Maori and Pasifika, Specialty Mental Health Services

Kasia 

This week has been an exceptional one for sharing and learning, mostly a lopsided proposition where I received the greater gifts for sure. I was fortunate to have been scheduled for a formal welcome, powhiri (pronounced popheree) on Monday, my 55th birthday at the marae, spiritual house, Te Whare Marie which translates to 'The House of Peace', while they were welcoming Kasia Madrzejewska , Masters in Clinical Psychology, and just arrived from Christchurch, New Zealand, as the newest team member.
We were first met by Ms. Jayne Tawhi-Amopiu, acting team leader, who gave us the traditional Maori welcome of grasping your hand and then putting her cheek to yours and kissing. Then Ms. Hinengakau Taurerewa, Dual Diagnosis Therapist, veteran of cultural folk medicine practices, and trained Chinese herbalist, did likewise and oriented us to the process of procession where we would be hailed with song-calling and she would respond in like. This is a slow movement toward the marae. Within a few minutes we were asked to remove our shoes so we could enter the marae, and sacred ground. The entire time there are 30 people inside the marae singing to us a welcome, and the men, about half the group, include a pantomime of hauling in a large rope while they sing/chant, which carries the significance of drawing in the great canoe that we would have traveled in to reach their iwi, literally the bones of their people. It was explained to me later that the area outside of the entrance to the marae is a war zone. In times past this would be where the marae members would attack if your intentions were seen to be untrustworthy. The Maori (a term given to the tribes of New Zealand by the white settlers) are a warrior people and the only tribal group that the British Commonwealth had not defeated in the Pacific. They settled with the historic Treaty of Waitangi in 1840 that is now at the center of many modern discussions for improved supports, consistent with the articles of the treaty. Once inside the marae the welcome would become a bit less formal with introductions and welcoming at length.
Those with the greatest mana, ( ma- to join, and na the sacred breath), or prestige, begin this process of individual introductions and welcome, and everyone speaks in Maori. The men with mana first spoke and then the elder women, and my specific escort was an older man who said that he is trained as a social worker and has worked a long time in the forensic mental health services. He helped make the welcome easier to understand by whispering some english translations to me once in awhile. I felt quite humbled with the high energy, traditional practices such as the communal singing and dance that was incorporated, and the music. Prior to entering the marae I was asked if I had a song, because they would have wanted to sing it in support of my welcome, but I could not think of one as this was unexpected on my part, and of course I was a bit overwhelmed as well. Several women had flowers in their hair as they rose to speak about their heritage and place. Each person in the marae spent a good amount of time addressing everyone in their introduction, telling of what mountain and river they have called home. I was to go last and by then I had enough of an idea as to what needed to be said that I was able to get across who my people are, where I am from, and what my purpose was in visiting. I enjoyed their responses and felt reassured that everyone was comfortable with my presence. So that was the first hour, and then we had to complete this welcome with a lot of food, because this is a sacred process and it is not complete until the food is eaten by all present. They made sure I sat amongst the group with high position while I ate. A lot of the food that was not eaten was packed up to bring out to community members.
I was surprised to see other pakeha, that is people of european descent and non Maori. One was Dr Richard Holt, from Minnisota, who has been serving there for the past several months and had an impressive handle on the language already. He is Consultant Psychiatrist for the adult team. Another is Dr Allister Bush, who is Richard's counterpart on the children's team who hails from the Christchurch area on the south island. Both welcomed me to sit in on clinical sessions and discussed their connections and the value of this service with me. My buddy in the welcoming procession, Kasia, being another pakeha. You might think from her photo above that obviously she would be non Maori, but that would often be a mistake, as many Maori decendents look very 'white' or european, but in fact have significant Maori heritage, and that is enough to claim that you are Maori. Last night I attended a wonderful show called "Walk a Mile In My Shoes" by the Bare Foot Divas: five amazingly gifted women who sang and spoke in turn to the issues of their heritage and the struggles they share with their people, one from Papua New Guinea, and one from aboriginal Australia, three from the Maori community. Two of the Divas shared examples of pakeha who for various reasons grew up with Maori families and became inculturated with Maori tradition and spiritual orientation, and spoke Maori as their first language, and then as adults had no desire to leave their Maori ways when sought out by their biological families. They had connected to mauri - the spark of life, that imbues the Maori people with their strength and connection to all spirits. So it was during my incredible welcome and embrace within this marae and the Maori Specialty Mental Health Services at Te Whare Marie. Oh! and the men in greeting also embrace your hand and engage you in the hongi, the sacred sharing of breath, where they put their forehead and nose up against yours and stay their to share the breath of life. I was impressed beyond words with this experience of welcome, the depth of connection right from the start, and was able then to engage each person as someone I knew and felt comfortable with, no longer a stranger. All through the week people here sought me out and welcomed my interest in their role, work, heritage, and future. If I appeared to be disengaged at any time someone would come over and ask if I needed anything. I can not remember a time when I felt more cared for in a work environment.

