Browsing by Author "Blake D"

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    A call for further action in reply to Rose and colleagues (2020)
    (2020-08-18) Hodgetts D; Van Ommen C; Blake D; Hopner V; Rua M; Groot S; Carr S
    Rose and colleagues are prominent scholars who have brought insights from across the social and health sciences to promote a compelling case for significant action to address inequalities in both physical and mental health. Below, we offer further points of support, critique and clarification in the spirit of co-operation, which appears to be central to the agenda of Rose and colleagues. The open letter is particularly useful in drawing renewed attention to how necessary it is to remind decision-makers of the need for structural changes to ensure equity in health for all. Many of the key arguments posed in the letter have also been evident in emergency management and community psychology literatures for some time. These literatures document how adverse socio-economic conditions often worsen outcomes from natural and person-centered disasters, particularly for people who already endure vulnerabilities (Luna, 2009; Tierney, 2019; Wisner et al., 2004; Blake et al., 2017)1-4. As is the case with other disasters, socio-political situatedness in terms of poverty, insecure work, discrimination and marginalization, and poor housing are influencing peoples’ psychological, physical, cultural and spiritual reactions to COVID-19. Therefore, it is vital to contest the unjust, social structures that perpetuate and exaggerate such adverse conditions, and champion for fairer and just solutions. We can do so by drawing on existing resources, such as the Sendai framework that offer responses to inequalities in outcomes following disasters. Such frameworks offer pathways of action to address urgent and critical responses to protect livelihoods, health and ecosystems for everyone (United Nations, 2015)5. We agree that many of the well-publicized predictions of a ‘tsunami’ of mental health concerns stemming from the present pandemic may well be overstated. Rose and colleagues rightfully assert that, regardless, it is important to address issues around resourcing and community development, and to stretch our collective efforts towards socio-economic transformations. It is also necessary to note that, due to ongoing inequities and a lack of adequate response to the consequences of everyday injustices (poverty and discrimination), mental illness is already endemic in many countries. Systems of response also need to be re-designed to address the inverse care law (Hart, 1971)6 whereby people who need care the least consume the most. Conversely, people who need care the most, access the least. Increases in service access proposed by Rose and colleagues are urgent. It is important to put initiatives in place to help people in distress to cope by enhancing early intervention and peer-support systems. Training more mental health professionals to meet the existing complex needs of diverse communities is crucially important. Our concern with an emphasis on therapeutic training and interventions that predominantly target individuals in distress is not to question its effectiveness in addressing certain difficulties such as trauma, anxiety and low mood. Nor is the only challenge the limited reach (i.e., the number of people that can be assisted) of this strategy and issues of scalability. Our concern relates to how such responses are predominately ameliorative, rather than preventative in orientation. Responses to wide-scale human suffering that only focus on therapeutic interventions should be treated with suspicion as often conservative, bureaucratic, and as a failure of political imagination. The fixation on therapeutic responses can act as an ‘action distraction’, which contributes to a fixation on responses to reduce suffering within individuals. This can result in the pacification and obscuring of calls for wider reaching efforts to promote community level wellness, and to prevent mental ill-health through preventive macro structural changes. To address health inequities and differentials across persons and population groups, we must also address the structural inequities that drive ill-health. We need to look further ‘upstream’ and prevent people from becoming ill (Hodgetts & Stolte, 2017)7. Increased access to therapeutic interventions needs to be positioned overtly as part of larger strategies towards systemic change. We applaud Rose and colleagues for also raising the need for a broader change agenda. As Rose and colleagues also propose, redistributive policies and practices are important in addressing issues of inequity and health inequalities. In doing so, these authors adopt a well-worn population health position that is enshrined in many nation states within graduated taxation and cash transfer systems. We would add that, the levels of inequity that many communities now face, despite the existence of such redistributive initiatives, suggests the need to consider other more radical strategies for change. After