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The Royal College of Psychiatrists Improving the lives of people with mental illness

Elective Psychiatry placement in Hamilton New Zealand, Hauora Waikato, April-May 2012

Maria Spears is a 4th year medical student at the University of Birmingham

Unique aspect

Hamilton base for Hauora Waikato

My elective is currently underway in the idyllic country of New Zealand. As someone who is interested in psychiatry as a career, I decided to plan a placement within a unique aspect of psychiatry. Luckily I found it at Hauora Waikato.

Steeped in Kaupapa Maori philosophy and teaching, this elective placement has exposed me to transcultural psychiatry involving the management, treatment and diagnosis of mental health conditions, within a cultural and spiritual framework.

 

The 3 'R's

Hauora Waikato is primarily a Maori, community-based, independently-funded mental health organisation, based in Hamilton city centre. It focuses on assessment, referral and treatment, allocating patients to appropriate services where their needs can be met. Hauora focuses on providing healthcare that specifically meets the cultural and spiritual needs of individuals. Patients do not have to be Maori to utilise the service; any patient can choose to commit to treatment with Hauora.

In terms of the Kaupapa Maori principles, at the most basic level it involves the 3 'R's:

  • Respect for others
  • Respect for yourself
  • Respect for the environment

 

Support network

Picture taken at Tamahere forensic hospital, at Maria Spears ‘powhiri’ (welcoming ceremony

Every morning at Hauora there is a ‘whakamoemeti’, which literally means thanksgiving. It involves singing of Maori hymns and prayers (‘karakia’) to start the day positively. Karakia are also used during consultations with patients if they request/accept it and in multidisciplinary meetings called ‘whiriwhiris’.

The importance of ‘whanau’ (family) is a key feature of the holistic approach at Hauora to helping patients with their difficulties. Hauora strives to develop a good support network for patients and has a variety of health professionals who interlink within the team. The concept of the healthcare team being like a family with elders who offer advice to other members, is a very traditional Maori principle. It certainly helps that everyone is in the same building and can communicate immediately.

I think this is one of the key factors which stands out for me - how there is a strong emphasis on the social and cultural aspects of the patient’s life and how everyone works as a collective for the patient. No decisions are made without consulting other members of the team first.

So far this elective has exposed me to a variety of subspecialties in psychiatric medicine: child and adolescent, early intervention, forensic, and maternal mental health. I've also managed to go out on home visits in the country, to a forensic rehabilitation hospital which focuses on Kaupapa Maori treatment, as well as clinics based at the town centre.

 

There is certainly a stronger emphasis on the patient’s cultural needs and background at Hauora

Although the underlying medical treatments for mental illness are very similar to UK practice, there is certainly a stronger emphasis on the patient’s cultural needs and background at Hauora. For example, I sat in on a nurse's assessment where a patient felt that she had been cursed with 'makutu' (evil spirits), which had been present during a 'tangi' (funeral).

For anyone thinking of organising a psychiatry elective, hoping to get more exposure and experience in sub-specialties with a cultural focus, it's worth considering a placement in New Zealand.


Many thanks to all at Hauora Waikato for giving permission to use these photographs.

  

 

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Comments

Re: Elective Psychiatry placem
Hello, I'm a medical student and I'd be really interested in doing a similar elective. I've tried to find an email address to contact Hauora Waikato and haven't been successful. I was just wondering if you could help me out? Thank you
Re: Elective Psychiatry placem
Hello, I'm a medical student and I'd be really interested in doing a similar elective. I've tried to find an email address to contact Hauora Waikato and haven't been successful. I was just wondering if you could help me out? Thank you
Re: Elective Psychiatry placem
Hi,
Similar to above, I'm looking to do a psychiatric elective in New Zealand, but am having difficulty finding contacts. Would you be able to help?
Thanks!
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