I recently finished reading the book Collaborative and Indigenous Mental Health Therapy: Tātaihono – Stories of Māori Healing and Psychiatry by Wiremu NiaNia, Allister Bush, and David Epston. It was a fascinating read about how traditional Māori healing and clinical psychiatry are not necessarily binary (see last week’s blog). NiaNia is a Māori healer who worked closely with Pākehā psychiatrist Allister Bush to aid troubled Māori patients through their spiritual issues—issues that are often deemed psychotic, and dealt with as such.
As a background to Māori mental health, a recent report by the Mira Szászy Research Centre (Hēnare, Lythberg, Nicholson, Horan, Longmuir, & Peni, 2017) found:
- Māori make up 60% of the patient population in psychiatric institutions
- Māori are 3.5 times more likely to be hospitalised for schizophrenia than non-Māori
- Despite higher needs, Māori are low users of early mental health services (stemming from a reduced access to services and a lack of culturally appropriate services)
The measurement and assessment of mental health constructs and psychological tests are based on Western or monocultural assumptions, standards and norms that exclude or disempower the importance and relevance of Māori cultural values (Durie, 2001; Johnstone & Read, 2000; Taitimu, 2008). Cohen (2014) surmises that the Māori statistics of mental illness has become an institutionalised pathology that assumes an inherent vulnerability to such disorders.
Long story short – Māori are overrepresented in the mental health statistics. The usual tragic result of colonisation, intergenerational trauma, unconscious bias, and inherent racism. I was part of the research team and it was quite a depressing literature review to be involved with. However, along this journey I came across an article by NiaNia that outlined his traditional—seemingly radical—methods of dealing with Māori spiritual issues. Since then I had been looking forward to reading this book.
When I finally got my hands on this book, I found the stories shared were sad, hopeful, and heart-warming all at once. The stories are told from all perspectives—NiaNia, Bush, as well as the patient and whanau—giving a more fulsome account. Bush provided a clinical lens, NiaNia a spiritual one, and the person directly affected shared their experience. The different perspectives was a refreshing format and made the stories more interesting and intimate. Those directly affected were given a voice, which is often not the case, and the language was easy to read, but littered with the academic/professional lens that Bush provided. This book gave me hope that had been hard to find when sifting through the gloomy statistics.
What I find so uplifting in these stories is that there are services out there working within Māori cultural frameworks. It is not a completely dire situation. Bush, as a Pākehā psychiatrist, has a very open mind and embraces Māori healing. He defers to NiaNia where necessary, and NiaNia’s role is to whakamana i te tangata, i te whānau. If only this could be integrated into all places, over many professional fields.
There is still a lot more work to be done, a lot more people to educated, services to establish, and Māori to graduate into these roles. But there is a pathway. This book is a reminder that we can make a difference, and that there are people paving the way. It may be a long journey, but it is one step at time. Sometimes I think we all need these stories to be reminded of that.
Check out Wiremu NiaNia’s webpage here: https://www.wiremuniania.co.nz/
NiaNia, W., Bush, A., Epston, D. (2017). Collaborative and Indigenous Mental Health Therapy: Tātaihono – Stories of Māori Healing and Psychiatry. Routledge
Hēnare, M. Lythberg, B. Nicholson, A., Horan, J., Longmuir, K., & Peni, T. (2017). Understanding cultural drivers that impact on health disparities for Māori in Aotearoa-New Zealand. Report prepared for Janssen NZ by Mira Szászy Research Centre, University of Auckland Business School.