Dr Kiri Tamihere-Waititi

Mental Health Awareness Week has come and gone, and I’m in reflection mode, once again, about the state of our mental health system.

My involvement with mental health, specifically clinical psychology, can be compared to the romantic love stage of a relationship that ends badly. For the first 18 months, you can only see perfection in your partner. It’s intense, it’s passionate, it’s euphoric, it’s nature’s anaesthesia. But it doesn’t last, and it’s a complete fabrication of reality, because when that dopamine wears off you see your partner for who they really are.

That’s me and psychology.

I finished high school, and went straight to university to become a psychologist. I had a lot of preconceived ideas about psychology. It was a highly regarded profession, and I thought it would set me on the perfect pathway to make a massive contribution to the health of my people.

I naïvely thought our people would be saved through psychology. So young and so dumb! But that was me for 10 years: studying psychology to make that massive contribution.

I hated every living moment of the study of psychology because it showed me that assimilation is alive and well in our institutions, and it taught me how much the system devalues everything Māori. I became disillusioned about the value of psychology for Māori, but I persevered because I thought psychology was the answer — I still had my romantic glasses on. Eventually I graduated with a doctorate in clinical psychology.

My love affair ended when I left the shackles of university. I was free, and didn’t have to play the game any more. I did a stint at Auckland prison and then moved to my husband’s iwi to practise psychology and look after their then health and social services arm, which has now been transformed into a Whānau Ora arm. I’ve been there ever since, designing and developing better ways to work with our people.

In my first year as the manager of Whānau Ora, a nanny came to me and shared with me her thoughts about my presence as a psychologist in the iwi. She told me that she and her friends had had a conversation and were somewhat saddened by my arrival. When I asked why, she replied: “Because all of a sudden, everyone is coming to you. They’ve stopped coming to me. They’ve stopped reaching out to us.”

And she was right. My title had, in many ways, taken away the mana from her and others who had always been the “go-to” people in the community. It was a bittersweet realisation. The whānau now had a “professional” to support them, but my presence had disempowered a support system that had been in operation before psychology came along.

I began to look further into the narrative around mental health and the impact psychologists and psychiatrists have on whānau capability to self-manage their own challenges, as they used to do.

I began to ask myself questions. Why is there such a huge demand now for mental health services? Why are our people not reaching out to their own whānau for support any more? Why are our mental health statistics getting worse? Why are mental health services seen as the saviour for our whānau? How have we become so reliant on mental health services? Where has our strength and resilience as a people gone?

I arrived at the conclusion that the mental health system has positioned itself into a space where it’s completely monopolising wellbeing.

During Mental Health Awareness Week, for instance, I heard numerous mental health “experts” carrying on in the media, offering endless strategies to cope with life’s stressors: going for a walk, reaching out to others, mindfulness, meditation.

And, on the surface, that seems like worthwhile, practical advice. But underneath that narrative lies an assumption that we’re sick — that we’re all suffering from a mental disorder. That’s because our mental health system is hellbent on finding a disorder to slot each of us into. It’s literally making us crazy.

Our mental health statistics are getting worse, and they’re getting worse because the system is built on identifying disease, dysfunction, deficits, and disorders — the killer D’s.

Our mental health system is heavily influenced by the American Psychiatric Association, which publishes The Diagnostic Statistical Manual for Mental Disorders (DSM) — the mental health bible which lists and describes all the mental illnesses you can expect to suffer from on any given day. It’s currently in its fifth edition and includes a whopping 300 or so mental disorders. (The first edition, published in 1952, had a mere 60 or so categories of mental disorder.)

So, are we getting sicker, or are we just getting better at creating more mental disorders to fit people into?

Search “mental health in NZ” on Google and you will immediately be greeted with terms like depression, anxiety, bipolar disorder, eating disorders, obsessive compulsive disorder, panic disorder, post-traumatic stress disorder, schizophrenia, suicide and stress.

This isn’t mental health. These are disorders that have been bestowed upon us by the psychiatric gods — and the only people who can treat any of these disorders are the so-called experts of mental health: psychiatrists and psychologists. Go to a psychiatrist and they’ll throw antipsychotics, antidepressants, and sleeping pills at you like lollies. Go to a psychologist and they’ll treat you with talking therapies like cognitive behavioural therapy.