Moana Kaio, med student, and Kara Mihaere, team psychologist 

Above is Moana and Kara, both are Maori, they shared many stories with me of their experiences with the mental health service. Moana had recently returned for her final few months as a medical student. She elected to return to further study the work done here at Te Whare Marie before she makes her final decision on the specialty she will pursue as a doctor. Kara is a team psychologist, and she gave me a book on Maori Health studies in which she is featured in one study showing the disproportionately high percentage of sleep disorders in the Maori people. In overview, the Maori represent a higher percentage in many categories of health issues that in part reflect the history of the discrimination practiced against them as a people. I met with several Maori, like Wakaiti Saba who grew up not being allowed to use her language in school, and in fact punishment was strictly used when they were caught using Maori words. She is part of an entire generation that were not allowed to use their Maori language. For many it was only through the elders that they were able to carry on the language and teach the children. Today Maori immersion schools are growing and it is a great point of recovery and renaissance for the Maori to have schools that use only their language and teach their world view about spiritual connection and relationship.

Below is a caption of my visit with the sister organization to the Maori Specialty Mental Health Services: Health Pasifika. This organization is headed up by the same leader, Malcolm Robson, and shares other staff from the Maori Services like Dr Allister Bush, and Consumer Consultant Te Wera Kotua. Health Pasifika is comprised of seven prime cultures, but Samoan is the predominant. The day I visited included Cultural Supervision for the staff. Some representatives from the Forensic Mental Health Services were present. They sang several songs accompanied by guitar and ukilalee. The elder woman playing the ukilalee began her service in 1969. She is a vibrant member of the team. I was fortunate to sit in on a conversation the group was busy with, focused on how to include traditional health practitioners, and one was present. It was a very constructive discussion of the issues confronting the western medical model. Dr Bush and Mal Robson were clear to endorse the value of additional options that improve the chances for recovery and see traditional healers as one more of these positive options, especially in light of families asking for access to these traditional healers. Then the discussion moved to how to enable better access to traditional healers who primarily are only known through word of mouth.

Carvings near the entrance of the Te Whare Marie marae

In the day, the wood carvings that adorned the marae were powerful statements of the mana of the iwi, hence the woodcarvers were highly esteemed and their skills used in many areas such as building the great canoes, the pou, pilasters to signify sacred grounds, and of course the iwi marae. I came to understand that there are many layers of significance to these artistic elements within all factors of the Maori culture and language. Everyday my conversations with staff brought up more significance of these greater depths of meaning and value in their language, art, and relationship, and how core these elements are in mental health recovery and wellness for Maori, and Pasifika peoples.

