Mahi a Atua: A Māori approach to mental health

Abstract

Māori are the indigenous people of Aotearoa New Zealand. European colonisation had a devastating effect on their communities and their way of life. While there is some evidence of a renaissance of Māori culture in recent years, like other indigenous people across the world, they continue to be massively overrepresented in their country’s figures for poor mental and physical health. In this paper, we briefly review the literature on the Movement for Global Mental Health and review the case that has been made for the use of indigenous psychologies in place of approaches based on Western psychiatry and psychology. We present two case histories where an intervention based on an indigenous Māori approach to negotiating emotional conflicts and dealing with mental health problems was used. This approach, called Mahi a Atua, was developed by two of the authors over a number of years. We conclude that indigenous approaches to mental health offer not just an adjunct to, but a real alternative to, the interventions of Western psychiatry. They provide a framework through which individuals and families can negotiate their journeys through mental health crises and difficulties. However, such approaches can also work on a socio-cultural level to promote a positive identity for indigenous communities by celebrating the power of indigenous deities, narratives, and healing practices that were marginalised and suppressed by the forces of colonisation.

Staff perceptions of the quality of care delivered in a New Zealand mental health and addiction service: Findings from a qualitative study

“…Recent qualitative research exploring effective and culturally appropriate care for Māori SMHAS users, particularly those with bipolar disorder, has shown the importance of incorporating te ao Māori, tikanga Māori (customs/ protocols), and involving whānau (family) in service delivery for Māori SMHAS users (Haitana et al, 2022a(Haitana et al, , 2022b(Haitana et al, , 2023Staps et al, 2019); approaches/elements which the 'medical model' has been described as incongruent with (Bush et al, 2019;Durie, 2011;Graham & Masters-Awatere, 2020;Haitana et al, 2022aHaitana et al, , 2022bStaps et al, 2019). Reports from some participants of an absence of Māori models of care in their workplace, suggests that increased utilization of Māori health models and clinical practice frameworks, such as Kaupapa Māori frameworks (Haitana et al, 2022a), Te Whare Tapa Whā (Durie, 1985), the Meihana model (Pitama et al, 2007), Te Ara Waiora a Tāne (Bush et al, 2019) and Mahi a Atua (Kopua et al, 2020), may be an important step in improving the quality of care for Māori SMHAS users. However, in order for the true benefits of this model/framework shift to be realized, there must also be adequate staff resourcing; previous research has indicated that high caseloads and short consultation times often lead clinicians to revert back to mainstream practices (Kopua, 2019).…”

Indigenous approaches to perinatal mental health: a systematic review with critical interpretive synthesis

“…This approach also addresses the discord between the dominant biomedical system and the beliefs and perspectives of Indigenous peoples, promoting engagement with services (Sylliboy and Hovey 2020), Liebenberg et al 2022). Re-engagement with Indigenous cultural and healing practices develops resilience and strength (Kopua et al 2020) and can contribute to supporting better outcomes.…”

The buddy bench and beyond: Exploring complexity-informed approaches to wellbeing education

“…Commentators often espouse 'universal claims' around successful positive education programmes based on Western assumptions, values, and contexts (Kern et al, 2020). The historical one-way flow of Western 'expertise' needs to shift to an environment that respects and values indigenous knowledge (Maree Kopua et al, 2020). In Aotearoa New Zealand, education policy and practice seeks to embrace indigenous perspectives on holistic wellbeing promotion: "Students' wellbeing is strongly influenced by ... where they come from, what they value and what they already know" (Ministry of Education, 2013, p. 17).…”