The Treaty Of Waitangi - Mental Health Crisis Management

THE TREATY OF WAITANGI 1
The Treaty Of Waitangi
Name of the University
Author Note

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In New Zealand, the risk of mental stress and addiction is very high. Due to high
treatment cost, the Maori people, their families, along with whanau, is unable to access
healthcare service(Baker, 2017). There is a crisis in the Maori community regarding the
mental health of unprecedented proportions. The mental health crisis management helps in
ensuring the safety and emotional stability of people experiencing an emotional crisis or
mental illness and avoid further deterioration of their health condition. The Maori health
perspective emphasized the significance of four interacting dimensions such as taha wairua
(spiritual health), taha hinengaro (emotional or mental health), taha tinana (physical health)
and taha whanau (family health), which were taken into account by the physicians to provide
a holistic approach of care for the patients(Kopua, Kopua & Bracken, 2019).
At Aotearoa, in New Zealand, the rates of people being affected by mental health and
addiction concerns are estimated to be 50 - 80 % of people over their lifetimes. With the
Maori community, the risk of mental health issues is 1.5 times more likely than non-Maori to
be affected.
Nurses are encouraged to cooperate with Maori people and whanau, support them
throughout their periods of crisis for developing their resilience and adaptive coping
strategies, which will help them to navigate the crisis of mental health with positive
outcomes.
The Treaty of Waitangi is an agreement that was established between the
representatives of the British Crown and the Maori community. It was designed to establish
novel rights and obligations of the Maori people(Came, Cornes & McCreanor, 2018). It
agrees to a partnership with Maori, for protecting their interest. It responses to the needs of
Maori and provides equal opportunities for them in the health sector and other areas. It is a
policy that protects the Maori people from unfavorable effects of colonization, ensuring them

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proper access to the benefits of the new society, since Maori community is the primary user
of health service, so health should be given the highest priority. This treaty comes with three
principle principles: Partnership, Protection and Participation(Hayward, 2017). According to
the nursing context, The Maori community has the right to execute their knowledge and
choose strategies that will ensure their well being; in other words, they should be able to
think and take actions for safety management independently(Wirihana & Smith, 2019).
According to the second principle of Participation, the nurses and patients should work
together in improving health outcomes and act fair with each other, sharing a common
purpose, which is ensuring better health.
The “Meihana model” is a framework which was developed as a clinical assessment
for helping health practitioners to improve their clinical and cultural care towards Maori and
non-Maori service users(Pitama et al, 2017). The Meihana model is focussed on enhancing
Maori health through appropriate assessment or interventions and monitoring processes.
Meihana model helps the nurses to provide culturally appropriate and socially determined
care and support to people. There are various components of the Meihana model: Waka
hourua (which signifies double-hulled waka) helps to demonstrate the importance of
considering both whanau and the patients for assessing health. Whanau encourages health
practitioners to be the support network of the patients; they are the stakeholders in patients
health and well being. They are involved in the establishment of collateral history and family
medical history and assess understanding the patient condition and symptoms. Tinana is
involved in maintaining of proper physical health of the patient. They are a important part of
the clinical assessment and cannot be considered without the other relevant components of
the world. Hinengaro deals with the psychological and emotional well-being of the patients,
Ratango hauora is ensuring everyone gets equal access to healthcare services(Martel,
Reihana‐Tait, Lawrence, Shepherd, Wihongi & Goodyear‐Smith, 2020), Wairua enhances

