Browsing by Author "Eade, Lorraine"
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- ItemMarlborough Maori experience in accessing mental health services via primary health care : an exploratory study : Te Kura Hinengaro Tangata, School of Psychology, Massey University, Turitea, Palmerston North, February 2007, thesis submitted in partial fulfilment of the requirements for the degree of(Massey University, 2007) Eade, LorraineNational and Maori health policy: A background The New Zealand government has clearly recognised the disparities between Maori and non-Maori health (Te Puni Kokiri, 2000a; Te Puni Kokiri, 2000b; Ministry of Health, 2002a). This has contributed towards a number of health strategies and policy development designed to improve Maori health. The New Zealand Health Strategy (2000) is the government's overarching health strategy, which acknowledges a special relationship between Maori and the Crown under the Treaty of Waitangi. It identifies Maori health as one of its key priorities and several subsidiary strategies have been launched to assist meet its national objectives for achieving Maori health gain. Four subsidiary strategies play a pivotal role in terms of Maori mental wellbeing. The key objectives outlined in He Korowai Oranga - The Maori Health Strategy (2002) are to improve access to appropriate services for Maori, improve Maori health outcomes and support Maori health provider development. Te Puawaitanga Maori Mental Health National Strategic Framework (2002b) suggests that opportunities need to be maximised for intra and intersectoral co-operation. These include objectives to improve training for General Practitioners and other health workers providing primary health care to Maori tangata whaiora (users of mental health services), with a focus on depression, anxiety, youth suicide and addictions. The Primary Health Care Strategy (2001) aims to build a strong primary health care system that will improve the health of all New Zealanders and in particular will focus on reducing inequalities in health. Te Tahuhu - The Second New Zealand Mental Health and Addiction Plan (2005) has, as one of its ten challenges, a stronger emphasis on primary health care. This challenge aims towards "building and strengthening the capability of the primary health care sector to promote mental health and wellbeing for tangata whaiora", and for the New Zealand health system to "continue to broaden the range, quality and choice of mental health and addiction services accessible for Maori", (p. 13,14). [From Introduction]
- ItemTe Tau Ihu Māori mental health outcomes and tangata whaiora experiences in Te Wahi Oranga (Nelson Acute Mental Health Inpatient Unit) : an exploratory study : a thesis submitted for the degree of Doctor of Philosophy at Te Kura Hinengaro Tangata - School of Psychology, Massey University, Turitea, Palmerston North(Massey University, 2014) Eade, LorraineThere are significant differences between Maori and non-Maori mental health in New Zealand. Maori have higher prevalence of serious mental health disorders than non-Maori, yet in comparison to non-Maori, Maori are less likely to access health services; are less likely to be referred to specialist mental health services by General Practitioners (GPs) and more likely through law and welfare agencies; are more likely to be involuntarily admitted; have higher admission (and readmission) rates, are more likely to be diagnosed with psychotic disorders on admission; and have higher suicide and mortality rates. The aim of this research was to explore outcomes for Maori in Te Tau Ihu (Nelson/Marlborough), New Zealand and understand Maori tangata whaiora (service users/patients) experiences from admissions through to discharge from a mental health acute inpatient unit in Te Tau Ihu. First, five years of inpatient data was collated to identify whether there were similarities between Te Tau Ihu Maori and Maori nationally in terms of admission rates, readmission rates, seclusion practices, length of stay and diagnostic data. Second, using a narrative inquiry approach embedded within a Kaupapa Maori framework, 13 tangatawhaiora were interviewed. This research has found that there are some similarities between Maori in Te Tau Ihu and Maori nationally in terms of the higher number of admissions and first time re-admissions, higher rates of psychotic disorders and seclusion. However, Te Tau Ihu Maori compare more favourably in terms of lower two or more subsequent re-admissions, and there is minimal difference between Maori male and female admission rates. In terms of tangata whaiora experiences, there are consistencies with other studies around concerns with medication, stigma and discrimination, lack of respect, boredom, fear and safety, and relationships with staff. There are also new learnings in terms of the complex relationship with medication, the importance of food and music as a relationship enabler, the strength of having Maori staff on the unit and a call for more therapeutic interaction. The findings endorse the need for more comprehensive care planning based on Te Whare Tapa Wha (mental, physical, family, spiritual dimensions) to better support tangata whaiora.