all, it is in historical moments like the present that it becomes more possible to seize the initiative and to consider rebooting the whole socio-economic system (neoliberalism), which is driving inequities in life chances and health. In this context, increases in redistributive policies can be re-imagined as ‘stopgap measures’ that are useful whilst we formulate more sustainable and transformative systems for ensuring equity, social justice and health for all. This requires us to ask if, for example, now is the time for jubilee? Is now the time to introduce policies such as universal basic incomes, maximum wage settings, and resource co-ownership models? Should the ancient concept of the commons (shared resources that are available to humanity) be embraced as a central principle for a more just economic system (Standing, 2019)8? What we are signaling here is the need to be even bolder and to broaden the conversation regarding how to relieve people from debt servitude and ensure nobody has to subject themselves to often abusive and dehumanizing penal welfare and social service systems (Hodgetts & Stolte, 2017)7. Such structural transformations may actually reduce the need for therapists and such expensive service systems. We should be asking more questions to which we do not have perfect answers. One avenue for addressing discrimination in the health, penal welfare and social services nexus in many nation states is to disassemble these systems and to provide the resources they consume directly to people in need. If people are resourced to govern their own affairs collectively, the chances of their flourishing alongside others are increased. This line of reasoning speaks to issues of self-determination and is a feature of calls from indigenous groups, in particular, to (re)gain guardianship over the resources that have been taken from them. Additionally, in addressing issues of inequality and discrimination in present systems, it is important to not limit our historical gaze. For example, Rose and colleagues assert that economic supports have been stripped away over the last decade. We agree, and would also foreground the impacts of longer time scales of dispossession and inequality that have set the stage for injustices in many nation states today. The present crises in many countries have been shaped by Neoliberalism over the past 40 years. These crises are also the products of historical processes of colonization/imperialism that continue to negatively impact minoritized communities. Relatedly, responses called for by Rose and colleagues will need to be reformulated in context specific ways. What is appropriate for the United Kingdom in addressing issues of diversity may not necessarily be appropriate in contexts such as Aotearoa New Zealand. In our context, the English version of the Treaty of Waitangi [1] (signed in 1840 by the British Crown and Māori leaders) set the stage for the dispossession of land, resources, power and cultural practices from Māori. Subsequent exploitation by the Crown has resulted in ongoing structural inequities. As such, systemic changes will need to include the enactment of genuine Treaty of Waitangi principles that are not exploitative and extractive. This could mean that, for example, iwi (tribes) exercise guardianship over the provision of health, social and education services for their members, and for other people residing within their tribal boundaries. This would likely result in a refocusing of initiatives away from short-term economic returns and towards a longer-term, inclusive and equitable strategic focus. For instance, Māori often operate from the position of intergenerational planning, capacities and relationships whereby certain decision-making roles are assigned to kaumatua (elders) as wisdom holders, alongside often middle aged "executive leaders" (enactors) who are supported by rangatahi (youth), and inspired by pēpi (infants). More broadly, such transformations are about honouring localised treaties and embracing indigenous rights and knowledges through enactments of generational change strategies designed to achieve healthy futures for all. We are surprised that the open letter appears to take on a somewhat executive tone and does not feature the language of collaboration as much as we feel is warranted. From our perspective, achieving effective change requires us to look out beyond our own expertise, models and journals. Recognising the socio-political situatedness of people’s lives and who gets to have a voice in decision-making processes is particularly crucial during and after disasters. Rasche (2018)9 reminds us that the social location and expertise of speakers often brings about possibilities to become an authority on other peoples’ situations. It is important that we engage directly with people who are adversely affected by the structures and issues to which we are trying to find effect responses. Policies and systems that are co-designed with the people being targeted tend to be more effective. To work effectively with others, it is also important we decentre our own ‘expert’ voices in order to hear the voices of others who have gained phronetic wisdom from having to carry the weight of adversity. Part of our shared change agenda must be to address inequities regarding who gets to be central to conversations and initiatives for change, and whose knowledge is valued and heard in these processes. We cannot leave the formulation and implementation of change strategies to the usual suspects. We are sure Rose and colleagues would agree that there are considerable sensitivities in considering efforts to work in partnership across dominant and marginalized communities. In the process, it is important to avoid falling into the trap of using labels that collapse diverse communities together as the ‘others’ (Fakim & Macaulay, 2020)10. For example, the BAME acronym used by Rose and colleagues is considered highly problematic by many members of the diverse groups that are supposedly ‘encapsulated’ in this term. For many, BAME is a distancing, cold and administrative ‘white term’. It homogenises and simplifies the heterogeneity of the intertwined histories of adversity that are experienced in varying ways by diverse groups of people. Such terms also act as apolitical euphemisms for historically politicised and reclaimed notions, such as Black, queer and indigenous. A key message in our response is that what we need to advocate collectively is not only more equitable access to mental health and community services, but also access to justice, sustainable incomes, adequate housing, good food, and supportive and violence-free relationships. As Rose and colleagues note, we need to ‘build back better’. This requires us to unpack whose notion of ‘better’ is being advocated. Who gets to decide what we mean by the creation of societies that are more equitable and offer fairer access to resources, so as those necessary to promote and sustain human flourishing. We were surprised that in asserting the need to build back better, Rose and colleagues did not refer to existing global structures that offer avenues for negotiating and enacting shared visions for humanity and wellness. There is an opportunity to link our efforts in with the 17 interwoven United Nations Sustainable Development Goals (SDGs). Widely consulted and signed-up to by stakeholder groups from almost 200 United Nations, the SDGs have been in effect since 2016 and will run till 2030. Directly relevant to our present dialogue, psychologists specifically fought to have mental health included in this global development agenda, under SDG-3. Of the remaining 16 SDGs, particularly important are SDG-17 (Partnerships for development whereby those targeted are positioned centrally in the formulation, design and implementation of change processes) and SDG-8 (Decent Work for all, which includes access to Sustainable Livelihoods and Wellbeing at Work). In advocating for change it is important to avoid re-inventing the wheel. As imperfect as they are, the 17 SDGs offer a platform for change on a global scale and in ways that preserve our geographical specificities. The wider point of these goals, and other structures like the Global Compact and the Sendai Framework, is that they offer accountability structures that can help determine the distribution of resources and opportunities for action within and across nation states. These initiatives can be harnessed to help us redress structural inequities, injustices, exclusions and violations of Human Rights. We would like to thank Wellcome Open Research for providing this opportunity to respond to the seminal open letter by Rose and colleagues.
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    A Kaupapa Māori conceptualization and efforts to address the needs of the growing precariat in Aotearoa New Zealand: A situated focus on Māori
    (John Wiley and Sons Ltd on behalf of British Psychological Society., 2023-01) Rua M; Hodgetts D; Groot S; Blake D; Karapu R; Neha E
    In Aotearoa New Zealand, the precariat is populated by at least one in six New Zealanders, with Māori (Indigenous peoples) being over-represented within this emerging social class. For Māori, this socio-economic positioning reflects a colonial legacy spanning 150 years of economic and cultural subjugation, and intergenerational experiences of material, cultural and psychological insecurities. Relating our Kaupapa Māori approach (Māori cultural values and principles underlining research initiatives) to the precariat, this article also draws insights from existing scholarship on social class in psychology and Assemblage Theory in the social sciences to extend present conceptualizations of the Māori precariat. In keeping with the praxis orientation central to our approach, we consider three exemplars of how our research into Māori precarity is mobilized in efforts to inform public deliberations and government policies regarding poverty reduction, humanizing the welfare system and promoting decent work. Note: Aotearoa New Zealand has been popularized within the everyday lexicon of New Zealanders as a political statement of Indigenous rights for Māori.
