Why New Zealand’s Mental Health System Needs Te Ao Māori to Fix Itself
Illustration: Ben Thomas
Health

Why New Zealand’s Mental Health System Needs Te Ao Māori to Fix Itself

As New Zealand launches an inquiry into its beleaguered mental health system, some mental health workers and consumers are saying the answers are on our doorstep: in traditional Māori strategies for mental health.
December 21, 2017, 2:39am

On the corner of the road, Selwyn Vercoe is stirring a coffee at The Station. A local bar built like an old railway carriage, it’s favoured by bar workers and chefs when they knock off shifts. The barman knows him, knows his coffee comes with two sugars. Selwyn also knows the DJ, who has him step beside the desk for a quick selfie. Across the road, he pops his head into the Karangahape Road business association to say hello, then checks through the window of the hairdresser’s next door where he’s negotiated to hang up-and-coming artists’ work. Vercoe, an artist and curator, is a familiar face here. He’s loosely known as the ‘Kaumātua of K-Road’.

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One week ago, he marched along this road in the hikoi against development of sacred lands at Ihumātao. The hikoi was made in honour of Hape, one of the first ancestors to arrive from Hawaiki.

As the march progressed along the road, one of Hape’s descendants told his story through a megaphone. The tale of Hape is that his feet were clubbed, and he was not considered able enough to make the long journey to Aotearoa. The waka left before he woke and left him behind, but he sent up a prayer and was sent a stingray to carry him to the new land. He arrived before the first waka, and standing on the ridge above the harbour, sung out a blessing—a karanga—to greet them. Hape’s name can be directly translated as ‘club footed’, but also rejected or left behind. The road along the ridge is named for Karangahape: a man who had been discounted, but came to offer great spiritual strength and mana to his community.

Today, as New Zealand reckons with devastating, difficult-to-shift statistics around youth suicide and depression, Selwyn says it’s time to start to paying attention to the tikanga Māori ways of doing things: the ways that, for a long time, were quashed and dismissed.

“Colonisation and that, they broke our structures. Te Whare Tapa Whā, it wasn’t applied in the homes and that’s where the dysfunction comes from,” he says.

On the bar’s table, he sketches out the four dimensions of Te Whare Tapa Whā: like the four walls of a house, the four dimensions of spiritual, physical, family and mental health must be balanced for it all to hold up. “The kids now might have mate hinengaro—mental sickness, or anxiety. Or whakamā—shame. We teach them kia kaha—to stand strong. Overcome fears, and to build mana. That’s how we change things”

Selwyn Vercoe and some of his art. Image by Michael Duignan.

As the New Zealand government begins its inquiry into the state of the mental health system, a cohort of professionals, artists, activists and community workers say learning from New Zealand’s indigenous traditions is one of our best hopes for solving the problems of the present and future.

New Zealand’s poor rates of mental health and devastatingly high suicide rates stretch across social lines, and affect Māori, Pākehā, Pacific nations and Asian communities. But in almost all categories, Māori are disproportionately hit.

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The trend is global: in the United States, for example, indigenous young people commit suicide at a rate 17 times the US average. Recent research has found land confiscation and development affects indigenous communities in ways that stretch far beyond the immediate loss of resource. In the United States, for example, research indicates that development of indigenous land for oil pipelines resulted in increased rates of suicide, domestic violence, diabetes and substance abuse among the land’s traditional guardians. Similarly, in Canada, even when development of indigenous lands brought more money into the community, it resulted in negative social impacts, including a higher rate of violence against women and children.

The impact of colonisation has a long arm. Studies of the impact of intergenerational trauma on Māori notes that the health effects of traumatic events and social breakdown are often observable several generations down the track, and exposure to trauma had long-lasting health effects, including higher rates of heart disease, diabetes, cancer, and poor mental health.

Other research indicates possibilities for how historic trauma can be passed down through generations: a small study of Holocaust survivors and their children in 2015, for example, found that parents exposed to extreme stress and trauma during the Holocaust actually experienced changes to their genetic makeup—and those changes were passed on to their children. The children of Holocaust survivors were also found to suffer a higher rates of anxiety or stress disorders.

Selwyn Vercoe at The Station on K Road. Image by the author.

