As with all of us, Rees Tohiteurureangi Tapsell, has inherited a myriad of genetic strands. Among his genes, there are those from a Danish sailor, Phillip Tapsell, who landed in Maketu nearly 200 years ago — and those from Hine-i-turama Ngatiki, after she and Phillip took a fancy to each other soon after his arrival.
Then there have been a host of influences on Rees, especially from his high-profile Ngāti Whakaue dad, Peter Tapsell, who was knighted after making his mark as an orthopaedic surgeon, and in politics, as a Labour minister and then as the first Māori Speaker of the House.
Like his father before him, Rees studied medicine at the University of Otago. He went on to train as a psychiatrist, specialising in forensic psychiatry. And he’s now the director of clinical services for the mental health and addictions services, and associate chief medical officer with the Waikato District Health Board.
Rees lives in Auckland with his wife Robyn and they have three sons, one of whom is a junior doctor at North Shore Hospital — and third generation Māori doctor.
Here, with Dale, Rees is reflecting on what he sees as some of the big influences on his life.
Kia ora, Rees. And you’ll note, I hope, my careful pronunciation, because I suspect you’ve had a lifetime of wrongly being called Reece, which is a much more common first name.
Yes, the name is Rees and it comes from one of my Pākehā tupuna, a Welshman, from my mother’s side. He was William Lee Rees, who came here via Australia. He was a lawyer on the West Coast of the South Island and then in Auckland.
In the late 19th century, William was appointed to a commission of inquiry into Māori land law, together with the MP for Eastern Māori, James Carroll, and Thomas Mackay, a former Land Purchase Officer. The Rees-Carroll Commission, as it was known, bitterly criticised the Native Land Court for granting Māori land title to individuals rather than iwi or hapū.
His cousin was William Gilbert Rees, who settled down in the South Island around Queenstown. And the Rees Valley and Rees Street in Queenstown are two of the places named after him.
Tell us about your mum.
Mum was a really bright woman who was brought up in a farming family at Matangi, outside of Hamilton. She was very much an outdoors girl, and she met my father when she was a theatre nurse at Waikato Hospital and he was a trainee surgeon.
She was Margaret Diane Bourke, although Dad, as well as her close friends, always called her Mungi. I understand that when she was born she had so much black hair that my grandfather called her Mangu, and “Mungi” stuck. When she was angry, we kids would call her Mangukaha. She was never called Margaret.
She was a really intelligent woman, and in some ways, it was a shame that, because of my father’s career, she ended up playing second fiddle to him and much of what he did. But she could‘ve done wonderful things, I think, if she’d been born in a different era, and if she’d had more opportunity.
That’s not to say that she didn’t do wonderful things in her role as a mother and as a wife. I remember having many different conversations with my father, who acknowledged — after a little bit of encouragement from me — that Mum was probably brighter than he was. From a purely intellectual sense, she was probably quicker and more intellectually attuned than he was.
But, in her circumstances, women like her were required to commit all their time, energy and intellect to their husband and children. And, of course, my father wasn’t the easiest man to live with. He was a man with incredible focus and drive — and also a belief that his way was always the right way.
Mum was a particularly important part of my life because Dad drove us children so hard, particularly me because I was the oldest son — and it was very important in my upbringing that the softer, caring, nurturing part of my life was looked after by my mother.
Bearing in mind your dad’s role in medicine and politics, I imagine you would’ve grown up in an interesting household.
Well, it was a little out of the ordinary. We lived on Tapsell Road in a house built by my father on family land in Rotorua. In fact, a number of his siblings had houses on that road, bequeathed to them by their grandmother.
Some of them moved away, but we stayed there, and I was brought up in a house surrounded by aunties, uncles and cousins. So I always had a strong sense of growing up among my wider whanau. Most of them came from non-professional backgrounds and did labouring jobs — although I do want to say that most of my dad’s siblings and many of my first cousins had a tertiary education.
And that was down to my koro Pita Tapihana and my grandma May’s expectations.
And what do you recall of your dad in those early days?
