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Soso’o le fau i le fau: An Appreciative Inquiry into Pacific Mental Health Practice and its Potential Contributions to Mainstream, Public Mental Health Policy in Aotearoa

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Thesis(6.93 MB)

Date

2023

Authors

Tuesday, Ruby

Supervisor

Waring, Marilyn
Boon, Juliet
Vaka, Sione

Item type

Thesis

Degree name

Doctor of Philosophy

Journal Title

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Publisher

Auckland University of Technology

Abstract

This thesis – Soso’o le fau i le fau: An Appreciative Inquiry into Pacific Mental Health Practice and its Potential Contributions to Mainstream, Public Mental Health Policy in Aotearoa – explores the topic of strength and success in Pacific mental health (MH) practice in Aotearoa/New Zealand, particularly in terms of how this strength and success might inform and improve mainstream (non-ethnic-specific), public MH policy. It aims to support the development of mainstream, public MH policy that values, affirms, and acknowledges the strength and success of Pacific MH practice, and that recognises and acts on the potential of Pacific approaches to MH to support the wellbeing of diverse New Zealand communities. This aim is pursued in response to ongoing discrimination against Pacific peoples and their values, understandings, and approaches (both generally and in health policy spaces), and to a “national MH crisis” in Aotearoa that is disproportionately impacting Pacific peoples. Talanoa – guided by the values associated with the Kakala Framework and the positive principles of Appreciative Inquiry - were undertaken with 33 Pacific MH practitioners (PMHP), service managers/leaders (PMHSM), Tāngata Whai Ora (TWO, MH service users) and family of TWO. During these talanoa the successes of PMHP and PMHSM were explored, alongside the strengths that informed and supported these. Participants shared that PMHSM and PMHP have been successful in a wide variety of ways, providing care that focusses on healing and on addressing the root causes of distress; that strengthens families and communities; that integrates different approaches to care in innovative and responsive ways; that meets wider health, relational, spiritual, and socioeconomic needs; that is culturally affirming; and that ensures TWO feel seen, valued, and genuinely loved. They also reflected that PMHP and PMHSM were particularly successful in creating work environments where staff felt safe, supported, and cared for. Underpinning and shaping these successes was the concept of Vā, and the spiritually resonant, relational onto-, axio-, and epistemological position that it expresses. The talanoa then explored participant views on what mainstream, public MH policy would look like if it valued, affirmed, and acknowledged both these successes, and the Vā as the strength behind them. Participant responses from this part of the talanoa were woven together into a collective vision for an inspiring and accessible policy, grounded in and nourished by the values, understandings and approaches indigenous to Aotearoa and the wider South Pacific. This vision includes a range of strategies and actions that participants recommended and that would help overcome entrenched workforce development and contracting issues; support a more transparent and accountable MH system; nurture cultural, community, and service user leadership; and contribute to the development of cost effective and innovative approaches to providing mental health care that actively empower TWO, families, and communities. Through this vision, the enormous potential of policy that values, affirms, and acknowledges the strength and success of Pacific mental health practice becomes clear, enabling this thesis to highlight the innumerable benefits that might be enjoyed by all New Zealand communities should such a policy be realised.

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http://hdl.handle.net/10292/17471

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Doctoral Theses