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Māori mental health

The Royal Australian and New Zealand College of Psychiatrists (RANZCP) prioritises the achievement of high-quality mental health outcomes for Māori. It promotes and advocates for the rights of Māori to culturally appropriate, accessible and effective psychiatric care.

This page provides information and resources to support mental health service delivery and appropriate assessment practices for Māori. They are intended for use by the Māori mental health workforce, as well as individuals, families and whānau.

Our Te Kaunihera mō ngā kaupapa Hauora Hinengaro Māori

Te Kaunihera mo ngā kaupapa Hauora Hinengaro Māori (Te Kaunihera) is a constituent committee of the RANZCP’s Practice, Policy and Partnerships Committee.

It provides the RANZCP with advice on issues relating to Māori, including clinical practice and psychiatry training, and advocates for the mental health of Māori. It also supports the recruitment of Māori doctors into psychiatry.

The committee is made up of Māori community members who have involvement in mental health service provision and policy development, as well as psychiatrists and trainees with direct experience of working in Māori mental health.

Cultural safety in Aotearoa

Strengthening the mental health workforce in Aotearoa, New Zealand, and ensuring cultural safety in practice are key areas of focus for the RANZCP. We recognise the status of Māori as tāngata whenua of Aotearoa New Zealand, and the obligations and responsibilities that arise from Te Tiriti o Waitangi. 

Psychiatrists in training are assessed to be culturally safe. They also must have a sound knowledge of Te Tiriti o Waitangi and demonstrate how its core principles of participation, partnership, and protection must be integrated into mental health services and practice to achieve equitable health outcomes.

Takarangi Cultural Competency Framework 

RANZCP supports and hosts wānanga regarding the Takarangi Cultural Competency Framework.

The Takarangi Competency Framework is Māori centric and centres its content a Māori world view. This has meant the development of the framework and the workshops, has required understanding of Māori notions of knowledge, wisdom and competency development. 

The Takarangi Competency Framework provides a benchmark against which all mental health and addiction practitioners can use to measure and develop their professional capability, personal competency, and confidence to work with Māori.

In the wānanga, accumulated facts or knowledge is processed so it can be integrated into one’s being. Please contact the Aotearoa, New Zealand branch for further information.

Cultural competence

Cultural competence has been defined by the Medical Council of New Zealand as a doctor (or any health care worker) who ‘has the attitudes, skills and knowledge needed to function effectively and respectfully when working with and treating people of different cultural backgrounds’. While it is important, cultural competence is not enough to improve health outcomes. Evidence shows that a competence-based approach will not deliver improvements in health equity. 

Cultural safety

The RANZCP promotes culturally safe practice. 

Working in a culturally safe way means identifying and respecting the values and beliefs of the people you are working with and using these as the basis for working together. It may take longer for some people or whānau to trust you because they have had prior experiences in the health system that were not culturally safe.

Cultural safety requires healthcare workers and their associated healthcare organisations to examine themselves and the potential impact of their own culture on clinical interactions and service delivery. 

This requires individual healthcare workers and organisations to acknowledge and address their biases, attitudes, assumptions, stereotypes, prejudices, structures and characteristics that may affect the quality of care provided. 

Cultural safety encompasses a critical consciousness where healthcare workers and healthcare organisations engage in ongoing self-reflection and self-awareness, and hold themselves accountable for providing culturally safe care, as defined by the patient and their communities, and as measured through progress towards achieving health equity. 

Cultural safety requires healthcare workers and their associated healthcare organisations to influence healthcare to reduce bias and achieve equity within the workforce and working environment. 

Health literacy

To ensure people have the knowledge and skills they need to manage their health, every health discussion needs to identify and meet the individual’s health literacy needs appropriately. Meeting health literacy needs is essential to providing health care because it gives people the information and skills, they need to manage their health. Health literacy includes knowing how to stay well and prevent health challenges, when and how to seek appropriate health care, engage in treatment, and make informed decisions. This also includes understanding other health conditions people might have and supporting the health of whānau and communities.

In practice

To provide culturally safe care, the health workforce needs to be aware of how their own culture and biases impact the quality of care provided, and regularly reflect on what they do to improve the quality of care they provide. 

In practice, this means actions such as: 

  • Greeting people appropriately 
  • Pronouncing people’s names correctly. If you are not sure how to pronounce a name, ask people for guidance and check whether you are getting it right 
  • Asking people about their knowledge, beliefs and values (worldview) and respecting these during the discussion and decision-making processes 
  • Asking people whether they want to start their appointment with a prayer and respecting this as supporting wellbeing 
  • Asking people whether they would like to have whānau or support people in the discussion and involving whānau in the discussion when the person would like this.

The Medical Council of New Zealand

The Medical Council of New Zealand (MCNZ) regulates the cultural competence criteria [PDF; 1 MB] which specialist medical education programs must meet, and provides resources on cultural competence for its members.

The New Zealand Psychologists Board

The New Zealand Psychologists Board Core Competencies For the Practice of Psychology in New Zealand [PDF; 312 KB] contains useful information on cultural competency and applying the principles of the Tiriti o Waitangi in mental health service delivery.