He himself worked extraordinarily long hours. He’d get up at 5 or 6 o’clock and start working. That could be out in the garden, or reading official papers when he became a politician. He’d continue doing that until he went to bed at 11.30 or midnight. That’s every single day. And he couldn’t understand why anybody else wouldn’t work that hard.
Then, all through my life there, because I was the oldest son in quite a patriarchal family, I had quite an important role. So he drove me hard. And I was working in the garden with him as soon as I was physically able. My father had a strong sense of social conscience. He wanted his boys to be occupied and working hard.
He kept four or sometimes five quarter-acre sections, in various parts of our neighbourhood, where he grew potatoes, cabbages, broccoli and beans. That’s over an acre of garden that we had to look after. Every day after school, all weekend, I had to garden — and mow the lawns of several people in our street who couldn’t look after their own lawns. And he’d expect that we’d go and help others in the neighbourhood and do bits and pieces for them.
So he instilled into all of us kids, and especially into me, his strong sense of social conscience and social service. Our life was a bit different from the other kids in our area. They’d be playing and riding their bikes when they were young, while I’d be working in these gardens. And, of course, at the time, I didn’t like that much at all.
In retrospect, of course, I realise that he was teaching us two things. Firstly, that nobody gets anywhere without working hard — and he wanted to make sure that we knew exactly what working hard meant.
And secondly, he wanted us to understand that the world can be a tough and uncaring place, and that life can bring some unhappy times. So we needed to be resilient. And resilience, he believed, can be learned only by experience.
Looking back, I thank him very much because I know now that, firstly, I can work hard and long hours and under duress without complaining. Secondly, I realise that I have a level of resilience. That early experience has meant that I don’t just fall over when things get tough.
Dad didn’t have much time for what he’d describe as namby-pamby ways, or for wringing your hands about things not worth worrying about. And I understood where that came from when I learned about his childhood. He was a boy coming out of the Depression, brought up by a father who’d been exposed to mustard gas in the First World War, and who was a very hard man.
So Dad wasn’t soft on us. In particular on me. And I can’t ever remember him saying: “Well done. You did a good job.” Not ever. If I got an A, he’d say: “Next time, it’ll be an A-plus”. If I got an A-plus, he’d say: “Well, next time it needs to be a Distinction.”
He did that, not because he was mean or unkind, but I think he realised that having some degree of expectation is a really important part of bringing kids up. He overdid it a bit. And we, his children, have often reflected on, and had a laugh about, how far he went.
Did your old man ever tell you he loved you?
Nor did mine. But I constantly tell my own kids that I love them.
Why do you think that is?
I think it’s the “shoes, clogs, shoes” thing. That’s a saying that Dad had: Shoes, clogs, shoes. That means that, if one generation does something one way, the next generation, largely in response to that, will do it in an entirely different way to make up for the deficiencies they thought they saw in the previous system.
But, yeah. My father would never hug me. Later in his life, I hugged him. I’d sometimes make him hug me. I’d just wander up and give him a hug. But with my kids, even now in their 20s, I’ll hug them. I’ll give them a kiss when I see them. I’ll tell them I love them.
Teaching your kids that they need to develop some resilience and strength of character is essential, but it’s just as important that they know and feel the love from the people bringing them up.
No doubt your dad had a range of thoughts about what he saw missing in the lives of many young Māori.
Well, he’d often talk about what our young people need, particularly now with all of the difficulties we’re facing in Māoridom. And it was a sadness for him that so many young Māori weren’t able, for whatever reasons, to learn three things.
One was the importance of discipline and having a clear sense of what’s right and what’s wrong. The second thing was learning how to work hard. And the third was developing the capacity to appreciate beauty — whether that was the beauty of a sunset or the beauty of the bush. Just simple beauty.
And from those views came another sadness — seeing so much vandalism. He saw that as an indication that there was no discipline, no commitment to working hard and being productive. Having no sense of beauty, either.
Now that your dad has passed on, you’ve become the go-to Tapsell voice on a number of issues. There’s an old saying: “You become a man when your dad dies.” Do you think there’s some truth in that?
