Lack of self-help information, especially in the early stages of illness • Coercive staff practices and breaches of human rights • Lack of staff understanding of cultural differences • Ineffective and uninspiring rehabilitation services • Lack of care and support from staff • Staff prejudice and stereotyping of Mäori people • Side-effects of medication and/or electro-convulsive therapy • Cultural inequality and misunderstanding in services • Authoritarian services that reinforce dependence rather than independence While PHOs will be able to provide the majority of services at a primary health care level, it is important to note that there are a range of Mäori mental health services in the community. These providers, which are sometimes referred to as Kaupapa Mäori services, have developed their models of care/service packages to complement the needs of the communities that they serve. Mäori providers have a wide range of settings in which to deliver services (such as from the marae to kohanga reo or in the home). The relationships that Kaupapa Mäori services have with mental health providers varies. However, there continues to be a necessity for Mäori providers and PHOs to form relationships to deliver complimentary models of service. A Kaupapa Mäori service provider would have as its core elements: • whänaungatanga • whakapapa • cultural assessment
64Primary Health Organisations: Service development toolkit for mental health services in primary health care• empowerment and tangata whaiora and their whänau • te reo Mäori • tikanga • kaumatua capacity • access to traditional healing • access to mainstream health services • quality performance measures relevant to Mäori • Àta Whakaaro Māori. All these elements, together with sound management systems and practices, are essential if a service is to be considered a kaupapa Mäori service and effective to achieve whänau ora.
Primary Health Organisations: 65Service development toolkit for mental health services in primary health care Appendix 4: Effective Primary Mental Health for Pacific Peoples By Fuimaono Karl Pulotu-Endemann. Introduction This appendix aims to: • identify the key issues in relation to meeting the mental health needs of Pacific populations in a primary care setting • point PHOs and primary health care practitioners to important documents and developments that have guided the development of Pacific primary health care and Pacific mental health • identify the key learnings in mental health service development that may be useful for PHOs in developing their organisations to be more responsive to the needs of their enrolled Pacific populations. This appendix represents a guide for PHOs on understanding the mental health needs of Pacific populations and ideas for how barriers to accessing care in a primary health care setting can be reduced and/or addressed. It summarises the key themes from a number of documents that may provide a useful point of reference for PHOs who want
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