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    Accessing primary healthcare during COVID-19: health messaging during lockdown
    (Taylor and Francis Group, 2022-03) Blake D; Thompson J; Chamberlain K; McGuigan K
    Accessing healthcare during a disaster matters for the well-being of people and communities. This article explores healthcare messaging about General Practitioner (GP) services for non-COVID-19 health concerns during the Level 4 lockdown in Te Papaioea (Palmerston North), Aotearoa New Zealand. Messaging from Government, media and local GP clinics were analysed to understand how people were advised to seek care for non-COVID-19 health concerns. We found inconsistencies in these communications, ranging from messages to not attend healthcare services because of possible COVID-19 surges, to messages with vague, or lack of, information. Government messages did include advice for seeking general healthcare, but this was largely rendered invisible due to the focus on ‘staying home, saving lives’. Media messaging was similarly influenced by these Government directives. Few GP clinics had websites, and few provided information about accessing general healthcare services. Clinics also lacked up-to-date telephone messages about seeking healthcare for non-COVID-19 symptoms and illnesses. All three sources neglected the cultural, social and contextual diversity of the local audience. We recommend that communication during disasters should be clear, concise and consistent. Further, GPs should be supported to have websites and telecommunication platforms. All communications should be inclusive and aim to reach diverse audiences.
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    Home drinking practices among middle-class adults in midlife during the COVID-19 pandemic: Material ubiquity, automatic routines and embodied states.
    (John Wiley and Sons, Inc., 2023-07-01) Lyons AC; Young J; Blake D; Evans P; Stephens C
    INTRODUCTION: Harmful drinking is increasing among mid-life adults. Using social practice theory, this research investigated the knowledge, actions, materials, places and temporalities that comprise home drinking practices among middle-class adults (40-65 years) in Aotearoa New Zealand during 2021-2022 and post the COVID-19 pandemic lockdowns. METHODS: Nine friendship groups (N = 45; 26 females, 19 males from various life stages and ethnicities) discussed their drinking practices. A subset of 10 participants (8 female, 2 male) shared digital content (photos, screenshots) about alcohol and drinking over 2 weeks, which they subsequently discussed in an individual interview. Group and interview transcripts were thematically analysed using the digital content to inform the analysis. RESULTS: Three themes were identified around home drinking practices, namely: (i) alcohol objects as everywhere, embedded throughout spaces and places in the home; (ii) drinking practices as habitual, automatic and conditioned to mundane everyday domestic chores, routines and times; and (iii) drinking practices intentionally used by participants to achieve desired embodied states to manage feelings linked to domestic and everyday routines. DISCUSSION AND CONCLUSIONS: Alcohol was normalised and everywhere within the homes of these midlife adults. Alcohol-related objects and products had their own agency, being entangled with domestic routines and activities, affecting drinking in both automatic and intentional ways. Developing alcohol policy that would change its ubiquitous and ordinary status, and the 'automatic' nature of many drinking practices, is needed. This includes restricting marketing and availability to disrupt the acceptability and normalisation of alcohol in the everyday domestic lives of adults at midlife.
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    ‘It's a sanity restorer’: Narcotics anonymous (NA) as recovery capital during COVID-19 in Aotearoa New Zealand
    (John Wiley and Sons Ltd, 2024-03-01) Mappledoram M; Blake D; McGuigan K; Hodgetts D
    Narcotics Anonymous has flourished globally across 143 countries as a key community response to problematic substance use, despite disruptions, including the COVID-19 pandemic. This research sought to understand how the Aotearoa New Zealand Narcotics Anonymous (NA) community engaged with NA meetings online during the 2020–2021 COVID-19 pandemic. During in-depth, semi-structured interviews, 11 NA members shared their stories of addiction, abstinence-based recovery, experiences of NA and managing pandemic restrictions. A narrative analysis identified four tropes particularly relating to how community members managed during the pandemic: responding via technology; maintaining recovery connections; creating opportunities; and consistency. Each trope showcases how NA members were able to connect online and garner support for their abstinence-based recoveries and, more generally, during unprecedented times. In addition, the NA members in this research narrated the opportunities the pandemic restrictions created for them, such as engaging with the NA programme in new ways and improving their quality of life. Members of NA were able to maintain their psychological, physical, spiritual and community wellbeing during the COVID-19 pandemic primarily due to existing recovery capital—peer-based support and the principles of the 12-steps of NA. The implications are that access to peer-based communities and salient recovery identities are pivotal during ordinary and extraordinary times. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement.
