SPINZ Symposium

At the SPINZ National Symposium 2009, the following paper will be presented: Emergency department re-presentations following intentional self-harm by Silke Kuehl and Dr Kathy Nelson.

The abstract is as follows:
A retrospective observational design was selected for a period of one year and data was collected from electronic clinical case notes. The sample consisted of 48 people with 73 presentations and re-presentations.

This study made several discoveries:
many re-presentations (55%) occurred within one day;
the exact number of people who re-presented many times to ED is unknown, but is far higher than reported in other studies;
fewer support people were present for the second presentation;
the documentation of triage and assessments by ED staff was often minimal, though frequently portrayed immense distress of this population;
cultural input for Maori was missing;
physical health complaints and psychosis were found with some intentional self-harm presentations; challenging behaviours occurred in at least a quarter of presentations;
the medical and mental health inpatient admission rates were approximately 40% higher for second presentations.

Recommendations in regard to the use of a triage assessment tool, cultural input for Maori and the need for a mental health consultation liaison nurse in ED will be made. Staff education, collaboration between services with consumer involvement and further research of this group are required.

Further to this, the link above goes to the list of talks to be given at this Symposium. There are a number of culturally-concerned topics, both Maori and Pasifika, as well as some basics regarding suicide prevention. Anyone with a concern for people tending towards suicide should try and make time to attend.

The NZ Tui (in the photo) is used as a kind of logo on the SPINZ site - photo by 'North of Auckland'

When the trees bend in the forest, there is always a reason

Two reports are now available online regarding the mental health of Pasifika people living in New Zealand. The first reports on a mental health study over the period 2003/4, so no doubt there have been some changes since the study was done.

The second has a particular focus on the first dedicated Pacific child, adolescent and family mental health service in Porirua, which was established in 2005

Exploration of Pacific perspectives of Pacific models of mental health service delivery in New Zealand, by T. Suaalli-Sauni and others.
This report was first published this year in the Pacific Health Dialog, volume 15, number 1, and summarizes the 2004 study, 'Pacific Models of Mental Health Service Delivery in New Zealand' which looked at concerns about the mental health of Pacific Islanders in New Zealand, and the way in which the various Pacific Island groups are not being well catered for in the general health system. There is discussion of the ways in which mental health has been dealt with traditionally, and how to a degree this still suits the older generation. However, it is not longer ‘a neat fit’ for the younger people.
Another issue is the fact of very different cultural viewpoints amongst the range of Pacific Islanders living in the country. One model will not suit all. There has already been a good deal of work done to bring traditional models together with contemporary viewpoints, and the study acknowledges the part Christianity plays in the lives of Pacific Island people.

Development of a child, adolescent and family mental health service for Pacific young people in Aotearoa/New Zealand, by Allister Bush and others.
While there is a mixed PI population in the Porirua area, the report tends to focus on the Samoan people and their approaches to children and family in the mental health context. This perhaps gives it a more specialised focus than it might otherwise have, but it also helps to show that each Island group needs to be addressed in a different way. This report has a number of 'stories' of different children and families that have been helped by the service.

Neither of these reports is long, but each of them gives considerable insight into the cultural needs of people groups that are now an established part of New Zealand's multicultural makeup. And there are many insights into the way in which we 'palangi' need to be aware of Pasifika traditions, spirituality and behaviours.

Link to the photo's original site

Fighting Shadows

Fighting Shadows: Self-Stigma And Mental Illness: Whawhai Atu te Whakamâ Hihira incorporates the experiences of 76 men and women from around the country; including Pakeha, Maori, Pasifika, Chinese, young people and refugees.
This study, produced by the Mental Health Foundation was launched on 9th July, 2008. It shows that "negative messages about mental illness in society shape and reinforce attitudes people hold toward themselves,” said Judi Clements, Chief Executive of the Mental Health Foundation of New Zealand. “These attitudes hold people back from full participation in society, and create a cycle of internalised stigma, or ‘self-stigma’"
Participants in the study described experiences of isolation, self-doubt, rejection by family and peers, and pessimism about their prospects of recovery.
However, participants also identified actions or ‘circuit-breakers’ to counter discrimination and negative thought patterns. These included: more visibility of people with mental illness, building peer support networks, affirming human rights, challenging negative attitudes, and encouraging mental health services to focus on recovery.
The full report can be read online. It's also available in book form, from the Mental Health Foundation.