Emma's in Tairāwhiti, where "by Māori for Māori" has the potential to be more than just a slogan in healthcare.
For this episode of Getting Better, we've stepped outside of day to day medical school training to go to Tairāwhiti where there's a higher proportion of Māori than anywhere else in Aotearoa. With Māori making up 48% of the population, it's one of the strongholds of our language. It also has one of the lowest life expectancy rates for Māori at just 69 years of age compared with 81 years for the general population. Suicide rates here are about double the national average. But with four Māori providers active in the rohe, "by Māori, for Māori" has the potential to be more than just a slogan here. The innovative approaches to mental health in particular singles this region out as the home of some of the most promising indigenous-led services to address our most intractable issues.
By Emma Espiner and Noelle McCarthy
On a winter's day last year, we visited Te Kura Huna, a whare wānanga in downtown Gisborne where Ngāti Pōrou psychiatrist Dr Di Kopua introduced us to Mahi a Atua, the mātauranga Māori-based approach to mental health, based on Pūraku that she's developed with her husband, tohunga tā moko Mark Kopua. Dr Kopua explains: "First and foremost, my identity is as a Ngāti Pōrou woman. But that will never take away the fact that I'm a psychiatrist. I worked really hard to get that tohu, and create change. I can always be a psychiatrist, whether I work in the DHB whether I continue to diagnose or prescribe or seclude, or put people under the Mental Health Act, none of those behaviours or behaviours that any psychiatrist wants to do, but the system has perpetuated it for so long. So all of these things that I'm saying don't make me less of a psychiatrist, but they do speak from a Ngāti Porou woman's voice."
Speaking from that voice has led to Mahi a Atua, a way of looking at family dynamics through a wholly indigenous lens, with a broader workforce supporting whānau than you'd be able to find in traditional western models. The Mahi a Atua approach was a tool in the kete of many kaimahi working in Te Kūwatawata, the kaupapa Māori mental health programme that was running when we visited Tairāwhiti. …
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