Academic journal article
By Skogstad, Philip; Skogstad, Inez; Britt, Eileen
New Zealand Journal of Psychology , Vol. 34, No. 1
Maori continue to be over-represented in many negative social statistics, but are less likely to voluntarily access mainstream mental health services than non-Maori (Ministry of Health, 2002). Reviews of Aotearoa/New Zealand Clinical Psychology training programmes (Abbot & Durie, 1987; Brady, 1992) identified a lack of Maori trainees and culturally specific clinical skills as key concerns. The writers review progress in these areas, with reference to the requirements of the Code of Ethics for Psychologists Working in Aotearoa/ New Zealand (2002) and the overall aims of the Maori mental health strategy, Te Puawaitanga (Ministry of Health, 2002). New Zealand clinical psychology programmes are extending the years of study and content areas for students to mirror the doctoral format of the USA and UK. However, this has generally not been matched by efforts to extend cross-cultural clinical practice skills for clinical psychology trainees. Recent initiatives to integrate taha Maori into the post-graduate diploma in clinical psychology programme at the University of Canterbury are outlined. It is suggested that the short-term goal of educating non-Maori to work with Maori is attendant upon the long-term goal of creating an environment that is more attractive to Maori students, thereby lessening the barriers to Maori participation in clinical psychology (Levy, 2002). Cultural training for clinical psychologists must be integrated into the overall course programme. Recommendations are made to achieve that aim.
Maori comprise approximately 15% of the New Zealand population. Maori continue to be vastly over-represented at the negative end of a wide range of social statistics, particularly for health, income, employment and offending. For example, Maori on average have a shorter life expectancy than Pakeha, even when living in more favourable socio-economic circumstances (Te Puni Kokiri, 2000). There is limited data on mental health service utilisation. However, the trends are for Maori to be over-represented in non-voluntary (hospital committal) or legislative pathways (forensic services) to receiving assistance, and to be underrepresented in utilisation of general medical practitioners and mental health outpatient services (Ministry of Health, 2002)
There have been several proposed strategies for addressing the disadvantage of Maori. The New Zealand Labour government attempted to implement a "closing the gaps" policy instructing all departments to develop plans and strategies for addressing the needs of Maori. According to Prime Minister Helen Clark, "closing the gaps between Maori and other New Zealanders is a fundamental goal of the new Labour government" (Te Puni Kokiri, 1999, p.1). Mental health policy has focused on providing more choices for tangata whaiora through there being a greater number of trained mental health staff. An example is the Ministry of Health's Maori mental health policy (2002) which aimed to increase the numbers of trained Maori mental health workers by 50% over 1998 baselines. Similarly, it was proposed that 50% of tangata whaiora should have the choice of a mainstream or kaupapa maori mental health provider. Te Rau Matatini (2002), a workforce development initiative aims "to ensure that Maori mental health consumers ... have access to a well-prepared and well-qualified Maori mental health workforce".
These strategies are based on the principle that Maori clients will often have a preference for working with Maori mental health workers. However, Maori may still opt to work with non-Maori, as occurs with the Department of Corrections Bicultural Therapy Model (McFarlane-Nathan, 1994). This combined with the still low numbers of Maori in key areas such as clinical psychology (Levy, 2002) suggests that non-Maori mental health workers need to be competent to work with Maori. These have been some of the factors in the authors' attempts to better develop the bicultural component of the University of Canterbury post-graduate clinical psychology programme. …