Real Outcomes for Maori

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Real Outcomes for Maori

• Terry Huriwai
• Matua Raki
• National Addiction Treatment
• Workforce Development Programme

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• Real outcomes for Maori with addiction related
  problems
• are multi-layered

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• Measuring real outcomes
• for Maori with
• addiction related problems requires a
• multi-dimensional tool

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• STARTING POINTS

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• Maori are more likely to have a substance use or
  gambling problem and a coexisting mental health
  disorder

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Maori Addiction Treatment

• Increase access to
• Increase retention in
• Improve outcomes of
• Provide a choice

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Sucking Eggs
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• Addiction

Gambling and Substance Use Continuum of
harm Chronic relapsing condition Treatment works
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• Outcome

Resource Allocation
Effectiveness
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• Effectiveness

Syndrome Relief
Cultural Identity
Symptom Relief
Social Functioning
Wellbeing
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• Social Functioning,
• Well-Being and Identity

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Social Participation
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• If the value base of the dimensions are
  different,
• can we/ should we
• measure real outcomes
• for Maori with
• addiction related problems?

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• What is a real outcome
• for a young Maori male with an addiction related
  problem?

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• TANE
• 24 year-old poly-drug user
• Alcohol and Cannabis Dependent
• Acknowledges his Iwi
• Dysfunctional relationships

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• the highest level of success is when a client
  has experienced whanau, hapu and iwi alienation
  feels comfortable about returning to their tribal
  roots

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• Colonisation the loss of
• land,
• language and
• Culture

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• Recovery is more than abstinence and symptom
  relief for the individual but involves
  re-enculturation of pro-social collective values
  and practices.

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• Access to, participation in, Maori culture is an
  important component in recovery and sustaining
  wellness

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Competent Maori

• Work with whanau who have
• addiction related problems in ways that apply
  cultural
• expertise infused with clinical knowledge.

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Cultural Expertise

• Addresses components of symptom relief,
  well-being, access and participation in Te Ao
  Maori and identity as a Maori minimising harm
  and sustaining wellbeing.

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Clinical Knowledge

• Addresses components of Symptom relief and well
  being minimising harm and relapse prevention

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Outcomes for Tane

• Reducing his substance use
• Advocating for resources
• Supporting strengths

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Outcomes for Tane

• Measure Changes in Substance Use
• Measure changes in relationships
• Measure changes in well being

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ATTRIBUTION

• We can measure symptom relief
• We cant easily attribute changes in well-being
  to our intervention

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In Realty

• Not everyone needs or wants re-enculturation
• Even people who have their culture have
  addiction related problems

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WORKFORCE

• Emphasising strengths and values as Maori
  requires workers able to work in a Maori
  cultural milieu that enhances clinical knowledge.

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Summary

• Real Outcomes for Maori go beyond symptom relief
• Real outcomes for Maori may be initiated or
  guided in treatment
• Real outcomes for Maori may not be attributable
  to our intervention

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• Maybe it is the relationship and journey that
  achieves the outcome.

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Terry Huriwai 64 033640480 64
0210327637 terry.huriwai_at_otago.ac.nz
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Mauri Ora