New Māori health model developed

A "ground-breaking" new Māori-centred approach to mental health has been created by researchers, and there are hopes it will soon be piloted around the country.

Funded by the Oakley Foundation, researchers from Te Whatu Ora Health New Zealand Southern (HNZS), Auckland University of Technology, University of Waikato and the University of Otago have developed "Pou Herenga" — a health model to ensure the cultural differences and needs of Māori mental health patients will finally be taken into consideration.

Co-author and University of Otago Hazel Buckland chair in psychological medicine Prof Paul Glue said psychiatric advance directives (PADs) were used to increase mental health patients’ autonomy and engagement in care to ensure the treatment provided was aligned with their preferences.

However, cultural backgrounds had an impact on what people wanted from a PAD; and that differed greatly between Māori and Pākeha.

"While Pākeha emphasise the individual over the collective, the opposite is true for Māori.

"The most important factor for Māori patients was the inclusion of family and friends in decision-making around PAD creation and use, which goes against current mental health legislation.

"Surprisingly, virtually no-one has studied cultural factors of mental health assessments, clinically or academically, which is particularly concerning given how Māori are known to disproportionately experience coercive mental healthcare, suffer inequity in decision-making about responses to their mental distress and have limited opportunities to seek mental health support that incorporates Māori knowledge and values."

Based on input from Māori mental health clinicians, service users and their families, the researchers created a culturally specific, tikanga-informed conceptual model, which they hoped to pilot soon.

Co-author and University of Otago psychological medicine senior research fellow Jessie Lenagh-Glue said the research was "ground-breaking".

"Up until we embarked on this work, there was nothing in the sector that took into consideration cultural differences and needs."