Health Pasifika conducting Cultural Supervision

Tua Hekenui, Cultural Therapist

This is Tua, Cultural Therapist, who works to bring Maori cultural connections/ opportunities into the lives of Maori who come into services. Many who come into these Maori services do not have much connection to their culture, and those that do have, often benefitted from the affirmation that these staff give in their traditional cultural practices like the offering of something like prayer at the beginning of each session, invoking renewed connection with their heritage, community, and spiritual relationships. He was very generous with sharing examples of his approach and work. Tua often takes a client for a walk to help the process of spiritual connection, usually beginning with the spiritual energy of the environment to invoke a new/ renewed connection, for the person with experience of illness. He is then able to steer the discussion toward the connection and spiritual significance to whanau, family, and the issues of recovery and its meaning for their family, iwi.  He is an artist who carves wood, a traditional role in his life's work. He also runs a free school, along with his wife, teaching traditional ways of the warrior skills and ethos, pointing out that Maori warriors had to be skilled fighters but even more skilled as healers (expected). He is currently enrolled in his second year in the Bicultural Social Worker School. Tua imparts an improved sense of belonging with his sharing of Maori world view. He showed me many examples of the creative expression and identity that is Maori in language, art, and philosophy. Many people here spoke of their spiritual connections, and it was a week of spiritual awakening for me. The connectivity we all need, a sense of belonging, relationship, I had only understood from a very limited perspective prior to my encounters with Jayne, Hinengakau, Tua, Te Wera, Richard, Allister, Karen, Kara, Moana, and all the others who spoke of their spiritual lives through their culture and work. Karen took me out and I met with several of the consumers she works with in the community, as well as at the recycling center and organic garden where many consumers spend a good part of their day.
Many here gave me materials to take home with me and took the time to show me examples of their work, and how their culture informs their work of supporting recovery. Tua extended an invitation for me to meet him at Te Ahurewa Topu Ma Taiaha, his School of Maori Weaponry. I feel honored for this and so many other welcoming acts made by the staff here. I hope one day to be able to host anyone from this service who can make it to my home and place of work.
   While listening to Tua, Te Wera, and Hinengakau, I was able to improve my appreciation and depth of understanding for the value and significance of language in its role of recovery. Our language enables us to reconnect and heal dis-ease, hence our talking therapies. Language is the vehicle for the discovery/ recovery of meaning in our community, our relationships, our wellbeing. Many of my discussions came across as analogous to the value of poetry and visual art with its layered meanings and overlay of dimensions that reveal different but complimenting elements of universal beauty. This is primarily done through connecting to the sacred spirits of the environment we hold relationship in. Perhaps none is greater than the sacred sharing of breath, na. The act of dissolving the distance between people and joining our communal spirits. These are universal themes and principles that transcend culture and religion, supersede programming, funding, and the many barriers that we often get sidetracked in. The Maori culture and its participants, especially at Te Whare Marie, showed me how crucial it is to grow these spiritual connections in order for services to be effective, and for people to recover their wellness. The high degree of welcome I experienced here and the ample generosity to share, teach, and touch, made it possible for me to gain heaps of new insight into the recovery process for people with mental illness, and for providers to grow a sense of purpose and pleasure in their work of helping people reconnect to their roots of culture and whanau, family, in a wider sense of the term.

 "Flo" ( "to be kind to your tongue" ) below, heads up Health Pacifika. She explained many of the details of their service and the challenges she faces trying to meet the needs of many cultures in her program. Mal Robson is in hopes of being able to improve the program by scheduling regular visits for staff here so they can operate 'off the same page', coming in from their various island locations and get grounded in the same philosophical/ values driven approach.
Below you can see a caption of Te Wera, Consumer Consultant, who allowed me to video record a presentation he does about the power of language in his culture, delivered via a simple telling of how parents typically teach their very young children to count to ten, and often unknowingly are also teaching them the Maori creation myth, which is a great example of the layering of meaning in language. I look forward to sharing this when I return home.
  

Folole laeli Esera, Team Leader for Health Pasifika  

Mr. Te Wera Kotua, Consumer Consultant, and spiritual mentor. 

Ms. Jayne Tawhi-Amopiu and Richard, a psychiatric nursing student from England

Nine greetings in each of the principle Pasifika  languages