Dr Waikaremoana Waitoki (Photo: Te Rawhitiroa Bosch)

There aren’t enough psychologists to meet the increasing demand for mental health care. Psychological services are in crisis. What are the solutions, and does the training of psychologists meet the needs in our communities?

Here’s kōrero from Waikaremoana Waitoki, a clinical psychologist and associate professor at Waikato University.

In my work as a clinical psychologist, I saw tamariki who had health issues and issues at home who were consistently overlooked by those who could have helped. These children started out with a simple health issue, but then were tied to what research shows to be a deliberate, and fast-tracked, pipeline to prison.

A child with a history of glue ear, who has no further intervention, is left behind in school because they can’t hear well. They’re often absent because of illness. At times, mum doesn’t have enough phone credit to let the school know, or she is whakamā that her child is home again. She’s also overwhelmed by the cost of after-hours GP services, of not having enough gas for the car, and the sheer stress of another cycle of sickness.

If her home is cold and expensive to heat, or if she’s in emergency accommodation with loose connections to local schools, the tether to the prison pipeline becomes tighter. When there’s not enough kai at home, our child, who is hungry and sick, is forced to disengage. And now, on top of all that, lunches in school may be cut. Why can’t we feed our children at school?

Our teachers need more support in classes that are filled with children and their families who have economic, social, emotional, and physical health needs. What happens when our child is seen as the problem? Not listening? Disruptive? Not engaged in their own learning? Incapable of learning?

I’ve seen the same issues with children who had asthma, learning difficulties, eczema, and vision problems. They had basic health issues which impacted their classroom experience because they needed time out of school.

And so our child became the problem. They are more likely to be excluded from school, or to escape school. But not succeeding in school isn’t their fault — it never is. They are pushed through the gaps created by colonisation and the extraction of wealth from their communities.

We have another child whose father has unmet mental health needs. What if this child can’t stay at school because their worry is so intense that they run away from school to go home to check on dad? What happens when the teacher, the social worker, and other adults around our child think it’s dad’s fault, or that our child is a problem? When do we notice the intense pain that children feel for their parents who are suffering unsupported?

I know of a wonderful educational psychologist who worked with our child above. She knew that she had to find out what was happening beyond surface blaming and “care and protection” issues. She could see that it was anxiety about dad that caused our child to run home every day to see if dad was still alive. Yet other psychologists had already decided that dad was the problem.

Little things could have helped. Like perhaps giving our child the means to text home to say: “Pāpā, kei te pai koe? Pāpā, are you okay?” Or perhaps asking our child’s teacher what work could be given to help her catch up.

This, of course, requires that our teachers are well-funded to do that extra work on top of their normal workload c and there needs to be well-resourced home support systems too. What if there was a kaupapa Māori health service accessible to every family? What if there was a kura kaupapa Māori in every locality, just like there are mainstream schools? We no longer have Te Aka Whai Ora, the Māori Health Authority, because Māori supposedly receive the same care as everyone else.

Our communities and our services are in crisis.

It’s absolutely shocking that glue ear or family illness is enough to put some children in a pipeline to prison. But this is what’s happening. Our issues are systemic issues, not individual failures. Those issues don’t start with the child at school. They started with the dismantling of Crown obligations to Te Tiriti o Waitangi.

If we truly want to help our children who are absent from school, we need to draw on the skills and knowledge of those whose training recognises the impact of intergenerational harms.

Instead, the government’s solution is to be more punitive. This is evident in decisions to remove funding from schools for unexplained absences (our sick child), to increase housing insecurity by allowing the ending of tenancies without a reason or a shorter notice period, to criminalise gang membership (but not all gangs — Destiny Church is not a gang apparently), to remove cultural reports in sentencing, to suggest fining parents, and to force our youth into “boot camps”. Whatever they’re called, forced military camps for youth who offend don’t work. Punishment is not a solution.

What has this got to do with psychology?

For starters, the majority of psychology academic staff in Aotearoa come from overseas. For Māori and Pacific psychology students, there are just three professors of psychology who are Māori and only two who are Pacific in the whole country. The discipline doesn’t reflect the knowledge that is held in communities, or the solutions that are needed by those communities.

When I look at what students are exposed to over six years of their psychology degree, there is little focus on kaupapa Māori knowledge. It’s an attachment, an add-on, rather than something that’s ingrained and embedded. The obligation to incorporate mātauranga Māori in academia — and in my case, psychology — often receives pushback. I’ve lost count of the number of times I’ve read in curriculum plans that mātauranga Māori (and the Treaty) will be included, yet the status quo of whiteness continues to be foundational to a psychology degree.

We need to build a psychology workforce that understands how to work with Māori, LGBTQI+, Pasifika, refugees and migrants, and minority peoples. The current curriculum in psychology is monocultural and very gendered.

After six years of studying how to be a psychologist, I still needed to learn how to work with my own people. I had learned a psychology that I didn’t know had developed on the lands, blood and tears of Indigenous peoples and the racist capitalism of the transatlantic slave trade. Auē!

My comments are to uncover the reach of systemic racism, which is so entrenched in the settler-colonial foundations of our universities.

Professors Leonie Pihama, Jenny-Lee Morgan, Linda Tuhiwai Smith, and many others, have generated a large amount of knowledge that could fill an entire psychology curriculum. I co-wrote a chapter on Indigenous psychology for an Australian psychology textbook to add to the pool of knowledge. I think it’s a complex, powerful chapter, because it’s informed by intergenerational knowledge of our society. Along with the other authors, Professor Bridgette Masters-Awatere and Dr Andre McLachlan, I wanted to show critical alternatives to western knowledge.

Was it well received? I was asked by a psychology academic colleague to teach the chapter. I wondered: Would this have happened with a mainstream textbook? They’d never say: “Hey, can you come and teach my class your chapter, because I don’t really get it?”

Is it acceptable that one can gain an academic or psychology position on the basis of being willing to learn about how to work with Māori? None of the other academic requirements work like that. “Yeah, I’m willing to learn how to be a lecturer, or how to be a psychologist. Give me the job and I’ll figure it out as I go.”

That’s harmful.

The first Māori professor of psychology said to me: “Psychology has had years to show that it’s helpful to our people.” In 2018, a claim was lodged with the Waitangi Tribunal outlining significant breaches of the Treaty of Waitangi across psychology — including regulation, education, and training.

The professional bodies are working to document where they can address systemic racism and eliminate harms. After 40 years of calling for change, things are happening — tauiwi and Pākehā allies have stepped up and are contributing to a shift. Māori perspectives in psychology are slowly being incorporated, and there is one minor in Kaupapa Māori psychology, some 40 years after kaupapa Māori was established.

I think psychology training institutions will catch up eventually.

We need to understand the curriculum of the society in which we live in, and to teach this. Our solutions recognise that our wellbeing is interconnected. Creating a new future for our child means building deep, lasting connections to healthy families, healthy homes, and a healthy future.

Dr Waikaremoana Waitoki is a clinical psychologist with work and research interests in kaupapa Māori psychology, adult, child and adolescent mental health, supervision, accreditation, and curriculum development. She is an associate professor in Te Pua Wānanga ki te Ao Faculty of Māori and Indigenous Studies at Waikato University and the immediate past president of the New Zealand Psychological Society. 

 As told to Connie Buchanan and made possible through the Public Interest Journalism Fund.

© E-Tangata, 2024