothers fearing that their child will never get married, have children, hold down a job, live a meaningful, purposeful life.

The transition from a state of distress to a state of well-being relies on an act of faith that our whanau is best able to provide. It is the capability and the wellness of whanau who will provide the most significant support in aiding recovery, rehabilitation, reintegration.

The greatest opportunity for holistic health to occur is when we make the space available:

- to enhance our spiritual foundation, our wairua;

- to stimulate the metaphysical, the hinengaro;

- to engage the ngakau, our emotional strength; and

- to nurture our physical essence, our tinana.

These elements all work as one, concurrently and separately, contributing to our optimal well-being, Mauriora.

As whanau, it is our greatest moral responsibility to develop and grow these capacities in order to attain whanau, hapu and iwi empowerment.

The source of life comes through our tikanga, our whakapapa, our reo and our cultural assets - marae, whanau, hapu, iwi. The breath of life passed down from our tupuna is well cared for if our spiritual and whanau connections are healthy.

Last week, one of our team was eating lunch, when he was approached by a whanaunga who was visiting Parliament. As soon as this relation learnt he worked for the Maori Party, my staff member was asked, “So, what can YOU do for me then?”.

This type of thinking, the dependency on another to provide, must be crushed. We must do those things for ourselves, we must celebrate being Maori and not leave it to agencies, to invest in our relationships and our well-being.

My friend responded to the question by saying “the real question is, what can we do for each other?”

It is not dependency that will lead us to a state of resilience - but inter-dependence. Knowing we can turn to each other for support - recognising your joy is my joy; your grief is my grief - is absolutely what good health is all about.

It is about living the kaupapa of manaakitanga - endeavouring to build mana-enhancing relationships, through the expression of aroha, generosity, mutual respect.

It is about rangatiratanga - walking the talk, following through on commitments made, demonstrating leadership.

I’m often amused at the question - who are today’s Maori leaders? I always respond, he tangata, he tangata, he tangata. Leadership is not the reserve of the individual.

Leadership is demonstrated when our nanny’s ask - “who’s looking after this mokopuna? Where are his socks? This baby needs some fresh air”. Leadership is demonstrated when our tamariki beg us to put our work away and spend some ‘family time’. Leadership is all around us - and when it isn’t - we may need to step up to the mark; to actively generate opportunities to promote kotahitanga - the importance of building harmony and moving as one.

Leadership is about ensuring whanau are actively present in the recovery plans, that whanau are educated and empowered to ensure they can all move together into the future. If we all take on ownership of the recovery we will prevent outcomes such as whanau members only accessing mental health services through referral from the justice system; or in stage of acute distress.

We will be able to ensure that Maori access mental health services, when and how they need to.

For success to be resounding, we do of course need service providers to take on board processes that reflect our values. We need services to actively recognise the importance of whakapapa, whanaungatanga, tikanga and te reo.

And I want, here to put on record, my absolute admiration for all those in Maori Mental Health Services - for your determination and commitment to working with our people.

You have understood the importance of identity, how a person places themselves in this world, their turangawaewae. You have respected the right of rangatiratanga, controlling our destiny.

You believe in the importance of ongoing learning, to ensure your workforce provides culturally competent, appropriate, professional and quality services to whānau.

There is still much to do.

We need to ensure that whanau are participating at all levels, that mana whenua are active partners in service delivery, and that primary health organisations and DHBs will support Maori aspirations for the achievement of whanau ora through the funding and planning processes.

We must all take steps forward with confidence and with determination; knowing that our greatest strength is in whanau ora.

He maioha te whanaungatanga - the treasure of whanau. Our source of greatest joy, our biggest comfort in times of grief. Let us be united in our answer to the question - what can we do for each other? We can be there.

No reira, tena tatou katoa.

ENDS

© Scoop Media