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    Māori households assembling precarious leisure
    (Taylor and Francis Group, 2024) Martin A; Hodgetts D; King P; Blake D
    Many members of the precariat in Aotearoa/New Zealand (NZ) struggle to access resources for leisure. This article draws on four interview waves with five precariat Māori (Indigenous peoples of Aotearoa/NZ) households (N = 32 interviews) using mapping and photo-elicitation interviews to explore participant leisure engagements. We document how precarious leisure for some Māori is assembled agentively by participants out of key elements associated with their situations (e.g. financial and housing insecurities) and core Māori principles and processes of whanaungatanga (cultivating positive relationships) and manaakitanga (caring for self and others). Participant accounts foregrounded the importance of mātauranga Māori (systems of knowledge) and culture in shaping contemporary leisure practices that can promote a sense of ontological security, place, belonging, connection, cultural continuity, and self as Māori. Though beneficial to self and others, participant leisure practices are rendered insecure by the resource restraints of life in the precariat.
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    Opioid Substitution Treatment Planning in a Disaster Context: Perspectives from Emergency Management and Health Professionals in Aotearoa/New Zealand.
    (10/11/2016) Blake D; Lyons A
    Opioid Substitution Treatment (OST) is a harm reduction strategy enabling opiate consumers to avoid withdrawal symptoms and maintain health and wellbeing. Some research shows that within a disaster context service disruptions and infrastructure damage affect OST services, including problems with accessibility, dosing, and scripts. Currently little is known about planning for OST in the reduction and response phases of a disaster. This study aimed to identify the views of three professional groups working in Aotearoa/New Zealand about OST provision following a disaster. In-depth, semi-structured interviews were conducted with 17 service workers, health professionals, and emergency managers in OST and disaster planning fields. Thematic analysis of transcripts identified three key themes, namely "health and wellbeing", "developing an emergency management plan", and "stock, dose verification, and scripts" which led to an overarching concept of "service continuity in OST preparedness planning". Participants viewed service continuity as essential for reducing physical and psychological distress for OST clients, their families, and wider communities. Alcohol and drug and OST health professionals understood the specific needs of clients, while emergency managers discussed the need for sufficient preparedness planning to minimise harm. It is concluded that OST preparedness planning must be multidisciplinary, flexible, and inclusive.
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    Recovery Capitals: a collaborative approach to post-disaster guidance
    (Australian Institute for Disaster Resilience, 2022-04) Quinn P; Gibbs L; Blake D; Campbell E; Johnston D; Richardson J; Coghlan A
    Knowledge from past disasters can inform and support recovery, yet these insights are not always readily accessible to recovery practitioners. To bridge this gap, effective collaboration is needed to produce practical, evidence-based resources. This was the focus of the Recovery Capitals (ReCap) project, a collaboration between researchers and practitioners across Australia and Aotearoa New Zealand. This paper presents a critical case study of the participatory processes involved in developing a recovery capitals framework and associated resources. The framework is based on an existing Community Capitals Framework that emphasises the social, natural, political, built, human, financial and cultural strengths and resources within communities. The Recovery Capitals Framework arose through applying the Community Capitals Framework to disaster recovery, with conceptual adaptations to reflect shared values, diverse perspectives and collective knowledge of recovery. The lessons learnt from this international and researcher-practitioner collaboration are analysed, and the application of principles of equity, inclusion and community-led recovery is evaluated. Shortcomings and innovations are examined in how resources were tailored to the cultural contexts of each country, and reflections are presented from the perspectives Indigenous and non-Indigenous contributors. These lessons can inform future collaborations that support inclusive, holistic and evidence-informed recovery efforts.
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    Supporting community recovery: COVID-19 and beyond
    (Massey University, 2021-06-30) MacDonald C; Mooney M; Johnston D; Becker J; Blake D; Mitchell J; Malinen S; Naswall K
    The rapidly evolving COVID-19 pandemic has created an unprecedented health, social and economic crisis, the long-term effects which are still unknown. It is clear, however that successful recovery will require strong community mobilisation, engagement and participation. Recovery is about regeneration, building back smarter and better following a disaster event, while providing opportunities to contribute to a more resilient and sustainable community for the future. Successful recovery recognises that both communities and individuals have a range of complex and interrelated recovery needs. These can be addressed within a holistic framework emphasising seven ‘community capitals’ (natural, social, financial, cultural, political, built and human). This summary document is provided for further discussion and to support agencies in their recovery planning and actions in the current COVID crisis as well as other disasters.
