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Ko te amorangi o ki muaKo te hapai ki muri
From chaos and confusion to navigating one’s pathway to hope and learning
T.Herewini 21.06.09 - Pscyhosis Conference - "Ko tenei te wa"
Culture
T.Herewini 21.06.09 - Pscyhosis Conference - "Ko tenei te wa"
• Beliefs & values• Competence• Time, space, meaning & assessment
T.Herewini 21.06.09 - Pscyhosis Conference - "Ko tenei te wa"
Values & Beliefs
Western Maaori-separation -integration-individuality -collective-nuclear -extended-privacy -company-disease/disorder -imbalance/breach/kehua-negative connotations -positive -medication -wairua/holistic health-viewed as disabled -gifted/spiritually in tune-words do not hurt -kanga can-respect jobs held -whakapapa, tohunga
T.Herewini 21.06.09 - Pscyhosis Conference - "Ko tenei te wa"
Psychosis - Clinical and Cultural
Western Maaori-start with diagnosis -understanding-personal dysfunction -system-psychic meaning not -symptoms informative essential for recovery-medications -external interventions-social supports -individual problems – wider dynamics-evidence based -ecological based
T.Herewini 21.06.09 - Pscyhosis Conference - "Ko tenei te wa"
Service deliveryand practice
• Policies and procedures• By Maaori for Maaori Services• Kaupapa Maaori Services• Taha Maaori Services• Mainstream Services with Maaori staff
• Bicultural, clinical and best practice
Ko Manawanui te wharenui
Ko Whatua Kaimarie te whenua
Ko Ngati Whatua te manawhenua
Nga tohu o tou aroha
E oranga mo apopo
T.Herewini 21.06.09 - Pscyhosis Conference - "Ko tenei te wa"
T.Herewini 21.06.09 - Pscyhosis Conference - "Ko tenei te wa"
Service Strengths
• History 1970s-current• Oranga Harakeke• Takarangi Framework• Service specific cultural assessments• Katahi Ora• Liaison• PA- wellness form• Maaori therapeutic programmes
• Kapa haka• Mau taiaha• Hauora tinana• Incredible Years• Ahu whenua• Wahine Toa Ataahua • Maori oke • Open Employment• Art Therapy• Hearing voices
Maaori TherapeuticProgrammes
T.Herewini 21.06.09 - Pscyhosis Conference - "Ko tenei te wa"
T.Herewini 21.06.09 - Pscyhosis Conference - "Ko tenei te wa"
Maaori Models of Health
• Te Powhiri poutama• Te whare tapa wha• Te wheke• Dynamics of
whaanautanga• Te Pounamu• Te Pae Maahutonga• Rangi matix• Service specific models• Lots more
Te whare tapa wha
• Understanding health & wellbeing• Address health problems• Framework for measuring health outcomes• Evaluate Maaori wellbeing• Four dimensions of health
T.Herewini 21.06.09 - Pscyhosis Conference - "Ko tenei te wa"
Te Whare tapa wha
Taha wairua
T.Herewini 21.06.09 - Pscyhosis Conference - "Ko tenei te wa"
• Connection to the natural environment• Empathy & understanding• Code for living – tikanga• Cultural identity• Capacity for spiritual engagement
Taha Hinengaro
T.Herewini 21.06.09 - Pscyhosis Conference - "Ko tenei te wa"
• Emotions• Intellect• Behaviour• Communication•World views
Taha Tinana
T.Herewini 21.06.09 - Pscyhosis Conference - "Ko tenei te wa"
•Mobility•Distress• Fitness• Level of risk•Development
Taha Whaanau
T.Herewini 21.06.09 - Pscyhosis Conference - "Ko tenei te wa"
• Relationships• Social engagement• Support to others•Dependency• Participation with whaanau
T.Herewini 21.06.09 - Pscyhosis Conference - "Ko tenei te wa"
Hua Oranga
• Wairua tikanga, respect, identity te reo, relationship te reo, environment envir management
Hinengaro education, occupation social outcomes, mental wellbeing risk taking
Tinana mobility, fitness, sport Height, weight, BP pain, blood
Whaanau intergenerational relationships capacity to care social cohesion
T.Herewini 21.06.09 - Pscyhosis Conference - "Ko tenei te wa"
Hine’s thoughts
Worst things “Confusion” “Didn’t know why I was there” “Getting offers to work with Maaori MH staff when I did not understand what was going on for me” “Given and injection and it was not explained why” “It hurt, I was mystified” “I would prefer a few mad or manic days, weeks or months than the 20kg I put on in one year”
T.Herewini 21.06.09 - Pscyhosis Conference - "Ko tenei te wa"
Hine’s thoughts
Best things “Making friendships at Manawanui” “Meeting people on similar level” “When I was going to Kapa haka and Mau tiaha it meant I could mix and mingle” “Having keyworkers that help with day to day stuff not the psychological” “Access to some free interventions” (medication, dietician, AOD, groups) “I have a choice whether I use them or not”
Ruia te kakaano o te tumanako ki roto i te maara o te hinengaro
“Aspire, perspire, inspire, expire”
T.Herewini 21.06.09 - Pscyhosis Conference - "Ko tenei te wa"