How Will You Hear My Voice? The Development of Indigenous-Centred Supported Decision-Making for Mental Health Service Users in Aotearoa New Zealand

Abstract

There is an urgent need in the delivery of mental health services to incorporate a more human-rights oriented approach, and promote supported decision-making, whereby individuals are supported their own mental health decisions based on their will and preferences. Aotearoa/New Zealand’s current Mental Health Act enables the use of compulsory treatment, which breaches both international obligations under the Convention of the Rights of Persons with Disabilities and the principles of Te Tiriti o Waitangi (the Treaty of Waitangi), the covenant between Māori and the Crown which demands partnership and equity and the principle of self-determination for Māori. Mental Health Advance Preference Statements (MAPS) have been identified as a tool to promote supported decision-making and allow people a voice in their own care. This paper examines the foundations of a new project which is Māori-centred and co-produced with stakeholders, including tāngata whaiora who experience mental distress and those who work and research mental health services. The aim of this project is to create and implement culturally appropriate and locally relevant MAPS-type tools and then evaluate the impact of implementation. It is posited this will lead to improvements in health and equity, particularly for Māori.