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    Telling Stories: Sex Workers’ Rights in Aotearoa New Zealand
    (School of Social and Cultural Studies Victoria University of Wellington, 2019) Blake D; Healy C; Thomas A
    The New Zealand Prostitutes’ Collective (NZPC) is an organisation founded on the rights, welfare, health, and safety of sex workers in Aotearoa New Zealand and globally. The collective is committed to ensuring the agency of sex workers in all aspects of life. After years of lobbying by the NZPC to overturn an archaic law founded on double standards, whereby sex workers and third parties were prosecuted for acts such as soliciting and brothel keeping, the Prostitution Reform Act 2003 saw the decriminalisation of commercial sex activities and allowed for third parties to operate brothels. Aotearoa New Zealand remains the only country to decriminalise most commercial sex work and endorse the rights of sex workers. Dame Catherine Healy has been with the NZPC since its inception in 1987. As the national coordinator she is a vocal lead activist and advocate for sex workers’ rights. She also publishes extensively on sex workers’ rights. In 2018, Catherine was presented with a Dame Campion to the New Zealand Order of Merit in acknowledgment for working for the rights of sex workers. Dr Denise Blake is an academic and the chair of the NZPC Board. Denise has been involved in the sex industry in a variety of roles for a number of years, and also advocates strongly for the rights of sex workers. In this interview, Catherine talks to Denise and Amanda Thomas about her work and the history of the NZPC.
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    The impact of Earthquakes on apartment owners and renters in te Whanganui-a-Tara (Wellington) aotearoa New Zealand
    (MDPI (Basel, Switzerland), 2021-08-01) Blake D; Becker JS; Hodgetts D; Elwood KJ
    Apartment dwelling is on the increase in many cities in Aotearoa New Zealand, including those in earthquake-prone regions. Hence it is important that people working in disaster management and housing improve their understanding on how the living situations of apartment dwellers influence their disaster management practices. This knowledge is crucial for efforts to promote safety and preparedness. This paper explores what enables and constrains apartment dwellers in their ability to prepare for an earthquake. Eighteen people were interviewed who resided in Te Whanganui-a-Tara (Wellington) two years after the 2016 7.8 magnitude (Mw) Kaikōura earthquake. Of central concern was people’s ability to prepare for disasters and access knowledge about building and structural safety and how this knowledge mattered to what apartment dwellers were able to prepare for. We found that the agency to prepare was dependent on whether people owned or rented their dwellings. We report on participant accounts of dealing with body corporations, landlords, emergency kits, other emergency items, and evacuation plans.
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    Updated psychosocial support: Evidence base in the COVID-19 context
    (Massey University, 2021-06-30) Mooney M; MacDonald C; Becker J; Blake D; Gibbs L; Johnston D; Malinen S; Naswall K; Tassell-Matamua N; Alefaio S
    This report summarises the emerging evidence base for psychosocial impacts and psychosocial support interventions in the COVID-19 pandemic in the following areas: The psychosocial and mental health impacts of the COVID-19 pandemic to date The evidence base for the effectiveness of psychosocial support services in the response and recovery to COVID-19 in supporting individual and community adaptation and well-being A brief overview of psychosocial interventions related to COVID-19 pertinent to the Aotearoa New Zealand context. Emerging impacts from the ongoing COVID-19 pandemic include impacts to physical and mental health, exacerbation of disparities, secondary impacts from public health measures (e.g. social distancing), and negative economic consequences. Several groups appear to be more at risk. Evidence suggests that ensuing psychosocial needs are immediate and are likely to continue long term. Psychosocial recovery plans and interventions need, as much as possible, to be evidence informed, flexible enough to stay relevant to the evolving context, address disparities, and adapt to and reflect different cultural and community contexts