The Pasifika and Maori community vision for culturally safe mental health support services

The Pasifika and Maori Mental Health Forum was held in Brisbane’s south on 19 February 2015, during which members of the lay public, as well as healthcare providers in the mental health sector were invited to participate in a series of focus discussion groups held on the same day. Participants were drawn from across the south-east Queensland urban region and divided into ethnic groups, with a total of 183 adults representing the following communities: Cook Islands, Fiji, Maori, Niue, Papua New Guinea, Samoa, Tonga and Tokelau, with separate groups for service providers and youth.

  • Culturally appropriate discussion formats known as talanoa and hui were used, which have been established as reliable methods in qualitative research with Pasifika and Maori [7].
  • Topics of discussion included: definitions of mental health and well-being; existing local community support structures; barriers to health service access; and desirable characteristics of a culturally specific mental health service. Thematic analysis was performed on transcripts of the discussions to identify common themes.

Main findings

Three themes were identified, regarding community concerns, needs and service preferences:

  • fear of stigma and judgement by others;
  • the need to be respected and valued in the local community for adequate support; and a
  • preference for holistic health services which generate a culturally safe environment.

Conclusion

Many Pasifika and Maori do not respond to healthcare which does not match their concept of health and wellbeing. While present efforts are commendable, mainstream mental health services available in the south-east Queensland region do not provide sufficient levels of culturally appropriate support. A combination of factors, including stigma and perceived lack of respect by services appear to lead to Pasifika and Maori patients delaying or avoiding clinical assistance during times of mental distress.

Recommendations

Consumers and service providers have recommended shifting from the current focus on crisis intervention and directing resources toward a planned, preventative multi-sectoral approach. In order to improve community acceptance of mental health services and overcome barriers to access by Pacific Islanders and Maori, a new approach must address specific cultural needs:

  1. Enhanced data collection procedures, to track health needs based on ethnicity (the actual size of Queensland-based Pasifika and Maori communities is unknown) as many Pasifika and Maori remain “statistically hidden” due to migration from/via New Zealand.
  2. Community health promotion, to de-stigmatise mental illness and educate people;
  3. Empowerment of community support structures, to link consumers to resources; and
  4. Provision of culturally safe and holistic care, as seen from the consumer’s perspective.