Support for Māori whānau and Pacific and Asian families and significant others who have been affected by suicide attempts – an analysis of the published and grey literature Kathryn Henare and Penny Ehrhardt HHeennaarree EEhhrrhhaarrddtt RReesseeaarrcchh commissioned by the Ministry of Youth Development April 2004 1 Acknowledgements............................................................................................................. 5 Disclaimer........................................................................................................................... 5 1 Executive Summary and Recommendations .............................................................. 6 1.1 Executive Summary............................................................................................ 6 1.1.3 General........................................................................................................ 6 1.1.4 Māori........................................................................................................... 6 1.1.4 Pacific people.............................................................................................. 6 1.1.5 Asian ........................................................................................................... 7 1.2 Recommendations for Service Delivery ............................................................. 7 1.3 Recommendations for Evaluation....................................................................... 9 1.4 Further Research ................................................................................................. 9 2 Purpose and Scope .................................................................................................... 11 3 Terminology.............................................................................................................. 11 4 Methodology............................................................................................................. 11 4.1 Search Methodology ......................................................................................... 11 4.2 Key Contacts..................................................................................................... 12 4.3 Personal Communications ................................................................................ 13 5 Extent and Quality of the Literature ......................................................................... 13 6 The Context............................................................................................................... 14 6.2 The Treaty of Waitangi, Colonisation and Demographic Change.................... 14 6.3 Intention to support family, friends and whānau affected by suicide attempts 15 7 Supporting Māori Whānau who have been affected by suicide attempts................. 16 7.1 Who are Māori Whānau?.................................................................................. 16 7.1.1 Cultural Identity........................................................................................ 16 7.1.2 The meaning of family and whānau.......................................................... 17 7.2 Suicide Attempts Amongst Māori .................................................................... 19 7.3 Māori Experiences of Suicide Attempts by Whānau Members and Significant Others ........................................................................................................................... 20 7.4 Sources of support for Whānau and Significant Others.................................... 23 7.4.1 Whānau ..................................................................................................... 23 7.4.2 General Practitioners................................................................................. 23 7.4.3 Māori Mental Health Services .................................................................. 24 7.4.5 Other sources of support ........................................................................... 26 7.4.6 Coordination ............................................................................................ 27 7.5 Directions for providing support for Whānau affected by suicide attempt ...... 27 7.5.1 Māori Models of Well-being ........................................................................... 28 7.5.2 Effective health services for Māori........................................................... 30 7.5.3 Information resources for Māori............................................................... 30 7.5.4 Mainstream Counselling Approaches....................................................... 30 7.5.5 Kaupapa Māori Counselling Approaches ................................................. 31 7.5.6 Tohunga .................................................................................................... 32 7.5.7 Canadian Native American Models.......................................................... 32 7.6 Conclusions....................................................................................................... 32 8 Supporting Pacific Families and Significant Others who have been Affected by Suicide Attempts............................................................................................................... 35 2 8.1 Who are Pacific Families and Significant Others? ........................................... 35 8.1.2 Cultural Identity........................................................................................ 35 8.1.3 The meaning of Family............................................................................. 36 8.2 Suicide Attempts Amongst Pacific Peoples...................................................... 38 8.2.1 Suicide Attempts in Pacific Island Countries .................................................. 38 8.2.2 Suicide attempts among Pacific people in New Zealand.......................... 39 8.3 Pacific Peoples Experiences of Suicide Attempts by Family Members and Significant Others ......................................................................................................... 41 8.3.1 The Centrality of the Family..................................................................... 42 8.3.2 Attitudes towards Mental Illness .............................................................. 43 8.4 Sources of support for Families and Significant Others after a Suicide Attempt. ........................................................................................................................... 45 8.4.1 Family and significant others.................................................................... 45 8.4.2 Church....................................................................................................... 46 8.4.3 Traditional healers .................................................................................... 47 8.4.4 General Practitioners (GPs) ...................................................................... 48 8.4.5 Mental Health Services............................................................................. 48 8.4.5 Other sources of support ........................................................................... 50 8.5 Directions for providing support to Pacific families affected by suicide ......... 51 8.5.1 Pacific Models of Health .......................................................................... 51 8.5.2 Pacific Mental Health Service Provision .................................................. 52 8.5.3 Mainstream Counselling and Support Services ........................................ 52 8.5.4 Just Therapy Approach ............................................................................. 53 8.5.5 Pastoral counselling .................................................................................. 54 8.5.6 Community Care....................................................................................... 54 8.5.7 Education and Resources .......................................................................... 54 8.6 Conclusions....................................................................................................... 54 9 Supporting Asian Families and Significant Others Affected by Suicide Attempts.. 57 9.1 Who are Asian Families and Significant Others?............................................. 57 9.1.1 New Zealand’s Asian Population.............................................................. 57 9.1.2 Asian Families and Significant Others ..................................................... 58 9.2 Suicide Attempts Amongst Asian Peoples ....................................................... 59 9.2.1 Suicide Attempts In Asian Countries............................................................... 59 9.2.3 Suicide Attempts Amongst Asians in New Zealand........................................ 61 9.3 Asian Families and Significant Others’ experiences of being affected by suicide attempts......................................................................................................................... 62 9.3.1 Attitudes towards mental illness ............................................................... 63 9.4 Sources of Support for Families Affected by Suicide Attempts....................... 63 9.4.1 Family and Friends ................................................................................... 63 9.4.2 General Practitioners................................................................................. 64 9.4.3 Mental Health Services............................................................................. 64