We have passed the era of psychiatric hospitals built in remote settings that affirmed the out of sight response for
those with mental distress. Though, many of those places became worlds unto their own, with varying reputations of being
places of recovery to places of disturbance.
The reality is that our current mental health units are built upon the old bastion of psychiatry that favour restricted
practices, locked up facilities and a mystery that reinforces stigma and discrimination associated with mental distress.
The reoccurring despair and disgust of our mental health units and systems are nothing new. When Māori are admitted to
these places, we tend to be subjected to inequity, institutionalised racism and a higher chance of being secluded and
restrained.
Until we address equity, indigenous practice, cultural competencies, and an increased investment in the Māori workforce,
we will still see our people struggle to flourish and thrive.
The mental health system has not worked for Māori and many others. The archaic practices and institutions that have
sadly been the treatment for whānau have only added to the historical trauma that Māori endured and survived. We still
thrive for the paradigm shift in the mental health system to fully encompass healing and indigenous practices.
Even with modern mental health units built in the last decade, their co-design processes seem to meet the aspirations of
staff of the day rather than meet the needs of the people who require a place for healing.
However, the most important aspect of any mental health unit is its therapeutic culture often reflected in the high or
low rates of seclusion or restrictive practices. In this regard the condition of the building is not the only issue.
If we had the choice, we would have a range of places for recovery and support that would be purpose built for whānau -
not focused on containment or custodial care. We would close down all old, dilapidated buildings representative of a
troubled history and we would drive out all restrictive practices. We would advocate for culturally and clinically safe
therapeutic care and community facilities, with healing environments with limited boundaries and flexible spaces.
We would promote regular lived experience and whānau led audits of mental health units to ensure optimum quality of
care, which would prevent the current lack of care in places of recovery.
We would insist that the use of Māori terminologies or Te Reo Māori names would only being used within these
environments if there were clear evidence of respect, manaakitanga at the forefront of all engagement and care for
people and their whānau .
We would celebrate the people who are committed to best practice approaches for todays needs, and mental health units
maintaining effective working relationships with Iwi and Kaupapa Māori services as partners in care.
Te Kete Pounamu: National Ropu | Te Rau Ora: www.terauora.com
This statement was inspired by Oliver Lewis Dilapidated’ mental health units undermining care’ a Newsroom article: