Mental health and addictions services in Tairāwhiti are disconnected, disjointed and struggling to respond to increasing levels of whānau need, a review has found.
Te Waharoa chief executive Hine Moeke-Murray. Photo: LDR / Alice Angeloni
It has led to a proposal called Whāriki: A Way Forward - He Huarahi ki Mua, which seeks to put whānau wellbeing at the centre of every level of the system.
Te Waharoa chief executive Hine Moeke-Murray, who is at the forefront of change in mental health and addiction response, said the review reflected issues "ingrained" in the system.
She believed recognising the issues was a strong starting point.
The proposal follows a review by district health board Hauora Tairāwhiti in 2019 and 2020 in which they heard from whanau with lived experience of mental illness and addiction, communities and service providers.
Whānau said they were not accessing help before escalation and crisis, and shared experiences of being turned away because they didn't meet the "criteria" for different services.
Those using services said they felt whakamā (shame or embarrassment) when engaging with providers, were frustrated by long waiting lists, "wrong door experiences" and having to repeat their stories to different workers and service providers.
The prevalence of racism and discrimination at all levels of the system were also highlighted and hindered the uptake of safe, relevant and quality care and support.
Research released on Monday showed 93 percent of Māori in Aotearoa experience racism every day, and even more - 96 percent - say racism is a problem for their whānau.
Hāuora Tairāwhiti planning and funding manager Nicola Ehau said the aim of the review was to help find a better way to respond to people, reduce complexity in the system and provide clear guidance on how to plan and resource services.
Public consultation on Whāriki began yesterday.
"It is a framework that places whānau wellbeing at the very centre of all our activities so that everyone, no matter where or who they are, can confidently get help when and where they need it," Ehau said.
"Whāriki represents a shift in the way services are determined."
Moeke-Murray, who heads Te Waharoa, said the creation of the unique service in 2017 as the pilot project Te Kuwatawata, showed Tairāwhiti had recognised change was needed.
She described Te Waharoa as a conduit, bringing people together so whānau in distress only needed to tell their story once.
They use mātauranga Māori principles and clinical care to find a pathway forward for people experiencing distress.
Te Waharoa was one of the service providers that fed into the review.
"We've taken what everyone has said, ourselves included, as a service provider and synthesised what a whole lot of community providers and whānau have said to look at how we can do this better," Moeke-Murray said.
"So the release of this document is about going back to them, to our community, to our providers and saying 'this is what you've said, have we heard this correctly?'
"And if we have, then we can start the next point on the journey."
The review reflected longstanding issues within the health system, she said.
"I think the issues have been ingrained for a very long time and that it's the way that a system dictates health in general, it's not necessarily how we approach people.
"Services are set up to deliver in a certain way. That may not necessarily be conducive to what some whānau in the community need."
The solution, which would see "whānau voice at the centre", would require change.
"I'm a firm believer that if you shift your attitude you shift your practice.
"It's going to mean all of us working together to get better at what we do and to be okay with saying 'we haven't done some things well'. The recognition that it needs to change is a starting point."
On racism and discrimination reported in the review, Moeke-Murray said it, unfortunately, reflected many people's experience of the system.
"When you think about racism, a system has been created to suit a set of people that created a social norm and everyone is expected to live in that social norm.
"But when that social norm or set of rules has been imposed, it's not okay.
"When it continues to be an imposition on people being able to access health and their choice in health, it's not okay.
"I think we have a real opportunity as Tairāwhiti to make a difference in our community but we need to be on the same page to do that."
Where to get help:
Need to Talk? Free call or text 1737 any time to speak to a trained counsellor, for any reason.
Lifeline: 0800 543 354 or text HELP to 4357
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Depression Helpline: 0800 111 757 (24/7) or text 4202
Samaritans: 0800 726 666 (24/7)
Youthline: 0800 376 633 (24/7) or free text 234 (8am-12am), or email talk@youthline.co.nz
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