This stuff doesn’t work for most people who experience distress, especially Māori. It may — and the jury is still out on this — help those at the more severe end of the spectrum. But most people are a long way from that end of the spectrum.

So, we’re being misled. We’ve somehow arrived at a point where normal life events are catastrophised and the only people deemed able to fix those catastrophes are the professions that start with “psych.”

We’ve been conditioned to believe, through the constant barrage of media messaging, that we can’t cope with life and we can’t fix our own problems. That we can no longer go to our nannies. And we have responded by undervaluing our own resources, our power to solve our own problems.

The system has lied to us about what really works. It tells us that what works is therapy and pills. It tells us that the solutions to our problems lie outside of our control, and that we must rely on someone or something else to get better. It tells us that our strengths and pre-existing skills have no value.

The truth, backed by a massive body of research, is that supportive relationships and networks, motivation, fostering and building pre-existing skills and resources, focusing on strengths, connecting with whānau, having high hopes and expectations, and being helped with a plan tailored to your needs, are the key ingredients necessary for someone to overcome their struggles.

Not pills. Not a psychiatrist. Not a psychologist.

These key ingredients, by the way, are what make up the philosophy of Whānau Ora. I’ve witnessed amazing shifts in the confidence of our whānau through focusing on these areas. I’ve witnessed whānau become empowered in the realisation of their skills and strengths — and in the realisation that they aren’t alone. By helping them to discover their inner strength, coping skills, resources, support, and aspirations, I’ve seen incredible shifts in the mindset of our whānau, which has a flow-on effect on those around them.

So why are we continuing to invest in a mental health system that’s disempowering all of that?

We are the product of “learned helplessness”. A psychological term, where a person has learned through repeated stressful circumstances that they have no control over a situation, and, consequently, don’t try to change it even when opportunities to make changes present themselves.

This is us with our mental health system now.

To use another relationship analogy, let’s say our mental health system is an abusive partner and we (the public) are the victim. Abusive partners strip away the confidence and self-esteem of their victims. They do this by isolating their victims from support networks. They constantly tell them what’s wrong with them and create a dependence on them. They make their victims feel like they can’t live without them, and they control the terms of the entire relationship.

In a way, the mental health system in New Zealand is our abusive partner. We need to get the hell out of this relationship by building up our inner strength, reconnecting with the support networks we once had, and building our resilience and our confidence to stand in our own strength, and to determine our own pathway.

We need to realise that there’s plenty more fish in the sea. And by fish, I mean other pathways of wellness. Our own models. We have oranga in our own stories, our own whakataukī, our waiata, our karakia, our mōteatea, and our own cultural structures, like kapa haka, traditional navigation, our arts, the maramataka.

We need to find a partner that sees our strengths, that adds value to our lives by empowering us and lifting our spirits to be the best versions of ourselves.

And before the haters start going to town — yes, I do believe there’s a place for psychiatrists and psychologists, but only as a last resort.

I also believe that the mental health system and all the professionals working within it should be planning themselves out of a job, working towards the day where their services will no longer be required. Planning for this will require an investment in programmes that build resilience, that develop connections and relationships, that develop strengths.

Programmes like Whānau Ora.

We have generations of history that tells us we could cope under the most extreme pressures without clinically qualified experts. We had our own experts, and they were our tohunga. They were our nannies and papas. They were our aunties and uncles. They were the leaders of our communities.

We must reignite the power that lies within our whakapapa and within our DNA. We must resist against being brainwashed into believing we’re helpless, because the power to heal lives within us.

Dr Kiri Tamihere-Waititi (Ngāti Porou, Ngāpuhi, Whakatōhea) is a former clinical psychologist. She is currently the head of Whānau Ora services at Te Rūnanga o Te Whānau, in Te Whānau ā Apanui, Ōpōtiki, Bay of Plenty. She is also leading the development of a Whānau Ora practitioner competency model for the Whānau Ora Commissioning Agency.

© E-Tangata, 2019