Undoubtedly. Not just when your dad dies. It’s when both of your parents die. When your parents are alive, you always have this sense of them standing behind you. They’ve shared your history. The good and the bad. They’re your blood. They’re your whakapapa.
And now, when there’s a problem in the family — or issues or problems wider than that — some people come to you, just as they used to do to my parents. And yes, in terms of being the oldest son, particularly within Māoridom and Te Arawa, there are some expectations. That’s one of the great things about tikanga.
When we had dad’s tangi over at Whakaue, at the poroporoaki on the last night, there’s that process in the whare, when it’s just you and your whānau, whanaunga, and people from your hapū and iwi sitting around and sharing stories.
And then, right at the end of that last night, before the last karakia and everybody goes to bed, there is sort of a formal poroporoaki process where the eldest son is the last to speak.
Everybody else has their say. And the eldest son must stand and say his piece. I think that’s a beautiful example of how we in Māoridom absolutely understand that that is the case. That’s the point at which the oldest son must accept his responsibility that comes largely from tikanga.
You’ve worked with many people who’ve missed out on the good fortune of having supportive parents teaching good ethics and principles. So it must be saddening to see so many young people who’re lost and don’t have the foundations that come from solid parenting.
I’ve done 20 years as a forensic psychiatrist and a few more before that as a general psychiatrist. And now I run a service. As a consequence, I’ve seen hundreds and hundreds of young Māori in that position. And it’s tragic. It’s tragic. And, when you talk with some of these young people, you can be almost brought to tears.
They don’t want their kids to end up living the life that they’ve lived. It’s just that they’re trapped and they don’t know any different. So, yeah, it’s prevalent. And it’s becoming more prevalent. Not just among young Māori. It’s young Pākehā parents, too.
They’re not teaching their kids to knuckle down and work hard and develop respect for others, as well as respect for themselves.
They’re not teaching their kids to help people in their communities who’re less well off. Or that there’s a need to give to others. That you can’t have everything you want, when you want it, just because you want it. Many of those things are functions of modern society. They’re problems we face right across the board.
Then there are issues of poverty and disadvantage — and severe substance abuse as well. In fact, if I was to pick one thing that’s increasingly undermining our whakapapa, it’s the level and the extent of the use by our young people of some of these higher potency cannabinoids and synthetics. In particular, methamphetamine.
Can we make more headway through education? Not just in schools, but in the homes too?
Of course, that’s of paramount importance. My father and my mother saw education as the absolute tool for emancipation. If you’re held down in any way — not that we were — but the only way to turn that around is to get some power. And education is power.
When we were young, all of the expectations were around educational achievement. I was read to every night. I was a voracious reader when I was young. And I used to read to my kids every day, so my kids have learned to enjoy reading and learned to see education as critically important.
And you can see, without that sort of encouragement, in many families there’s a poverty of understanding and knowing what to do to help your kids have a better future.
And we’re not just talking about one generation of this, but about generation on generation on generation of unemployment, of poverty of exposure to pro-social life, of alcohol and substance abuse, of domestic violence, and ultimately, mental illness and all that comes with that. It’s absolutely tragic.
I wonder if we can just backtrack a bit and talk about your work as a forensic psychiatrist, and what led you into that.
Well, forensic psychiatry focuses on the interface between law and mental health. That’s meant giving expert testimony in court at trials, sometimes for the prosecution, sometimes for the defence, where I’m required to give an opinion about a person’s mental state, both at the time of an alleged offence as well as at the time of the trial.
As a clinician, I’ve also worked in forensic mental health units, where we treat patients who’ve been found not guilty by reason of insanity, or unfit to stand trial, or who may have been in prison but require inpatient treatment.
I was attracted to forensic psychiatry because I’ve always been interested in why people think and act the way they do. And it’s particularly interesting when considering people who’ve committed serious violent crimes.
One thing that’s been of major concern to me during my time as a forensic psychiatrist is the increasing prevalence of methamphetamine and its effect on people’s mental state and serious violent offending.