Mauriora Health Education

The Mauriora website offers free and paid online training courses on cultural competence, Māori healthcare, and the Te Tiriti o Waitangi. It also has a course on Māori healthcare and the Te Tiriti o Waitangi for overseas-trained doctors. 

Please note that these online courses are not RANZCP endorsed or endorsed for RANZCP CPD points.

Current initiatives

RANZCP Aboriginal, Torres Strait Islander and Māori Trainee Financial Support Initiative

Up to A$6,000/calendar year is available to assist with the costs of specialist training (e.g. RANZCP training fees, assessment fees, attending conferences) and other activities to achieve Fellowship.  

Find out more and apply

Clinical practice

RANZCP Clinical Practice Guidelines

The RANZCP’s Clinical Practice Guidelines (CPGs) are a suite of practical resources for psychiatrists and other mental health clinicians which draw on the latest international evidence-based practice. The CPGs provide guidance on appropriate mental health treatment options in Australia and Aotearoa New Zealand.

RANZCP Clinical Practice Guidelines

Health strategy

The New Zealand Ministry of Health has produced a range of documents relating to Māori and mental health strategy.

Māori health strategy

Mental health strategy

Support and engagement with family and whānau

The RANZCP values the contribution that all people with lived experience of mental illness make to improving the quality of mental health care. Carers and the wider whānau (family) play a crucial role in supporting the treatment and recovery of Māori with mental illness, including creating an environment which is culturally safe. 

Learning resources

RANZCP supports and hosts wānanga regarding the Takarangi Cultural Competency Framework. 

The Medical Council of New Zealand (MCNZ) regulates the cultural competence criteria.There are specialist medical education programs that provide resources on cultural competence and safety. 

Te Tāhū Hauora | The Health Quality and Safety Commission New Zealand have produced a series of modules designed to encourage health professionals to examine their biases and how they affect the care they provide, their interactions with patients, and the impact this has on their health outcomes. 

References

  1. RANZCP. 2022. Position Statement 107: Recognising the significance of Te Tiriti o Waitangi (PS 107). https://www.ranzcp.org/clinical-guidelines-publications/clinical-guidelines-publications-library/recognising-the-significance-of-te-tiriti-o-waitangi
  2. Manatū Hauora. 2019. Achieving equity. www.health.govt.nz/about-ministry/what-we-do/work-programme-2019-20/achieving-equity
  3. Te Pou. 2010. The Takarangi Competency Framework. https://d2ew8vb2gktr0m.cloudfront.net/files/resources/takarangi-competency-framework-essence-statements-poster.pdf 
  4. Te Kaunihera Rata o Aotearoa. 2019. He Ara Hauora Māori: A Pathway to Māori Health Equity. https://www.mcnz.org.nz/assets/standards/6c2ece58e8/He-Ara-Hauora-Maori-A-Pathway-to-Maori-Health-Equity.pdf
  5. Te Kaunihera Rata o Aotearoa. 2023. Cultural safety. https://www.mcnz.org.nz/our-standards/current-standards/cultural-safety/ 
  6. Te Kaunihera Rata o Aotearoa. 2019. Statement on cultural safety. https://www.mcnz.org.nz/assets/standards/b71d139dca/Statement-on-cultural-safety.pdf
  7. Te Tāhū Hauora | The Health Quality and Safety Commission. 2022. Learning and education modules on understanding bias in healthcare. https://www.hqsc.govt.nz/resources/resource-library/learning-and-education-modules-on-understanding-bias-in-health-care/
  8. Te Tāhū Hauora | The Health Quality and Safety Commission. 2023. The Code and your rights. https://www.hdc.org.nz/your-rights/the-code-and-your-rights/your-rights-when-receiving-a-health-or-disability-service-poster-in-te-reo-maori-easy-read/
  9. Te Tāhū Hauora | The Health Quality and Safety Commission. 2023. Te Ao Māori Framework | Te Anga Ao Māori. https://www.hqsc.govt.nz/resources/resource-library/te-ao-maori-framework/
  10. Te Tāhū Hauora | The Health Quality and Safety Commission. 2023. Guide for health professionals caring for kaumātua | Kupu arataki mō te manaaki kaumātua (Frailty care guides). https://www.hqsc.govt.nz/resources/resource-library/guide-for-health-professionals-caring-for-kaumatua-kupu-arataki-mo-te-manaaki-kaumatua-frailty-care-guides-2023/ 
  11. Te Tāhū Hauora | The Health Quality and Safety Commission. 2023. Code of expectations for health entities' engagement with consumers and whānau. https://www.hqsc.govt.nz/resources/resource-library/code-of-expectations-for-health-entities-engagement-with-consumers-and-whanau-web-version/
  12. Te Tāhū Hauora | The Health Quality and Safety Commission. 2023. The Code of Health and Disability Services Consumers' Rights. https://www.hdc.org.nz/your-rights/the-code-and-your-rights/

Last updated 29 May 2024