Ko te amorangi o ki mua Ko te hapai ki muri From chaos and confusion to navigating one’s pathway...

Ko te amorangi o ki muaKo te hapai ki muri

From chaos and confusion to navigating one’s pathway to hope and learning

T.Herewini 21.06.09 - Pscyhosis Conference - "Ko tenei te wa"

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Culture


• Beliefs & values• Competence• Time, space, meaning & assessment


Values & Beliefs

Western Maaori-separation -integration-individuality -collective-nuclear -extended-privacy -company-disease/disorder -imbalance/breach/kehua-negative connotations -positive -medication -wairua/holistic health-viewed as disabled -gifted/spiritually in tune-words do not hurt -kanga can-respect jobs held -whakapapa, tohunga


Psychosis - Clinical and Cultural

Western Maaori-start with diagnosis -understanding-personal dysfunction -system-psychic meaning not -symptoms informative essential for recovery-medications -external interventions-social supports -individual problems – wider dynamics-evidence based -ecological based


Service deliveryand practice

• Policies and procedures• By Maaori for Maaori Services• Kaupapa Maaori Services• Taha Maaori Services• Mainstream Services with Maaori staff

• Bicultural, clinical and best practice

Ko Manawanui te wharenui

Ko Whatua Kaimarie te whenua

Ko Ngati Whatua te manawhenua

Nga tohu o tou aroha

E oranga mo apopo



Service Strengths

• History 1970s-current• Oranga Harakeke• Takarangi Framework• Service specific cultural assessments• Katahi Ora• Liaison• PA- wellness form• Maaori therapeutic programmes

• Kapa haka• Mau taiaha• Hauora tinana• Incredible Years• Ahu whenua• Wahine Toa Ataahua • Maori oke • Open Employment• Art Therapy• Hearing voices

Maaori TherapeuticProgrammes



Maaori Models of Health

• Te Powhiri poutama• Te whare tapa wha• Te wheke• Dynamics of

whaanautanga• Te Pounamu• Te Pae Maahutonga• Rangi matix• Service specific models• Lots more

Te whare tapa wha

• Understanding health & wellbeing• Address health problems• Framework for measuring health outcomes• Evaluate Maaori wellbeing• Four dimensions of health


Te Whare tapa wha

Taha wairua


• Connection to the natural environment• Empathy & understanding• Code for living – tikanga• Cultural identity• Capacity for spiritual engagement

Taha Hinengaro


• Emotions• Intellect• Behaviour• Communication•World views

Taha Tinana


•Mobility•Distress• Fitness• Level of risk•Development

Taha Whaanau


• Relationships• Social engagement• Support to others•Dependency• Participation with whaanau


Hua Oranga

• Wairua tikanga, respect, identity te reo, relationship te reo, environment envir management

Hinengaro education, occupation social outcomes, mental wellbeing risk taking

Tinana mobility, fitness, sport Height, weight, BP pain, blood

Whaanau intergenerational relationships capacity to care social cohesion


Hine’s thoughts

Worst things “Confusion” “Didn’t know why I was there” “Getting offers to work with Maaori MH staff when I did not understand what was going on for me” “Given and injection and it was not explained why” “It hurt, I was mystified” “I would prefer a few mad or manic days, weeks or months than the 20kg I put on in one year”


Hine’s thoughts

Best things “Making friendships at Manawanui” “Meeting people on similar level” “When I was going to Kapa haka and Mau tiaha it meant I could mix and mingle” “Having keyworkers that help with day to day stuff not the psychological” “Access to some free interventions” (medication, dietician, AOD, groups) “I have a choice whether I use them or not”

Ruia te kakaano o te tumanako ki roto i te maara o te hinengaro

“Aspire, perspire, inspire, expire”


Ko te amorangi o ki mua Ko te hapai ki muri From chaos and confusion to navigating one’s pathway...

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