š Culturally Safe Telepsychiatry š±, Better Bipolar Care šæ, Equitable Endometriosis management, and more
MÄori health research highlights from the past week
šš½ Kia ora, Iām George Gray, a public health physician doing my best to keep up with the latest health research that can help improve outcomes for MÄori.
This edition explores culturally safe telepsychiatry practices, priorities for improving bipolar care for MÄori, and the opportunities for better manegement of endometriosis and preterm birth. We also take a look at primary care enrolment data and touch on some key policy discussions.
š¬ The Latest Research
Exploring culturally safe telepsychiatry practices for MÄori, Pacific and Asian communities in Aotearoa
Barnett, L., Vara, A., Lawrence, M., Ma'u, E., Ramalho, R., Chen, Y., Christie, G. and Cheung, G. (2024), "The use of telepsychiatry during COVID-19 in Aotearoa New Zealand: experiences, learnings and cultural safety", The Journal of Mental Health Training, Education and Practice, Vol. ahead-of-print No. ahead-of-print. https://doi.org/10.1108/JMHTEP-04-2023-0035
This qualitative study aimed to better understand telepsychiatry use in Aotearoa during COVID-19, focusing on cultural safety for MÄori, Pacific peoples and Asian communities. Interviews with 18 psychiatrists and trainees identified three key themes: cultural safety considerations like session preparation and equity; clinical practice aspects such as patient selection; and processes for running telepsychiatry services. The findings provide practical insights for delivering culturally safe telepsychiatry, and highlight the need for frameworks, infrastructure and training to support telepsychiatry services that meet the needs of MÄori, Pacific and Asian mental health service users in Aotearoa. More resources and expertise are required in this area. Health providers could implement the enablers identified in this study to make mental health services more accessible.
Key priorities identified to improve mental health services for MÄori with bipolar disorder
Haitana, T., Clark, M. T. R., Crowe, M., Cunningham, R., Porter, R., Pitama, S., Mulder, R., & Lacey, C. (2024). The Right to Equal Health: Best Practice Priorities for MÄori with Bipolar Disorder from Staff Focus Groups. Healthcare. 12(7). https://doi.org/10.3390/healthcare12070793
This study aimed to identify priorities to improve mental health services for MÄori with bipolar disorder in Aotearoa. Focus groups with 22 health professionals found that key changes are needed at the clinical, structural and organisational levels. Priorities include transitioning to tikanga-based models of care, investing in the MÄori health workforce, resourcing whÄnau to contribute to holistic wellbeing, increasing support for MÄori under compulsory treatment, addressing impacts of social deprivation, implementing collaborative shared care plans, and incorporating healthy kai. The findings highlight the urgent need for mental health system reform in Aotearoa to better meet the needs of MÄori with bipolar disorder and their whÄnau.
Exploring Timely Endometriosis Care for MÄori: Are We Meeting Their Needs?
Ellis, K., Tewhaiti-Smith, J., Munro, D., & Wood, R. (2024). The perspectives of MÄori and pasifika Mate KirikÅpÅ« (Endometriosis) patients in Aotearoa New Zealand. Societies (Basel), 14(4), 46. https://doi.org/10.3390/soc14040046
This recent study examined the challenging journey MÄori and Pasifika individuals endure to receive an endometriosis diagnosis in Aotearoa. Participants reported an average delay of 11.6 and 12.4 years respectively from symptom onset to diagnosis, significantly longer than a prior Aotearoa cohort. Low awareness of endometriosis, normalisation of severe symptoms, shame, and negative healthcare experiences contributed to delays. Participants also voiced experiences of dismissal or doubt from healthcare providers, and the impact of cultural and socioeconomic factors on their access to care. The study also explored the desires for future changes in endometriosis care as voiced by the participants, emphasising the need for more subsidised care, increased research funding, and enhanced education.
Enhancing Preterm Birth Care in Aotearoa: Are Clinical Practice Guidelines Meeting Equity Goals?
Hunter, B., Dawes, L., Wadsworth, M., Sadler, L., Edmonds, L., McAraāCouper, J., Allen-Mokaraka, T., & Groom, K. (2024). An evaluation of the quality, suitability and impact on equity of clinical practice guidelines relevant to preterm birth for use in Aotearoa New Zealand. BMC Pregnancy and Childbirth, 24(1). https://doi.org/10.1186/s12884-024-06415-0
This study examined the relevance and quality of clinical practice guidelines concerning preterm birth in Aotearoa, with a particular focus on their impact on health equity for MÄori. The research found a significant gap in indigenous involvement in the development of these guidelines, despite the critical role of equity tools. The study advocates for a national best practice guide tailored to Aotearoa's unique context. This should incorporate targeted approaches to ensure equitable preterm birth care outcomes. Health professionals are encouraged to support the development and implementation of such culturally sensitive guidelines to enhance healthcare for MÄori and other groups.
š Chart of the Week
š” Primary Care Enrolment - Recently Te Whatu Ora published the quarterly performance report for October-December 2023. The report highlights the opportunities to improve primary care enrolment; overall, 85% of adults of MÄori were enrolled in primary care. Among newborns, the Q1 data showed that 70.1% were enrolled in primary care. Without primary care enrolment it is much more difficult and expensive to access healthcare. Addressing this issue should be a top priority.
ā In Brief
š° Risks of Sale of Oral Tobacco and Nicotine Products - This Public Health Communication Centre briefing discusses the potential risks of allowing the sale of oral tobacco and nicotine products, especially in relation to youth addiction. It highlights concerns about predatory marketing to young people and the lack of clear evidence on the benefits of these products compared to existing alternatives.
ā”ļø The Fast-Track Approvals Bill has raised concerns about potential environmental degradation and threats to public health. The prioritised projects, including mining and major roading projects, may bypass public consultation and environmental safeguards, impacting air and water quality as well as contributing to climate change.
šFree flu vaccines for those aged 55-64 - Influenza vaccination is now available throughout Aotearoa for those over 65, or those younger with certain medical conditions. Last winter, MÄori and Pacific People aged 55-64 received free vaccines, but funding was not continued by Pharmac this year. WellSouth PHO is now funding flu vaccines for all MÄori and Pacific people in the region.
šŗš³ Iwi Chairs Meet UN Special Rapporteur to Address Erosion of Indigenous Rights in Aotearoa - The National Iwi Chairs group will meet with the UN Special Rapporteur to discuss concerns about eroding Indigenous and MÄori rights, focusing on legislative changes impacting MÄori self-determination, child welfare, dispute resolution, professional access, and language revitalisation, as well as addressing climate change, environmental threats, and health.
ā¤ļøāš©¹ ACC acknowledges past shortcomings in serving MÄori. ACC state they are working to improve services to better support MÄori clients. New initiatives aim to address barriers and provide culturally responsive care.
š¬ End Notes
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