DR TE KANI KINGI: Now where was I? So we have...
Culture can be applied in a international setting.
and just some... and on a national scale. And just grab some...
some snippets here. I actually asked around the office about what characterises the kiwi culture.
People talk about barbeques, beaches, drinking,
the bach and the quarter acre section, the beach, and the Wellington Sevens. [laughter]
Apparently now it's a cultural activity. [laughter]
I've been to ten. [laughter]
Unfortunately, I can't tell you who won the final in any of those years. [laughter]
But they're just examples and they're not a comprehensive list of examples by any means.
But I guess just some of the things that characterise the kiwi culture
according to my colleagues at work and things that we can all relate to.
So culture... One point I really wanted to make was that everyone has culture, even if you don't think you have.
It's probably because you've got a lot of culture that you don't think you have
because you're so immersed in it. So that's an important point.
And culture can exist on national, regional, organisational, group,
and what people are most familiar with is this idea of ethnic culture.
Belonging to a particular ethnic group.
And culture - fundamentally going back to that definition of what culture is -
and can prescribe values, beliefs, and behaviors which guide
people's lives, their expectations, and aspirations.
I was at a presentation that Professor Mason Durie gave a few years ago,
and he was talking about culture and health.
He talked about traditional Māori culture.
And he said, "Fundamentally, culture in ancient times was a framework for health and wellbeing."
That every cultural practice actually could be linked back to health
and providing a framework for living.
There were a couple of questions I had, but...
around certain protocols of my tribe, but he didn't have an answer for it. [laughter]
But frameworks for living and which guide your behaviours.
Moving on to the question of culture and mental health, I want to talk,
just quickly, about Māori culture and mental health and mental wellbeing.
And then shortly after that, just pose some questions for people to think about.
In terms of providing a context - this is a quote that
Mason Durie said in 1997, I think -
Materoa, you were there, weren't you?
It was a while ago. It was a long time ago, I was at this -
it was a Māori mental health summit here in Wellington.
It was a long time ago. Materoa will tell you -
there might've been a few people there...
We had released a plan called Puaho: a five-part plan for Māori mental health.
It was that long ago, actually, that I was doing the OHPs--
you flip it, flip the acetate. [laughter]
A lot younger then. But people were surprised by this comment here,
and it just highlighted to the audience the
problems that were attached to Māori mental health or Māori mental illness, as it was.
The problem that we've subsequently found, and as a result of a
fairly major psychiatric epidemiology study that was conducted -
actually, it was completed about 4 years ago -
was that the problems have probably gotten worse in the last 10-11 years.
And here's a... in order to provide some sort of context to the issue of
Māori mental health or Māori mental ill-health.
Here's some of the rates there that were generated from the epi-study.
The main ones there, at the bottom, that more than 50% of the Māori population,
over their lifetime - the lifetime prevalence rates are always higher.
More than 50% of Māori could expect to have some type of mental health problem.
At 12-month prevalence - essentially, those that have had a problem in the previous 12 months,
from when the survey was taken - up to 30%, one in three.
And the one-month prevalence, which is essentially those that
had mental health concerns at the time of the survey was about one in five.
So the results were concerning,
but also, I guess, highlighted the need to focus considerable effort, I guess,
on strategies to improve Māori mental health and wellbeing.
And I'm sure people agree that - a number of strategies are required,
from service development, improving access, and workforce development,
and I just want to talk about, now, I guess the role of culture in terms of promoting
Māori mental health and wellbeing.
Actually, I think I've got a couple more slides in terms of the -
many of the problems that they found from the epi-study were moderate to severe,
so typically they weren't small issues.
Comorbidity is a significant issue.
Surprisingly - despite the severity of illness, the access was poor,
and much of the burden was felt by the poor, the young, and women
in terms of the rates of mental health problems.
What is surprising to a lot of people is that the rates increased dramatically -
the admission rates for Māori increased dramatically from about the mid-1970s till now.
Prior to that, Māori were... there was no prevalence studies conducted,
but prior to that, Māori were scarcely visible within psychiatric facilities,
but the rates boomed from about the mid-1970s onwards.
We're not too sure why, but that's the picture that's being presented.
Any questions so far?
Matua? He pātai anō?
AUDIENCE MEMBER: Kia ora. Is it true that...
Kia ora tātou. Is it true that
a lot of our Māori mental health comes from alcohol,
drugs, and all of those things? Or is it something that began long ago?
DR TE KANI KINGI: He pātai mīharo tērā.
It used to be that the leading cause of first admissions for Māori males
not so long ago, was drug and alcohol-induced psychosis.
There is no evidence to suggest that Māori are biologically or physiologically predisposed
to mental ill-health, and in fact,
I guess an example of that is the fact that the rates increased so dramatically from the 1970s.
We... I'm glad Materoa's nodding her head.
Lifestyle factors are largely to blame.
It's not... the rates aren't so high because we're Māori,
the rates are so high because we're exposed to environments
that aren't conducive to positive mental health. When you're poor,
when you're unemployed, when you've got no place to live,
all these factors combined create an environment that isn't good for mental health and wellbeing.
Unfortunately, our people are clustered in those areas.
So in answer... in response to your question, yes, a lot of problems related to behavioural factors,
probably alcohol one of the main - I think we tend to, with the sort of kōrero around P and cannabis,
we tend to forget that alcohol's probably the biggest drug [laughter] and tobacco.
The country, they're trying to stamp that out.