Access to culturally appropriate support can be a significant protective factor against poor mental health and suicide. Photo / 123RF
Access to culturally appropriate support can be a significant protective factor against poor mental health and suicide. Photo / 123RF
OPINION:
New 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. Māori 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 Māori) have been largely acknowledged, with Health Minister Andrew Little confirming plans to establish a Māori 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 Māori 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 Māori, leaving the public mental health system woefully under-equipped to deliver culturally appropriate support. This is in spite of the fact Māori are at least 1.5 times more likely to face mental health distress than non-Māori.
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 socio-economic factors that Māori 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.
Dr Angela Lim. Photo / Supplied
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 Māori app with the help of health insurer nib and nib foundation. Its development was informed by two years of reviewing literature, conducting interviews, and co-design (working closely with both a Māori translator and a Māori psychologist) to accurately capture the essence of what is important to Māori 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 Māori, but also the world view of te ao Māori and mātauranga Māori — 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 Māori, 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 Māori mental health, it's clear we cannot continue with the status quo. I wait with interest to see how the Māori 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.
• Dr Angela Lim is the CEO and founder of Clearhead and a former paediatrics doctor. You can read this article in te reo at https://www.clearhead.org.nz/mi
