JUDI CLEMENTS: Could it also be that the Eurocentric psychiatric system is predisposed to diagnosis?
DR TE KANI KINGI: Yep, that has been raised as..
they're predisposed to diagnosis, and also,
the diagnostic categories were developed outside of this country,
and they weren't always able to take into account, I guess, cultural variables,
and there's... when you talk to people that've been in the sector for a long time,
misdiagnosis seemed to be rife in some instances
where cultural nuances were unfortunately interpreted as signs of a mental disorder.
There's a whole, whole range of international factors as well.
We note during the 1970's that New Zealand went...
I guess the economy was in a fairly depressed state
and Māori and Pacific Island people tended to suffer more from the economic decline,
and urbanisation was also blamed to a certain degree.
All very... and actually, it's a useful introduction into the next slide,
in that while we are all fairly aware of the problems with Māori mental health or Māori mental illness,
in a contemporary sense, the first examination that I can find into Māori mental health
was actually designed to find out why the rates were so low within the Māori population, Matua.
So why the rates were so low?
There's a quote from a guy called Ernest Beaglehole, 1947:
"The fact that there are fewer neurotic and psychotic illness among Māori than among Pākehā in New Zealand
"emphasises, amongst other things, the tremendous value to the Māori of possessing a psychological security
"that comes from tribal and family security."
So, who's an... any anthropologists in the audience?
Good, I'll fire away. [laughter]
Anthropologists will sit at the back of the room and observe people.
And he was trying to find out, why are these Māoris so mentally stable?
And this is the hypothesis he came up with - and there's other quotes, too. Kinda prophetic quote here:
"Judging from experience in other parts of the world, we may hazard a guess that the increasing adjustment of Māori
"to the Pākehā way of life, with its standards and values, morality and behavior, will bring a tendency
"for the Māori mental disease figures to approximate more and more to those of the Pākehā population."
So, with respect to this, I guess,
conversation about the relationship between culture and mental health and wellbeing,
this is an early example of an anthropologist, an academic in the 1940s talking about the relationship
between culture and cultural values and how it provided a protective mechanism
in terms of mental health and wellbeing.
However, there was a warning that as the Māori population potentially - he was speculating at this stage -
that as they became more urbanised and these cultural foundations were eroded,
it's probably not going to be too good for the mental health and wellbeing of the indigenous population.
Quite a prophetic comment in that it seems to be that he was right.
Remember, this was in the 1940s.
I'm trying to drag the presentation out a bit so that we won't have time for questions at the end... [laughter]
I'll just wait... I'll send a text message or something, [laughter] and get someone to call.
It raises two questions, and I don't know if I have the answer, but:
Has Western culture caused Māori mental ill-health?
Well, no. In a nutshell.
Has it contributed? Possibly.
But Māori mental... mental health is far too complex for it to be attributed to any one issue.
And we know that some Māori are doing quite well in Western society.
So I don't think Western culture has caused Māori mental ill-health.
I think what has caused it partly is the breakdown of these cultural practices for health and wellbeing.
It's actually okay when they're broken down,
but it's when they aren't replaced by anything positive,
that's the real issue.
The second question: Would a return to ancient traditions and values solve contemporary mental health concerns?
Again, probably not.
However, culture can fundamentally play a very significant role -
I believe, anyway - in promoting mental health and wellbeing.
However, culture - and again, I believe - needs to be placed within a contemporary context
and in a way that's meaningful to the population in modern times.
How that's done, I don't know. But some people, particularly those involved in the provision
of mental health care to Māori, have done a very good job at exploring ways in which
culture can contribute to mental health and wellbeing.
And, of course, I'm going back to some of those earlier slides and pictures.
Unfortunately some people have, I guess, left their traditional culture behind and adopted other cultures
which aren't always good for mental health.
A gang culture would be one example, I suspect.
Drug culture would be another culture.
So leaving behind one culture for another doesn't necessarily mean a positive outcome,
depending what the culture is.
And as I said, there is a possible application of traditional concepts and cultural practices to modern times,
and I think that might be the key - how they apply to modern times.
So, my final slide here - implications for mental health in Aotearoa New Zealand.
If we look at my earlier definition of culture:
a set of shared attitudes, values, goals and practices that characterise a group.
Well, I guess there's an opportunity there.
If we can promote a culture where mental unwellness is not tolerated within our country, within our nation,
when the shared attitudes, values, goals, and practices of our society
are able to promote mental health and wellbeing,
and lastly, when we have a culture of tolerance and acceptance -
when that's promoted and cultivated,
it's going to require - and this is high-level blue skies thinking -
but it's going to require a cultural shift within our society,
if we want to take advantage of culture as a mechanism to promote mental health and wellbeing.
Some people think it can't be done.
However, we've seen cultural change occur in this country time and time again,
on a number of issues. And it can happen quite quickly.
There was an outcry when people were forbidden to smoke in bars.
They said, "It'll never work. It's part of our culture.
"Smoking is part of our culture." In the space of three, four, five years,
you walk into a pub and someone's smoking in there, you think they're smoking cannabis. People are so shocked.
There's a culture attached to wearing a seatbelt.
There's a culture, although it's not always adopted by everyone,
a culture attached to not drinking and driving.
So if we can apply culture in a way that's embedded within our society,
and in ways which promote mental health and wellbeing,
I think that's another strategy that we can adopt, I guess, in order to promote mental health and wellbeing.
It's going to be a challenge, though.
I think I'm - it's my final slide.
But thank you for listening, no time for questions? [laughter]
CIARAN FOX: Plenty of time for questions.
...Questions? [laughter]