Objective: Lifetime prevalence rates in Te Rau Hinengaro (The New Zealand Mental Health Survey) suggest eating disorders are at least as common in the M aori population as the non-M aori population, yet little is known at a population level about those accessing specialist mental health treatment for eating disorders in New Zealand. The aim of this study was to describe the population undergoing specialist mental health treatment for eating disorders and compare M aori and non-M aori clinical characteristics and service use. Method: This study uses the Programme for the Integration of Mental Health Data data set, managed by the New Zealand Ministry of Health to describe the characteristics of people with eating disorders and their use of specialist mental health services from 2009 to 2016. Results: There were 3,835 individuals with a diagnosed eating disorder who had contact with specialist mental health services in this time period, 7% of whom were M aori. Within the cohort, M aori had a higher prevalence for a bulimia nervosa diagnosis, fewer diagnosed with anorexia nervosa, and a higher prevalence of other psychiatric comorbidity than non-M aori. Discussion: There is discrepancy between the proportion of service users accessing specialist mental health services who are M aori and the assessed crude prevalence of eating disorders for M aori in national estimates. Once M aori are in specialist services; however, their use of services is comparable to non-M aori. Further research is needed to highlight the experiences of those M aori with eating disorders and address barriers to accessing services for M aori with eating disorders.

Although the demand for aged residential care increases, low use of aged residential care by Indigenous people raises questions about unrecognised barriers to health care. The objectives of this systematic literature review are to (a) examine current scientific literature that reports older Indigenous people’s experiences in aged residential care and (b) describe critical factors that shape Indigenous people’s preferences in aged residential care settings. We conducted a systematic review of studies using an online search of the literature. A total of 6,233 citations were retrieved, and 45 studies examined in full-text. Eight studies met the study inclusion criteria. Indigenous older people were found to be younger, had higher prevalence of complex health conditions, and were less likely to receive dental and mental health services on admission to aged residential care. Their preferences for care were more likely to be evident in aged residential care facilities where the Indigenous composition of staff reflected the Indigenous makeup of its residents.

Background Eating disorders (ED) can have profound effects on family members and carers. These impacts can be experienced across multiple domains and may contribute to the maintenance of ED symptoms. In the absence of any New Zealand studies quantifying this, and given country-specific differences in access to care and treatment, this study explores the psychosocial and economic impacts on those caring for someone with an ED in New Zealand. Methods Carers (N = 121) of those who had, or still had, a self-reported ED (82.6% anorexia nervosa) completed an online survey open between December 2016 and October 2020, adapted to the New Zealand context. Questions addressed ED recency and recovery status of the individual cared for, treatment access, and the financial and psychosocial impact on the carer. Data analysis included descriptive statistics, with financial cost data converted to the equivalent of 2020 New Zealand dollars. Results Most (88.6%) recruited carers reported still caring for someone with ED symptoms of varying severity. A majority reported difficulty accessing treatment for the person they cared for, with a sizable minority (45%) paying for private treatment, despite few having private insurance. Carer losses typically included reduced income and productivity, travel costs, and other miscellaneous costs. Carers reported significant psychosocial impacts across a range of dimensions including family life, interpersonal relationships, and their own personal well-being. Conclusions Carers in New Zealand report impacts which are far reaching and longstanding, covering their own personal and interpersonal well-being and that of those around them. While most of those they care for get access to public (free) treatment at some time or another, the wider financial and economic impacts on carers are significant, and likely to take years to recoup. Though not unique to EDs, interventions and supports for carers are much needed in New Zealand, alongside more comprehensive research methodology to further determine positive and other impacts of EDs over the long course of the caregiving role. Highlights A majority reported difficulty accessing treatment for the person they cared for 45% paid for private treatment, despite few having private insurance Carers reported reduced income and productivity, travel costs, and other costs. Carers reported significant psychosocial impacts on family life, interpersonal relationships, and their own personal well-being. Carers provide a pivotal role in supporting treatment and recovery in their family member with the These findings will be relevant for funders and service providers in developing further approaches to address barriers and gaps in service provision to reduce impacts on carers, and as a result, those with eating disorders.

There are differences between research that is performed in an Indigenous setting using Western methodologies and research performed using Indigenous methodologies. Kaupapa Māori research provides opportunities for Māori, the Indigenous people of New Zealand, to participate in and influence research agendas and processes while providing a platform for Māori to contribute to empirical knowledge about Māori peoples. Using the central tenets of whakawhanaungatanga (Māori process of establishing relationships), this article discusses and explains why kaupapa Māori research is well suited to explore the experiences of older Māori in aged residential care in New Zealand. To do this, the theoretical and methodological framework of kaupapa Māori research is discussed.