Changing the mental health discourse with ‘Mahi a Atua’

By Te Kuru o te Marama Dewes

Consultant psychiatrist Dr Diana Kopua is calling for a stronger focus on indigenous knowledge in mental health, pointing to recent provisional health statistics that show disproportionately high rates of Māori suicide.  Kopua delivered a keynote address to the Māori Law Society at their annual conference in Wellington.

“When people are in distress, they resort to their worldviews and if we're disconnected to those then how are we meant to re-engage, if the systems do not accept indigenous knowledge [are] as good as, if not better, for Ngāi Māori when they're in distress," says Kopua. 

The Wai 2575 report shows the institutional racism that exists in the New Zealand health system, says Kopua.

“...and it's uncomfortable right?  And there's absolute fragility when you do mention terms like racism and talk about the inequity for Māori, particularly in NZ we consider ourselves as having a fair society but these statistics don't show that.”

Kopua developed Mahi a Atua in 1996 as an engagement, an assessment and an intervention based on pūrākau (Māori creation and custom narratives).

“When we start talking about these pūrākau and the whakapapa of jealousy and the whakapapa of violence, without pathologising, without discriminating, without labelling, then more people are willing to open up.  We've seen it in rooms with families, individuals, in wānanga.”

Kopua says that western approaches to mental health are failing Māori.

“In order to reform the mental health and addiction services, we must return to our indigenous ways of knowing.  We must scale-down the Western paradigm and our understanding of distress and we need a new conceptual model to understand distress.”

Kopua is currently taking the Mahi a Atua initiative around the country.