Finding recovery and hope the Maori way.

Huritea te rito o te harakeke Kei hea to kodmako e ko Ki mai ki ahau He aha te mea nui o tenei ao Maku e ki atu He tangata, he tangata, he tangata! Mauri ora.

When someone has a mental illness, it affects their family, friends, employers and communities. As a mental health worker or mental health nurse, you may have asked yourself many times whether your work is really necessary. The answer is, of course, "very". The education, support, advocacy and care mental health workers offer to people affected by a mental condition are vital.

Some of the key qualities we carers need are resilience, a passion and compassion for people, an ability to think outside the square in order for innovative ideas to emerge, and being able to create a balance between one's work and life outside work. In Maori, we call this ahi kaa--keeping the home fires burning.

During the 1996 Mason Report inquiry into mental health services, (1) it became apparent that mental health consumers/tangata whaiora who had received treatment in large psychiatric institutions were often labelled misfits by communities because of their illness. One of the outcomes of this report was the Ministry of Health's Like Minds Like Mine campaign, launched in 1997. This originated from the Mental Health Consumers' Forum and was designed to reduce the stigma and discrimination of mental illness. This project was to be consumer-led, a vision never fully realised.

The aim of this innovative campaign was to raise awareness that mental illness is a common condition, affecting one in five New Zealanders. The new media approach saw celebrities "coming out of the closet" and admitting to the nation they had a mental illness. "Know me before you judge me" was the campaign's catch phrase. People began to pay attention, and accepted that friends and neighbours with mental health conditions were ordinary, everyday people who had to deal with extraordinary circumstances. Education programmes were developed locally and regionally to address issues of stigma and discrimination. These programmes sought to change attitudes towards people who have had, or continue to experience a mental condition.

One area where awareness and education are making a significant difference is within Maori whanau and communities. As Maori continue to strive towards reclaiming their traditional wellness methodology, there is a noticeable increase in self-empowerment--tino rangatiratanga--for all involved in the learning process. The catalyst for this change has been language. The ongoing resurgence of te reo Maori and the increase of Maori health workers have opened the way for more Maori affected by mental conditions to express themselves. So too, has the use of words and phrases that specifically relate to health and wellness: words like awhi, manaaki and tautoko that have a deeper meaning for Maori working towards their individual well-being. Words that at one time people tended to shy away from, eg stress relief, needs, depression, manic, highs and lows, are now not so scary to use or talk about.

Taking the indigenous message abroad

In 2005, while I was a co-ordinator for the Like Minds Like Mine project for an iwi health provider, a group of us had the privilege to be invited to speak at the National Empowerment Centre Alternative Conference in Phoenix Arizona. For many of the participants, it was the first time they had been out of New Zealand. We spoke about recovery our way--the Maori way--and what culture means for indigenous people in our journey to physical, spiritual, mental and social health. Culture, for us, identifies a process of well-being and wholeness that reconnects us to whakapapa, our identity, to our land, our turangawaewae, our spirituality, making us who we are today. Our experiences were recorded in a documentary Ko Whanganui Te Awa, which screened on Maori TV last October. Towards the end of 2006, Progressive Party leader Jim Anderton launched a depression awareness campaign that saw a new batch of television commercials and media advertisements aimed at increasing public awareness around depression. The message was "there is hope".

Finding what works for Maori

The frustrating part of any new initiative is assessing whether it meets the needs of Maori. Different population groups have particular approaches to well-being. Maori have a unique approach to well-being and a methodology that is unique in its multi-dimensional incorporation of tangible, intangible, physical and metaphysical effects and manifestations. Cultural trainer Amster Reedy referred to some of these traditional Maori philosophies in his address at the Te Runanga annual general hui last month (see p23).

I have had the privilege of observing Maori whanau appropriate more effective strategies--in contexts that many would consider too desperate for any process to be effective--and they've made them work, often reassessing and modifying them to meet needs in their particular environments. They have made them work because anything less would have resulted in the toss of someone they loved, someone who shared their whakapapa, or whose whenua had been returned to the same marae, or who had helped them. It is not acceptable that anyone be lost. Afterall, the most important thing of all is people, people, people.

Reference

(1) Mason, K. H. (chairperson) (1996) Inquiry under s47 of the Health and Disability Services Act 1993 in Respect of Certain Mental Health Services: Report of the Ministerial Inquiry to the Minister of Health Hon Jenny Shipley. Wellington: Ministry of Health.

Manny Down, Cert mental health, has been a mental health worker since 1985. For the last four years he has been an educator and co-ordinator for the Like Minds Like Mine project in iwi health. He has also been a tutor in mental health at the Universal College of Learning in Wanganui. Last month, he became an NZNO organiser, based in the Palmerston North office.