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the connectedness and togetherness between the patients and the nurses and lastly Taiao
deals with maintenance of proper environment for providing adequate healthcare. Ngā Hau e
Whā identifies the components which reflect on the influence of historical and current
societal effects on Maori as the indigenous inhabitants of Aotearoa in New Zealand.
Whakatane brings together the relevant information from the Waka Hourua and Ngā Hau e
Whā and integrates them within formulation, diagnosis and treatment procedures. It also
supports the nurses to acknowledge and mitigate personal and biases within formulation,
assesement and treatment.
The “Hui process” is a framework for enhancing the relationship between the doctor
and the Maori people. The Hauora Māori curriculum developed the Hui process, and it is well
accepted in medical education(Cardno, Rosales-Anderson & McDonald, 2017). The
components of the Hui process includes are mihimihi which is an initial greeting
engagement, the second component is whakawhanaungatanga which means build a
friendship, Kaupapa means attending to the purpose of the encounter and
poraki/whakamutunga means ending of the session.
In healthcare the Hui process helps the nurses in providing better healthcare to the
patients by enabling them to incorporate the skills of mihimihi for introducing themselves to
the patients, helps to establish initial engagement with the patients and their whanau,
whakawhanaungatanga helps them in building a strong friendly relationship with the patients
establishing a cultural connection with them(Molyneux, 2017). It is a holistic approach that
assist the patients in gathering more accurate interpretation and understanding of the patients.
The third component of the hui process is Kaupapa which helps in obtaining in-detailed
information about the patient, making them confortable so that they can trust the nurses while
sharing their sensitive personal informations(Reid, Varona, Fisher & Smith, 2016). It helps
the nurses in developing and strengthening ways of responding towards the distress or crisis

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by utilizing their strengths and supports. The last and final component is Poroporaki, which
brings the engagement to a closure as the person and their whanau meet their goals and no
service provision is required for them.
Whanau involvement is very crucial in mental health care. People who suffer from
mental illness receive support from their family and extended family, who encourage them
throughout the treatment period(Masters-Awatere & Graham, 2019). The nurses inform and
educate whanau about mental illness and help them understand their role in the loved ones’s
recovery and also assist them in communiting with the loved one. The nurses are involved in
developing the whanau confidence to make a positive change and maintaining a healthy
relationship.
The nurses attitude and behaviour towards the patient greatly influence the overall
treatment procedure. A nurse should follow the ‘patient-centered’ approach to cure the Maori
people, create a friendly bond with them, respect their dignity and human rights and should
encourage more patient engagement(Heidelberg, 2017). A nurse should be open, honest and
sincere person who will be able to maintain privacy and safety of patient information. The
attitude of a nurse should be non-judgemental and unbiased and empathetic towards the
patients(Bennett & Liu, 2018). They should be able to understand the concern of the patient,
work together with the patients and develop plans to resolve those. Each nurse have to be
self-determined regarding the ethical and legal rights of the patients(Hatton, Marques &
McIntosh, 2017). Self-determination, also known as autonomy is based on the informed
content in patient care. Every patient has the right to know about the treatment procedure and
approaches are taken to cure them, and it is a nurse’s duty to provide them with accurate and
complete information that will facilitate an informed judgement(Perlman, Patterson, Moxham
& Burns, 2020). The nurses should also encourage the patient and their families to be present
and assist them while making clinical decisions. The Meihana model provides a theoretical

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understanding while Hui process gives a practical approach to guide nurses in treating
patients. The recovery-oriented approach is to build a meaningful and satisfying life and
personal identity and provides mental support and hope to the patients in fighting the disease.
Recovery-oriented practice enhances hope, social inclusion and community participation
along with helping the patients in setting their health goals and self-management.
For Maori and their whanau to experience safe and secure nursing care, the healthcare
systems should have a culturally responsive nursing workforce that can deliver high-quality,
culturally sensitive healthcare service to them. The Maori mental health and addiction service
is an indigenous response for providing effective, integrated, holistic and culturally
responsive health care initiatives to improve the health outcomes of Maori people. It is
designed to heal patients through access to cultural resources. All healthcare professionals
and service must accept and continue to support and apply the Maori model of mental health
care as a solution and strategy to fight against the predominant mental health crisis among
the people in New Zealand.

