Common Mental Disorders Depression - New Zealand Doctor

Chapter 9 Models of care
• networking by all kaimahi internally and intersectorally
• a physical environment conducive to Mäori beliefs
• autonomy and control in development of Mäori mental health services
• striving to work with whänau, thus contributing to overall Mäori development
• access to information that assists informed development
• building and maintaining relationships at all levels with consumers, whänau groups
and individuals on a national, local and international level
• acknowledgement of Mäori processes, both at a managerial level and within
service provision.
Workforce issues
Current efforts to increase Mäori health workforce recruitment and retention are
having a positive effect. A recent report 555 has described key success factors as follows:
• Mäori led, focussed and targeted interventions
• consistent investment over a prolonged period
• emphasis on the development of dual cultural and clinical competencies
• integration of student support programmes within a university environment
• provision of comprehensive support to tertiary students, including financial
assistance, access to Mäori mentors and peer support, and inclusion in
communities of learning
• congruence with industry needs
• supported transitions into and between study and work
• attention to the broader determinants of Mäori health workforce participation
• action across workforce development areas (including secondary schools).
Primary-care based mental health services
Mäori working in mental health have consistently described the interdependence
of Mäori as the individual’s responsibility to a collective that is linked by whänau,
whänaungatanga and whakapapa. 200 Whakapakari Ake Te Tipu, the Mäori Child and
Adolescent Mental Health and Addiction Workforce Strategy 200 advocates a cross-sector,
all age approach to reflect a holistic view of health. The primary care sector has been
identified as the logical place for the delivery of mental health care to Mäori, as it offers
better prospects of early intervention and the management of comorbidities, and is
more closely linked to community agencies such as schools, maraes and recreational
centres. 200 This will require developing the workforce and upskilling primary care workers
so that interventions can be delivered in primary care settings. 200
Whakapakari Ake Te Tipu provides examples of primary-based mental health services
that deliver early intervention programmes for young Mäori and reduce the divide
Identification of Common Mental Disorders and Management of Depression in Primary Care 123