Selwyn says rediscovering his heritage through artwork is what drew him out of a cycle of mental illness and drug abuse. He began practicing as an artist just three years ago, discovering art therapy when in rehab to kick a decade-long methamphetamine habit. The drug habit triggered mental health issues, including depression and anxiety—and discovering art and tikanga Māori health model Te Whare Tapa Whā has been key to his recovery.

“That’s what art has done for me it’s helped me to reconnect to my cultural identity, to learn about other cultures, and to keep all of those things in balance,” he says.

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Beyond his own recovery, Selwyn now works to pass on what he’s learned. He’s worked mentoring young people through Nga Rangatahi Toa, a programme that matches talented youth with high-profile artists in their field. For the past three yours, he’s curated People of Karangahape Road, an exhibition that brings together artists of 32 ethnicities and their artwork. He works to place more prominent, famous artists alongside newcomers, to give them a foot in the door.

One of the themes, he says, is taking pride in heritage. “That means our own values, our own ethics.”

"The big problems kids are facing is that our families aren’t as healthy as they should be. Families were the cornerstone of our traditional Māori values, and if the families are not healthy or supported enough, then the problems can get passed down generation to generation.”

Petrus Blokker-King practices mau rākau at a class in Christchurch

Petrus Blokker-King is in his second year of high school. He lives in Christchurch, where communities are still feeling the aftermath of earthquakes of 2010 and 2011. The city has some of the lowest rates of youth wellbeing, and highest rates of youth deprivation and mental illness in the country.

A lot of kids had to move around when schools in Christchurch were shut down because of the earthquakes, he says. “So we’ve been kind of jumping from school to school.”

“My parents have tried to keep me in schools that support like, Māori language and lifestyle and all of our traditional values.” He is quietly-spoken, startlingly articulate, reflective in a way you don’t always associate with fourteen-year-old boys.

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“The big problems kids are facing is that our families aren’t as healthy as they should be,” he says. “Families were the cornerstone of our traditional Māori values, and if the families are not healthy or supported enough, then the problems can get passed down generation to generation.”

By re-grounding kids in their way of life, and connection with their ancestors, he believes you can start to fix things. King goes to Te Pā o Rākaihautū, a local Māori immersion school, and is a member of three different mau rākau programmes, where he’s taught the ancient art of Taiaha—a martial art based on indigenous weaponry—as well as tikanga Māori values and skills for mental health. Every week, you can find groups of kids practicing in the halls, spinning their weapons.

“Taiaha is a really cool art, but we use it as a vessel—to show values, to build character,” he says. “Programmes like this get our people back together, they show people that there is a better future out there than jail and poverty.”

Community and whānau worker Rudolph Diaz is King’s teacher, and has been working with the schoolkids over the past year. He says the value of the programme is that they embrace the whole person and seek to build a community, rather than just focusing on diagnosis and symptoms of illness. He says he’s watched it build kids’ mental health and resilience.

“At a lot of mental health practitioners and agencies, we all focus on the physical outcomes of the mental health and using the physical things [like medication] to put down somebody as remedy,” he says - “Which helps sometimes, but most of these times and cases there is a need for connection, for caring, you know caring is actually a cure.”

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The mau rākau is a vehicle, he says, to provide that connection and a closer connection to Te Ao Māori, to the ancestors their weapons are named for.

“Even though others may look and think we’re just doing this Māori martial arts movement, actually there is a spiritual connection to that, not just physical. We are also doing the mental health fight.”

And it works, King says. “I think they have changed my life, and they have changed other kid’s lives.”

“Even though I haven’t had so much of a bad life, as other kids with poverty or gangs and stuff, I definitely think my mindset has changed from what it used to be. My life choices have been switched into—will this benefit me? Will this benefit my culture? Will this respect and pay homage to my ancestors?”

"If you use the tools from the Māori and Pākehā you will be more likely to succeed. So I think having a mix of both whānau and we all come together, that’s how we can push each other out of these bad situations.”

Today, he believes those working in government and the mental health system should look at what’s working. “A lot of government and and influential people are looking for ideas, like what can we implement to fix these problems and all that.”

Māori have been discussing this kaupapa for a long time, he says, and now they can share that knowledge. It’s time to show people that “this is definitely a good way of fixing these problems, and I think that’d be really beneficial for New Zealand, for all of the families, Māori and Pākehā, and all the kids.

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“There’s that quote from Sir Apirana Ngata, that if you use the tools from the Māori and Pākehā you will be more likely to succeed. So I think having a mix of both whānau and we all come together, that’s how we can push each other out of these bad situations.”

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Earlier this year, a study published today in the New Zealand Medical Journal found while Māori and Pacific communities had the highest rates of depression and anxiety in the country, they were diagnosed far less than those of other ethnicities.

The authors concluded that there was “an ethnic inequality in diagnosis". Their research comes on the same week as a United Nations report into mental health units, which found Māori were secluded four times more often than non-Māori, and for longer periods. It was published on the same day as a study that finds young Pacific men are among the most at risk in the country of suicide.

Shaun Robinson, chief executive of the Mental Health Foundation, told VICE that "Institutional racism is prevalent in New Zealand and continues to form barriers to Māori and Pacific Islanders accessing the care they need."

He called for the integration of pōwhiri, karakia, mihimihi and kai into the mental health system. "We know these practices are effective and useful," he says. "The presence of Māori and Pacific Islander staff, appropriate cultural assessment and the fostering of tino rangatiratanga for tangata whaiora and their whānau can help to reduce these inequalities."

Mary O'Hagan

"We need to use that very holistic, nurturing, collective worldview when we’re designing these systems and we’ve got it right on our doorstep.”

But introducing tikanga to mental health isn’t just helpful to Māori, mental health campaigners say. Pākehā also stand to benefit from more holistic, community-focused models of care.

Mary O’Hagan, a mental health activist, expert and consumer, says the existing system is too medicalised, too focused on psychiatry and diagnosis, rather than building an community model of care.

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“The tragic thing is, if you're Māori, you're more likely to be using [mental health services]. And if they’re alienating and not helpful for me as a Pākehā, it’ll probably have double that effect if you’re Māori. We need to use that very holistic, nurturing, collective worldview when we’re designing these systems and we’ve got it right on our doorstep.”

O’Hagan is a mental health advocate who has seen the system from both sides of the fence. She was institutionalised a number of times in her 20s, but has since spent her life managing her mental health outside the hospital system, and advocating for others attempting to do the same. She sits in the offices of PeerZone, a Mental Health peer-support organisation in Wellington. The meeting room wall is covered with an enormous mural of a wharf, stretching out toward the horizon. Her hair is cut into blunt white bob and she is a straight-forward, unapologetic talker. “My background is, of course, someone who’s used mental health services,” she says. “So I probably come with a different lens than someone who went to nursing school or medical school. You come out with a different sort of worldview.”

O’Hagan has worked in mental health advocacy for more than 20 years, fighting especially hard for patient rights and centring mental health consumer’s own experiences and autonomy. But now she’s tired of battling for incremental change in the system. It’s time to re-imagine it completely.

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“It’s very easy to say what’s wrong with something,” she says. “It’s much harder to construct a better system or a better way of responding.”

But New Zealand is lucky, she says, in that we already have models of more integrated, holistic community care available to learn from: tikanga Māori.

"The crux is that we don’t need a better mental health system, we need a community well-being system”

Back when O’Hagan was being hospitalised with a mental health diagnosis, the system had little to offer beyond “pills, pillows and psychiatry,” she says. Now, she’s advocating for a system that takes psychiatry out from the centre of mental health, and makes it just one spoke in the wheel of community-based care.

“The crux is that we don’t need a better mental health system, we need a community well-being system,” she says.

Her latest project has been in drafting a ‘community wellbeing manifesto’ of changes to the system. It includes re-allocating resources to support people experiencing mental distress while they’re in the community, and offering more holistic support—help with accommodation, education, job-hunting, social support and community integration.

“All of this has a lot of resonance with Māori cultural approaches—it’s about being connected with your community, it's about a holistic approach that does not privilege the medical approach but gives equal credence to the mind, the spirit the social context as well as the physical.

“I believe that we need to use a Māori worldview in helping us design these type of systems.”
“It’s not just helpful to Māori, but everyone.”

Need to talk?
Free call or text 1737 any time for support from a trained counsellor
Lifeline – 0800 543 354 or (09) 5222 999 within Auckland
Suicide Crisis Helpline – 0508 828 865 (0508 TAUTOKO)
Healthline – 0800 611 116
Samaritans – 0800 726 666

This series was made with help from Like Minds Like Mine and the Mental Health Foundation.

Follow Tess on Twitter: @tessairini