Mental health support that is fit for purpose
NAccess to culturally appropriate support can be a significant protective factor against poor mental health and suicide.
ew Zealand’s public health system is broken — and nowhere is that more obvious than in mental health. Almost half of New Zealanders fit a description of a mental illness and around one in five of us will be diagnosed with a mood disorder, such as depression or anxiety, during our lifetime. Sadly, there’s also (on average) an eight-year delay between when someone first experiences symptoms and when they seek treatment — with only 20 per cent reporting that they actually get the help they need.
Our current model is failing us — and it’s even worse for our indigenous populations who are often marginalised. Ma¯ori continue to be over-represented in our suicide statistics and make up almost 40 per cent of the users in our public mental health service.
The inequalities in our health system (especially in relation to Ma¯ori) have been largely acknowledged, with Health Minister Andrew Little confirming plans to establish a Ma¯ori Health Agency to help mitigate this discrepancy before the next election. Perhaps it’s no surprise though, that this was the one area that the Health and Disability System Review panel (led by Heather Simpson) failed to come to a consensus on.
Thinking specifically about Ma¯ori mental health and the inequities that exist in that space, there are multiple challenges associated with delivering culturally relevant mental health support, when and where it’s needed. In fact, less than 4 per cent of clinical staff identify as Ma¯ori, leaving the public mental health system woefully under-equipped to deliver culturally appropriate support. This is in spite of the fact Ma¯ori are at least 1.5 times more likely to face mental health distress than non-Ma¯ori.
Cultural connection, and access to culturally appropriate support, can be a significant protective factor against poor mental health and suicide. The current mental health system, reflective of the disconnected cultural identity, institutional racism, urbanisation, and socioeconomic factors that Ma¯ori have faced in the context of post-colonial New Zealand, does not adequately allow for this to happen.
I’ve always been passionate about tackling inequalities in health, and from my experience as a paediatrics doctor have witnessed how these risk factors can contribute to negative health outcomes. While I didn’t specialise in mental health, I knew if I wanted to make the biggest difference to the quality of people’s lives, it would be the space to innovate in — technology would be the key.
And so it will be as we seek to break down cultural, emotional, physical and financial barriers, and provide tailored, culturally appropriate support for our most vulnerable communities.
I founded Clearhead in 2018 — a digital mental health company that uses Artificial Intelligence and Machine Learning to provide tailored wellbeing support. Recently we launched our te reo Ma¯ori app with the help of health insurer nib and nib foundation. Its development was informed by two years of reviewing literature, conducting interviews, and codesign (working closely with both a Ma¯ori translator and a Ma¯ori psychologist) to accurately capture the essence of what is important to Ma¯ori when seeking help. The solution we’ve developed enables users to complete a cultural mental health assessment in a stigma-free manner and incorporates not just te reo Ma¯ori, but also the world view of te ao Ma¯ori and ma¯tauranga Ma¯ori — a way of being and engaging.
We’re incredibly proud of what we’ve delivered, but on its own, it’s not enough.
By improving mental health outcomes for Ma¯ori, we are improving them for everyone, helping achieve our vision of ensuring every New Zealander is able to access the mental health support they need to maintain their wellbeing.
When it comes to our public health approach to Ma¯ori mental health, it’s clear we cannot continue with the status quo. I wait with interest to see how the Ma¯ori Health Agency will function within the general health system and what it proposes to deliver by way of tailored solutions. I hope it doesn’t disappoint.