Te Iho Maori Mental Health training Programme

This is an excellent website that goes a long way to foster a better understanding in regards to the cultural and spiritual aspects of Maori people in regards to mental health. I will also place it in the links system for future reference.

Click on it here : Te Iho Maori Mental health Training Programme.

Here are some excerpts on Maori Cultural considerations

“Mate Mäori, for example, leads to an affliction said to be related to spiritual causes, and requires the intervention of a traditional healer, a tohunga. In Rapuora, the 1984 study of the health of Mäori women, one in every five women respondents said they would go to a Mäori traditional healer if they had a mate Mäori though not all knew who might be an appropriate healer, nor could one in five women say what was meant by mate Mäori.1  The term refers essentially to a cause of ill health or uncharacteristic behaviour which stems from an infringement of tapu (a tribal law) or the infliction of an indirect punishment by an outsider (a mäkutu).2  The prevalence of mate Mäori has never been recorded although there are published accounts of isolated cases of the condition and its management.3 It may take several forms, physical and mental, and various illnesses not necessarily atypical in presentation may be ascribed to it. 

While mate Mäori applies to physical as well as mental illnesses, increasingly it has become a focus to explain emotional, behavioural and psychiatric disorders, presumably because many physical illnesses are now seen as having a more specific cause. Thus there is no single clinical presentation and clinicians need to be alert to the possibility that relatives may have considered the possibility of mate Mäori. Most families will be reluctant to discuss mate Mäori in a hospital or clinic setting, fearing ridicule or pressure to choose between psychiatric and Mäori approaches. In fact, one approach need not exclude the other; cooperation between traditional Mäori healers and health professionals is now becoming acceptable to both groups. Mate Mäori does not mean there cannot be a coexisting mental disorder. At best, the term is a comment on perceived causes of abnormality rather than on the symptoms or behaviour which might emerge. Yet it remains a serious concept within modern Mäori society, and to many people, mate Mäori sounds more convincing than explanations that hinge on a biochemical imbalance or a defect in cerebral neurotransmission.

Other situational responses may present as if they were mental disorders. Whakamaa for example, a mental and behavioural response that arises when there is a sense of disadvantage or a loss of standing, can be manifest as a marked slowness of movement and a lack of responsiveness to questioning, as well as avoidance of any engagement with the questioner.A pained, worried look can add to a picture that is suggestive of depression or even a catatonic state. But the history is different and the onset is usually rapid – unlike those other conditions where a more gradual development occurs. Sometimes, because Mäori will often report seeing deceased relatives or hearing them speak, a diagnosis of schizophrenia or some other psychosis may be made. However, if visions or hearing voices are the only symptoms there is never a firm basis for diagnosing a serious mental disorder.”

Also on the site there is an interesting Excerpt from Mason Durries book “Tirohanga Maori”. See the full excerpt here

A brief quote from the link:

Illness And Treatment
Prior to 1976, professional and academic interest in Mäori perspectives on health and sickness tended to confine discussion to particular clinical syndromes which were unique to Maori and of anthropological as much as medical interest. Makutu and mate Mäori, for example, attracted considerable comment from Western-trained psychiatrists, though tended to be reinterpreted as superstitious phenomena and of doubtful diagnostic significance 3,4.  Mäori concepts of illness were increasingly reinterpreted by the medical anthropologists in mental and psychic realms, scarcely relevant to the vast majority of human illnesses and hardly applicable to contemporary times. It was left to Mäori writers to point out the continuing relevance of culture to illness and treatment, and to provide some balance for the more esoteric ideas which had appeared in the earlier medical and scientific literature. The process started with an examination of medical practice and hospital procedures to determine the significance of culture to Mäori patients in everyday situations. Durie concluded that, although Mäori were more often than not Westernized, or at least appeared to be, cultural heritage continued to shape ideas, attitudes, and reactions, particularly at times of illness. ‘The concepts of tapu and the perception of illness as an infringement against tapu are central to much of the anxiety and depression which surround the Mäori patient while in hospital. Family involvement at times of illness is likewise a very traditional and culturally necessary attitude which must be recognised in the management of the whole patient and not just his impaired organ.’ 5

The relationship between tapu and noa, and explanations of illness based on a postulated breach of tapu, continued to have meaning for Mäori and therefore had implications for doctors in the management of Mäori patients as well as the care of the deceased as long as they were still in hospital custody. Because early retrieval of a relative’s body was critical to uphold the mana of the family and the individual, mourning Mäori families were grossly offended if the body were not released within twenty-four hours of death. Post-mortem delays, or simple administrative inefficiencies, could add immeasurably to the grief of an already distressed family.

AT the bottom of the link above, there is a PDF of the entire chapter which can be downloaded.

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Interesting concepts, I thought in particular how relevant cultural considerations are to health. There is the whare model of health. I hope you all enjoy looking through the site. I did.

PLEASE NOTE: TE IHO HAVE BEEN HAVING TROUBLE WITH THEIR WEBSITE AND IT IS CURRENTLY UNDER REPAIR. YOU MAY HAVE PROBLEMS VIEWING IT AT PRESENT ( 28TH APRIL 2010)

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