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Atawhai: Making It Safe To Talk About Family Violence In Healthcare

New research makes it easier for healthcare workers to respond to family violence, by connecting primary care services with community knowledge and resources.

Dr Claire Gear, Research Fellow at the AUT Centre for Interdisciplinary Trauma Research (CITR) and Atawhai project lead, said: “Family violence is a key determinant of ill health. To prevent future harm, the value of responding to family violence must be explicitly recognised within health care policy and practice”.

While primary care workers are well positioned to provide early interventions, sometimes it’s hard to know exactly what to do or how to help.

Atawhai is a three-year study, funded by the Health Research Council of New Zealand, to improve primary care services for those impacted by family violence.

Dr Gear leads a research rōpū founded on Te Tiriti partnership that is working alongside primary health providers, community services, and tāngata whenua in the Bay of Plenty to develop novel responses to family violence.

So far, a series of deliberative dialogue workshops have been successful in developing trust-based relationships and safe ways of working.

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“During these workshops, our research participants share what it’s like to care for people who are experiencing family violence and explore what is needed to support safe and effective responses,” said Dr Gear.

“We learn from our shared experiences, we value and look after one another in this work, and this generates confidence in knowing how to help as well as building trust in local services and local people.”

Accountability to whānau can be shared across the community, reducing the burden for individual health professionals.

Dr Anna Rolleston, Director of The Centre for Health in Tauranga and a member of the research rōpū, said: “Atawhai connects people who don’t usually work together, because the way that the system is structured keeps them apart. By bringing together medical services and community services, we will get different outcomes that work across both spaces”.

Atawhai was the name given to the project by Reon Tuanau (Ngāi Te Rangi).

Ngareta Timutimu MNZM (Ngāi Te Rangi, Ngati Ranginui), kaitiakitanga and research rōpū Atawhai, said it’s a kaupapa for all families, all whānau, and all peoples.

Whai means to explore, to research, to pursue. Ata means to do that sensitively and slowly, at the speed that is required by the whānau that seek help. That may mean finding solutions quickly or walking alongside whānau long-term.”

This kaupapa strongly aligns with Te Aorerekura, the first national strategy to eliminate family violence and sexual violence, launched in December 2021.

“Through people in different parts of the system taking time to listen and learn from each-other we’ll build understanding about how to connect to deliver sensitive, integrated, responses to people impacted by family violence and sexual violence. I am heartened by the deliberate way in which Atawhai is seeking new understanding to improve responses,” said Marama Davidson, Minister for the Prevention of Family and Sexual Violence.

“Te Aorerekura is very clear about the importance of community and tāngata whenua leadership, the need to try new things we have not done before, and being open to learning new ways of working. I look forward to hearing more about the ways in which this mahi shapes understanding and action from here.”

The Minister met with the research rōpū and will attend an Atawhai workshop with research participants in Tauranga on June 16.

Atawhai weaves together complexity theory and tikanga Māori research methodologies to enable a different way of viewing the response to family violence, rather than a prescribed set of guidelines.

Conceptual statements act as building blocks for primary care providers – What would you do if it were you? – Know who you are and where you come from – We need to know our community and believe we can make a difference – Realise the bias we each carry.

“Our collective learning indicates that who you are matters. Family violence is deeply rooted in societal trauma. Taking time to reflect on how your worldview influences your practice is critical. Understanding local history, whenua, whakapapa and the impacts of colonisation and racism can transform the way that you practice,” said Dr Gear.

“Part of reframing our response to family violence is realising that we don’t have to fix the problem, but be someone that whānau can trust.”

Best practice is usually developed through research findings that are distilled and shaped into guidance that informs health professionals. This study moves away from linear concepts of evidence to more inclusive ways of knowing.

Dr Gear said prescribed responses can lose their real-world applicability.

Atawhai recognises that we continuously learn in multiple ways – inclusive of different practices, cultures, and contexts within healthcare – and it is through our relationships that knowledge moves,” she said.

“Our kōrero reframes the way that we respond to family violence in healthcare. We create the space to be present, to engage with whānau authentically and openly, with compassion and respect. It’s a way of engaging with people that would benefit all health practice.”

Atawhai is generating an influential network of primary care professionals dedicated to preventing family violence. This network connects people, organisations, information and tools to safely journey with whānau in their experience of family violence. Members will have confidence in knowing what to do and how to help, have access to trusted local referral services and be able to share challenges with like-minded people.

To join the Atawhai network go to www.atawhaitia.co.nz

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