WatawataTe Kuwatawata - Presentation Cutting Edge 2018

Presenters: Hine Moeke-Murray, Lybian Moeke, Diana Kopua, Mark Kopua & Hinetangi Coleman

Tena tātou

It was a privilege to be asked to present the Te Kuwatawata kaupapa for the Pre-Māori caucus for Cutting Edge this year.

Background:

Te Kuwatawata is a Tairawhiti Initiative that brings a Single Point of Access for Mental Health and Addictions into the community.  Te Kuwatawata is unique for a number of reasons, and one if these is the partnership agreement.

Te Kupenga Net Trust leads the Contract for Te Kuwatawata and is a Consumer led Advocacy and Peer Support Agency, Hauora Tairawhiti and Pinnacle Health are in Partnership with Te Kupenga to ensure that we collectively provide this service.  How exciting that it is led by our consumer whānau.

This initiative was won through the Innovation Fit for the Future Funding from the Ministry in 2017 for a 15-month Pilot to address the following:

  1. Te Kuwatawata – a single point of access to all mental health support services in Tairāwhiti (clinical and non-clinical) for all whaiora and their whānau experiencing distress.
  2. Deliberate reinstatement of Mātauranga Māori into services through a partnership with Te Kurahuna and the embedment of Mahi a Atua.
  3. Strengthening whanau and increasing community capacity across Tairāwhiti.

Through this Te Kuwatawata seeks to address Inequity and Institutional Racism within current systems that keep Māori at the bottom of the health outcomes. 

So what makes this different?

Te Kuwatawata is a new innovation which is leading systemic change in the mental health and addiction sector in Te Tairawhiti. It is the mainstream Tairawhiti model for an integrated single point of access for all referrers to mental health and addictions services. It is serving both Maori and non-Māori, who are experiencing distress. In summary Te Kuwatawata:

  • Offers an immediate response to whānau experiencing distress across the age continuum.
  • Strengthens whanau and community capacity in Tairāwhiti to respond effectively to distress in our community.
  • Promotes whanau choice regarding a range of approaches to wellness.
  • Believes that peoples' stories matter. 
  • Re-instating mātauranga Maori through Mahi a Atua, a Māori traditional form of storytelling and understanding, to promote positive health outcomes for whanauWorks with
  • whanau in a deliberate way and aligns the most appropriate support services tailored to whanau needs and preferences.
  • Measures outcomes using an evidenced based tool, Feedback Informed Treatment.
  • Measures success via equity.
  • Has access to clinicians as an integral part of the team and provides a clinical response when indicated.
  • Uses data and evidence to inform decision-making.
  • Aims to address and eliminate institutional racism.
  • Is a flexible learning environment, adapting and making changes as we develop.

Te Kuwatawata offers a range of approaches these include access to therapies that would be expected to be delivered within Mental Health and Addiction services including CBT, DBT, and acute solution focused Therapies, EMDR, and access to medication if required.

At the core of Te Kuwatawata is Mahi a Atua and is a pathway forward for Maori Mental Health. It provides a way of being for whanau to understand and make sense of their distress. It is an engagement, an assessment and an intervention based on Pūrakau (Maori creation and custom narratives). These pūrākau provide a framework on which individuals and communities can consider, better understand, interpret their experiences, and find solutions according to their traditional cultural norms.

Mahi a Atua:

To change health outcomes for Māori, change needs to be made on how we understand and approach health.  As we know, within Mental Health and Addictions, a western biomedical process has been primary practice.  Has this worked – well evidentially it hasn’t.  Māori are still the highest service users, with over-representation throughout the health system.  What needed to change?  It was obvious that one key component is the way we work with whanau.

What has been integral to the continued success of Te Kuwatawata is the way in which Te Kura Huna has developed wānanga for local workforce development.  Māori methodologies are taught through pūrākau every week for two hours.   This is then transferred into practice within Te Kuwatawata. 

In order to change how we view and work in health – especially for Māori, we need to shift our thinking to shift our practice.  Shifting our thinking and practice comes through deliberate workforce development.  This is Te Kura Huna.

Feedback Informed Treatment:

This is an international data collection programme that captures the view of whānau and the Mataora who work together in Te Kuwatawata.  This data helps to inform us whether the way in which we are working is effective for whanau.  Data informs forward movement.  Forward movement needs to be determined by the whānau and community.  This assists us to ensure that we are working toward whānau outcomes that are measurable for them and more importantly, measures whether we are getting this right.

We are new, we are innovative, we are community led and focused.

This was presented to Cutting Edge 2018. 

 

Naku na

Hine Moeke-Murray