1 MoH DocNgai Māori Insights for A Kaupapa Māori Primary (Community) Mental Health & Addictions Service Model: The Analysis by Awa Associates

Expanding access to and choice of primary mental health and addiction services for whānau with mild to moderate need is a flagship initiative for the government and the cornerstone of the Wellbeing Budget 2019.

The Ministry of Health carried out a series of hui Māori-a-motu from September through to November 2019 to gather information on the design and development of a Kaupapa Māori primary mental health and addiction service model with Māori in the sector.

Hui were held in five locations, Whāngārei, South Auckland, Rotorua, Palmerston North and Christchurch. Other locations such as Waikato, Gisborne, Porirua and Nelson also contributed feedback to the process. Sector stakeholders provided information through submissions and email summaries of hui.

This external and independent analysis of data from all hui and information has been provided by Awa Associates. The analysis will inform Te Kawa o Aotearoa o ngā rātonga hāpori Kaupapa Māori Hauora Hinengaro, Hauora Wāranga (Aotearoa Kaupapa Māori Primary (Community) Mental Health and Addiction service specifications).

The Kaupapa Māori thematic analysis identified 23 themes of relevance to a Kaupapa Māori Primary Mental Health and Addictions service model. These themes were further analysed to identify dominant themes that were evident in the feedback data collected.

https://www.health.govt.nz/system/files/documents/publications/awa-association-report-14feb2020.pdf

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Evaluation of the Partners for Change Outcome Management system (PCOMS) in a Gambling Treatment Setting2 MoH

The AUT Gambling and Addictions Research Centre undertook the study in partnership with gambling harm minimisation service providers.

PCOMS is an international tool that was developed for counselling situations to improve therapeutic counsellor-client relationships and to collect and use client data to measure client outcomes and monitor client-counsellor relationships.

One important aspect of the evaluation was the trial of a Kaupapa Māori Outcomes Rating Scale (KORS) in parallel with the Outcomes Rating Scale (ORS) that is closely associated with PCOMS.

Key findings included evidence that:

  • the tool worked with a range of clients from different ethnicities including Māori, Pacific and Asian clients. On a case by case basis, counsellors should consider using the KORS rather than ORS for Māori and Pacific clients. Alternatively, these clients should have the choice of completing either scale as a measure of their treatment and progress
  • use of the tool was inconsistent across counsellors and the purpose of the tool wasn’t necessarily understood by clients
  • where the tool was used by counsellors, it was used appropriately by them to discuss treatment direction with their clients
  • however, there was mixed evidence as to whether use of the tool resulted in better health outcomes.

The report provides useful insights into how such tools could be used in the NZ setting, and how similar tools could need modification for the New Zealand population.

The Problem Gambling Foundation has used the evaluation results to inform their operational decision to not continue with the PCOMS as a tool in their clinical practice.

https://www.health.govt.nz/system/files/documents/publications/evaluation-partners-for-change-outcome-management-system-pcoms-gambling-treatment-setting-8oct-2020.pdf

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3 MoHA Mixed Methods analysis of Gambling Harm for Women in New Zealand

Internationally and in New Zealand, gambling research from an explicit women’s perspective is rare. Accordingly, gaps in our current understanding of how women are affected by gambling, as both gamblers and as affected others, are likely to constrain harm prevention reduction efforts.

The World Health Organization (WHO) supports multiple layers of gender analysis in health research and policy, accounting for personal and community-level impacts of gender, and investigation of the interactions between sex and gender and their dual impact on health.

Using a mixed methods approach and informed by data collected through the National Gambling Study (NGS), this study enabled a multifaceted exploration of the context, issues and factors influencing women’s gambling related harm in New Zealand and suggests pathways for harm reduction.

The findings are informing the Ministry’s thinking about how gambling harm minimisation services could be refocussed and revitalised to better meet the needs of women harmed by gambling. The refocussing and revitalising of services to better meet client needs is an important component of the current gambling harm minimisation strategy.

Key findings

The AUT Gambling and Addictions Research Centre undertook the study. The researchers found that:

  1. gender issues and ideology infuse gambling practices and experiences of harm
  2. women’s socio-cultural positioning as primary caregivers for families contributes to gambling harm by placing unrealistic expectations on women, while simultaneously constraining their ability to      prioritise their own wellbeing and access rest, relaxation and support
  3. gambling venues in local communities appear to offer women respite, distraction, comfort, time-out and/or connection – while placing them at heightened risk of experiencing problems and harm
  4. promising avenues for addressing gambling harm for women in New Zealand include reducing electronic gaming machines (i.e.,pokies) gambling opportunities in community settings, promoting gender equality and women’s community connectedness in gambling harm prevention and reduction activities, and explicit and ongoing commitment to gender-aware gambling harm reduction research, policy and practice.

https://www.health.govt.nz/system/files/documents/publications/a-mixed-methods-analysis-of-gambling-harm-for-women-in-new-zealand-8oct2019.pdf

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4 MoHNew Zealand National Gambling: Qualitative Phase

This study extended the utility of the National Gambling Study by undertaking semi-structured interviews with 50 National Gambling Study participants who were recruited based on their gambling risk levels from prior interviews.

The study provides insights into the reasons why and how different groups of at-risk gamblers transition between five different types of gambling risk behaviour, and the points of intervention.

The report is detailed and complex in the wide variety of factors found to influence change in gambling behaviour. The research highlights the complexity of the interactions influencing behaviour and gambling addiction. The research is significant because it is based on a study of the same group of people whom have been followed over time.

The findings enhance wider understanding of gambling behaviour, explored ‘why’ and ‘how’ inter-related behaviours or motivators affect gambling behaviour, and highlighted factors that support long-term recovery. The importance of gambling advertising and the common theme of Lotto advertising, increased exposure to online gambling, and the convergence of gaming and gambling elements as triggers for relapse in risky gambling behaviour are timely insights to inform current policy thinking.

https://www.health.govt.nz/system/files/documents/publications/new-zealand-national-gambling-study-qualitative-phase-9oct2019.pdf

 


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