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REFERENCE:
Baker, M. (2017). Collaborative and indigenous mental health therapy: Tataihono-stories of
Māori health and psychiatry. Journal of Indigenous Wellbeing, 2(1), 108-110. DOI:
10.4324/9781315386423
Bennett, S. T., & Liu, J. H. (2018). Historical trajectories for reclaiming an indigenous
identity in mental health interventions for Aotearoa/New Zealand—Māori values,
biculturalism, and multiculturalism. International Journal of Intercultural
Relations, 62, 93-102. DOI: 10.1016/j.ijintrel.2017.05.005
Came, H., Cornes, R., & McCreanor, T. (2018). Treaty of Waitangi in New Zealand public
health strategies and plans 2006–2016. The New Zealand Medical Journal, 131(1469),
32-37.
Cardno, C., Rosales-Anderson, N., & McDonald, M. (2017). Documentary analysis hui: An
emergent bricolage method for culturally responsive qualitative research. DOI:
10.20507/MAIJournal.2017.6.2.4 DOI: 10.20507/maijournal.2017.6.2.4
Hatton, W., Marques, B., & McIntosh, J. (2017). Mātauranga Māori and Therapeutic
Landscapes. In The IAFOR International Conference on Global Studies 2017: Official
Conference Proceedings. Barcelona, Spain: The International Academic Forum.
Retrieved from http://papers. iafor.
org/wp-content/uploads/conference-proceedings/CITY/CITY2017_proceedings. pdf.
Hayward, J. (2019). Treaty of Waitangi settlements: Successful symbolic
reparation. Successful Public Policy, 399. DOI: 10.7810/9781927131381_1

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Heidelberg, R. F. (2017). Interventions to Decrease Escalating Violence in a State Psychiatric
Hospital: Interacting with Patients Meaningfully with Unconditional Positive Regard
and Always Available (IMUA) (Doctoral dissertation, Brandman University).
Kopua, D. M., Kopua, M. A., & Bracken, P. J. (2019). Mahi a Atua: A Māori approach to
mental health. Transcultural psychiatry, 1363461519851606. DOI:
10.1177/1363461519851606
Martel, R., Reihana‐Tait, H., Lawrence, A., Shepherd, M., Wihongi, T., & Goodyear‐Smith,
F. (2020). Reaching out to reduce health inequities for Māori youth. International
Nursing Review. DOI: 10.1111/inr.12565
Masters-Awatere, B., & Graham, R. (2019). Whānau Māori explain how the Harti Hauora
Tamariki tool assists better access to health services. DOI: 10.1071/py19025
Molyneux, C. (2017). Collaborative and indigenous mental health therapy: Tataihono-stories
of Maori healing and psychiatry [Book Review]. New Zealand Journal of Music
Therapy, (15), 129.
Perlman, D., Patterson, C., Moxham, L., & Burns, S. (2020). Examining mental health
clinical placement quality using a self-determination theory approach. Nurse
Education Today, 104346. DOI: 10.1016/j.nedt.2020.104346
Piltch, C. A. (2016). The role of self-determination in mental health recovery. Psychiatric
rehabilitation journal, 39(1), 77. DOI: 10.1037/prj0000176
Pitama, S. G., Bennett, S. T., Waitoki, W., Haitana, T. N., Valentine, H., Pahiina, J., ... &
Palmer, S. C. (2017). A proposed hauora Māori clinical guide for psychologists:
Using the hui process and Meihana model in clinical assessment and formulation.

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Reid, J., Varona, G., Fisher, M., & Smith, C. (2016). Understanding Maori ‘lived’culture to
determine cultural connectedness and wellbeing. Journal of Population
Research, 33(1), 31-49. DOI 10.1007/s12546-016-9146-0
Thomas, E. C., Zisman-Ilani, Y., & Salzer, M. S. (2019). Self-Determination and Choice in
Mental Health: Qualitative Insights From a Study of Self-Directed Care. Psychiatric
Services, 70(9), 801-807. DOI: 10.1176/appi.ps.2018000544
Wirihana, R., & Smith, C. (2019). Historical trauma, healing and well-being in Māori
communities. HE RAU MURIMURI AROHA, 2.