Naturally, in the course of your professional work, you’ll have picked up a host of insights and skills in helping those in serious need. But I wonder what you feel may be the most important lesson you’ve learned in dealing with our most troubled people.
The first thing is that, in my job, it’s really important to have some sense of what your own strengths and weaknesses are. It’s difficult to work with other people if you don’t know what you’re good at yourself and the things you can help other people with. And I think it’s also valuable to have a strong sense of humanity and to enjoy connecting with other people.
I don’t mean connecting with people as patients, prisoners, or some other category, but just connecting with people because they’re people. They’re full of interesting things — good things, bad things. And it’s important to be able to engage with them, and, above all, to treat each person just as another person. Good or bad. There are very few people in the world that are purely bad. I’ve met a few of them, but there aren’t many.
The knack of being able to engage easily with people isn’t just a useful tool in your professional kit. It’s also entirely consistent with the idea of whanaungatanga. I mean, that’s what whanaungatanga is all about. It’s about establishing where our connections are as people.
And the links through our ancestors. Where was the connection between our ancestors? Like, this one came and married this one and the offspring was this, and we have this link here. That’s very consistent with the idea that making a connection with people is a critically important first step in that journey.
As I understand it, for some years now, it’s been widely accepted that Māori health has four sides to it. There’s tinana (physical health), there’s whānau (family and social health), hinengaro (mental or emotional health), and wairua (spiritual health). And they all go together. That’s Tapa Whā, introduced by Mason Durie back in the 1980s.
But I wonder if you’ve found that such an approach creates some problems for non-Māori admissions — or for treatment of Māori by colleagues who’ve come from overseas. What do you make of Tapa Whā and the reactions of others to it?
I think that’s just our way. Well, in the first instance, it was Mason’s way. But it’s our way of describing the universal worldview. If you were to go over to the middle of Syria or anywhere, and ask people there what they think is important in terms of your health, they’d say: “Family. Spirituality. My psychological wellbeing. And my physical health.”
The important domains of their life distil into those four things. So I don’t think there’s anything particularly special about us Māori in that regard. But there are a number of tensions brought about largely by Westernisation and capitalism and the effect of the pursuit of money driving everything.
And so other things that may be more important get lost or left behind. I think that’s what we’ve seen in Pākehā society. For example, we end up having laws around privacy that are at odds with the idea of whānaungatanga. And that’s a tension that we have to manage every day.
On one hand, we’ve got families who want to be actively engaged, yet on the other hand, we might have individual patients, and not just non-Māori patients, saying: “I don’t want my family involved. I don’t want you talking to them. I don’t want them to know about me.”
So, instantly, you have a situation where the law is at odds with what we know to be right. Psychiatrists, psychologists and clinicians have to work through that.
Sometimes we get it right. Sometimes we don’t. My experience is that in the vast majority of cases, it isn’t because people aren’t doing the right thing, or don’t care. Instead, it’s just because they don’t know how to appropriately manage their way through that process.
Then there’s historical trauma. Many of our people are going through difficulties with mental health issues, substance abuse and so on, as we’ve discussed. But perhaps they’re suffering from historical trauma — from loss of land, culture, reo and decent family dynamics. Is that connection real? Is this historical trauma still affecting our people?
Absolutely. There’s no doubt about that. If you strip everything back to the time when we suffered the onslaught of colonisation, you can see the beginnings of all of that. The historical roots, undoubtedly, can be laid at the feet of colonisation.
Before the colonists got here, by all accounts, as recorded by our old people and by historians, we lived a pretty harmonious life. We were physically well. There was mental illness but it was certainly not as prevalent as it is now. People basically got on with their lives. Yes, they fought wars and they did the things that people do, but people got on with their lives. Then the colonists came, and it all went to hell in a handbag.
Of course, there’s been some reparation. But I don’t think that the reparation, although it’s essential, is the quickest, most appropriate, or most effective way of turning around the effects of those traumatic experiences.
I think the way out of the problem may not simply be reversing the way we got into it. The reality is that we, as Māori, need to work out how to live in the world that we have now. And Pākehā have to work out how to live with us in that world.
This interview has been condensed and edited for clarity.
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