By Steve Menzies
For generations Māori have been chronically underserved by New Zealand's healthcare system. As a nation we now face a list of unenviable health statistics, including the fact that the suicide rate for young Māori is among the highest in the developed world[1].
In New Zealand the reality is that more than half of the people who take their own lives are not diagnosed with mental health issues. In many cases suicide risk is linked to stresses such as poverty, homelessness, unemployment, and addiction.
On 07 May 2021 the Government announced that Sir Mason Durie, the highly respected academic and psychiatrist, had been selected as the first appointment for the new Māori Health Authority. Sir Mason believes the solution to issues such as the high Māori suicide rate, lies in helping communities to support and nurture their rangatahi to manage these stresses before they even reach the health system.
"The approaches we need may not be best found in an A&E department or even in a psychiatric ward, but in the communities where they live and in people who know how to reduce the distress in all sorts of ways. Not just by counselling," he says.
For several years Sir Mason has worked as a mentor and adviser for the Te Taitimu Trust, which was set up in 2007 to help support the wellbeing of vulnerable tamariki and rangatahi in the Hawke's Bay. The trust was set up by Zack Makoare, a former freezing worker from Flaxmere who lost his 15-year-old son Kelly to suicide in 2000.
In 2017, Zack was recognised with the Supreme National LifeKeepers Award for Suicide Prevention, after 10 years of running camps that have helped rangatahi to lift their spirits by connecting with our coasts and waterways. Sir Mason says the trust has now helped over 3000 young people increase their wellbeing by building skills around empathy, teamwork, responsibility, and leadership.
"I think the work Zack's doing is groundbreaking. His work is about wellness for young people and so that's hugely important in an environment where very often the people he's working with might never otherwise experience the notion of wellness.
"Some people define Māori by their disparities and disadvantage, but that's not a very good definition. The other way of looking at it is to define people by their potential. And that's what Zack's work is doing," he says.
While there are excellent mental health services in Hawke’s Bay, Zack believes they are not always accessible in a timely fashion nor necessarily appropriate for those who do not have a definable mental illness even though they might still be seriously unwell.
"Too much of our focus is on a medical model. I think we should use a model that's more inclusive of how Māori think at least, as an indigenous person, and how we can work with our environment to keep ourselves well," he says.
Zack believes the solution lies in rekindling the daily traditions of the past and his vision is to build a wellbeing centre as part of his whānau's new papakāinga development at Te Hauke, 20 kilometres south of Hastings. Zack says Te Pā Oranga will be built across a hilltop, together with homes for six families, "like we used to live in the past, where people live together and work together".
Zack's vision for Te Pā Oranga is to create a preventative residential programme which places wellness, whānau and te ao Māori at the centre. It will provide a safe and supportive space where rangatahi can receive help to build their wellbeing and resilience.
Carla na Nagara, the Director of the National Suicide Prevention Office, understands the value of creating community spaces where young people can find both emotional and practical support.
"When I was a coroner looking at hundreds of cases and talking to families, one of the things I kept hearing was the importance of having safe places for young people. They can be places where the person is given the support and networks to know what their next step might be in terms of practical help. Often, it's practical problems that drive people into distress, not clinical problems," she says.
Zack says it has taken many years for the 96 co-owners behind this Ngāti Kahungunu papakāinga initiative to develop a shared vision about the role they could play in supporting their wider community. While funding from Te Puni Kokiri has supported the development of affordable housing for six families, they are now fundraising for the development and operation of the new wellness centre.
When competed, Te Pā Oranga will have the capacity to house 8-10 tamariki and rangatahi from across Hawke’s Bay at any given time. Rangatahi will assist whānau in the management of community gardens and an outdoor auditorium will provide a space for presentations and performances.
At full capacity, the centre will be run by three kaimahi who will live in the whare and be responsible for the delivery of the programme. Zack says the papakainga whānau will also be trained so that they are able to step in and provide support whenever it might be needed.
"Te Pā Oranga will help us create a space where we can kai together, work together, karakia together, have fun activities together, learn together, and plan our lives together. Each day will be about forming a positive routine to help rangatahi build their self-confidence, responsibility, and empathy," he says.
While he may not have the same academic credentials as his mentor, Sir Mason believes Zack embodies the potential that we all have to serve our own communities.
"He wants to create an opportunity for young people to feel good about themselves, to be resilient, to be confident, to be brave and to move forward. Key to it though is leadership and I think, in that sense, the young people he's working with, he's helping them to become leaders as well," he says.
[1] 2020 provisional statistics: https://coronialservices.justice.govt.nz/assets/Documents/Publications/2020-Annual-Provisional-Suicide-Statistics.pdf