Horomia Speech: Psychosis Early Intervention
Hon Parekura Horomia
Minister of Maori Affairs, Associate Minister of Education, Associate Minister of Tourism, Associate Minister of Fisheries, Associate Minister of Social Services and Employment (Employment),
Ngati Porou Hauora – Early Intervention in Psychosis National Training Wananga
6pm Saturday 24 November 2001
It is an honour to be invited to open the fourth Early Intervention in Psychosis National Wananga this weekend.
I see the theme of your conference is Maori and Bicultural approaches and perspectives. And with a focus on working in small and rural communities, and how to make limited resources stretch. I suspect that for many of us in our communities, this is already a way of life.
I am pleased to see so many kaumatua, kuia, whanau, midwives, psychiatric workers and mental health workers take the chance to step back from your mahi and come together to see what each of you are doing in your own communities.
Tairawhiti has some unique features. 90% of the population is Maori. 95% are affiliated to one iwi, Ngati Porou. A large majority of the population is young.
The East Coast health provider, Ngati Porou Hauora services an area from Potikirua in the north to Anaura Bay in the south, with a population of six thousand, throughout a geographical spread of five thousand square kilometres. The coast is rural and isolated with a scattered population and small townships connected by State highway 35. There is no public transport.
Against these odds which are not insurmountable but which pose significant hardships, this health initiative I am privileged to launch today is as much about a vision as about finding solutions for Maori health problems.
“Manaakitia nga mea katoa hei oranga
Wairua, hinengaro, tinana me te whanau
To promote total healthcare
for better health
Spiritual, mental, physical and family
Ngati Porou Hauora have taken this holistic approach as they developed their comprehensive, patient focused and integrated mental health service.
The shift from institutional care to a continuum of care between primary and secondary services may not be without difficulty.
Any move towards a system which challenges accepted ways of doing things may encounter those who are not so willing to embrace change.
For example, the focus of the western model of care on the individual’s physical well-being, often at the expense of their spiritual, emotional and family health needs, will face challenges from your work. For Maori, culturally appropriate services are essential.
Ngati Porou Hauora’s goal is to develop services that meet or exceed the expectations of consumers and their whanau living in Ngati Porou. Leadership hinges on keeping that focus, making innovative changes and challenging any barriers that alter the focus. The continued support of management is crucial both to rapid learning and the creation of a safe environment to trial new ideas.
Rural isolation creates staffing problems - recruitment, retention and lack of capacity to enable staff development. It even affects the ability to take holidays. The service relies heavily on staff gaining qualifications through extramural study, locally based skills sharing and in-service training with visiting skilled professionals.
Nevertheless, whatever barriers exist to frustrate our people - and there are many - this has only served to strengthen resolve, to make them more determined, and to ensure their focus remains on programmes which benefit clients and their whanau.
The demands on the health system have intensified over the last few years and this will continue. Ngati Porou Hauora’s focus is on early intervention strategies of support. Assisting people before they become unwell enables them to be empowered and take control of their own lives. Early intervention is a crucial and integral component of mental health care for Maori and needs to be recognised as such, rather than as an adjunct.
This government’s integrated approach to development will support whanau, hapu and iwi based approaches, such as the early intervention strategies developed and used by Ngati Porou Hauora.
I believe all whanau deserve the best services. To enable the best services to be provided, we need the best workers available to deliver the services. It is therefore important for workers to be skilled in working with whanau and to be knowledgeable about them, their circumstances and their issues.
While I believe clinical skills and knowledge are important so too is competency in recognising and catering for the values, culture and beliefs of the client and their whanau.
In Ngati Porou, the kuia and koroua come to Te Puia springs for the healing powers of the ngawha. Services for children and kaumatua are free and travel subsidies are offered. Workers go out to deliver services in peoples’ homes and communities. Whanau help plan and manage their own care plans. We have our ngahere for rongoa Maori too.
It is important that Ngati Porou develop and drive their own services. Ngati Poroutanga runs through the entire service. There is no other service exactly like this and there shouldn’t be.
These hui are important to network and share ideas. From this hui, take the ideas and actions that will work for you and your community. I believe you are showing leadership in taking up the challenge of providing a comprehensive, patient-focused and integrated mental health service. It is my pleasure to open the fourth early Intervention in Psychosis National Training forum at Tolaga Bay.
In concluding, I would like to acknowledge the contributions of my Associate Minister of Maori Affairs, Minister Turia, in her capacity of Associate Minister of Health. She is doing a great job and has my total support.
Finally, I would also like to acknowledge the contribution many Maori have made to the health sector through their strong leadership at all levels of the sector - clinical, health management, and health policy. We must continue to nurture this input.
Our people deserve the very best – excellence in early intervention is the goal.
Tena rawa koutou