A new research report, Ki Te Whaiao – Understanding kaupapa Māori approaches to compulsory mental health care, finds that approaches grounded in te ao Māori are highly effective at de-escalating inpatient situations and helping to avoid the use of seclusion and restraint in compulsory mental health care.

Published by the Board of Te Aka Whai Ora, Ki te Whaiao finds that kaupapa Māori approaches could play an important role in supporting a phased approach to eliminating seclusion within five years, and bringing an immediate end to mechanical and chemical restraint.

"Seclusion and restraint are particularly harmful practices that are used on Māori up to 5.5 times more than anyone else, and for longer periods," says Carlton Irving, Chief Clinical Advisor Allied Health.

"We know that Māori are over-represented in the mental health system, experiencing inequity and racial disparities in addition to inter-generational harm and trauma that many Māori already experience elsewhere in their lives.

"This research highlights the disproportionate use of these methods. Whilst the number of people being secluded overall have decreased by 26.9 percent since 2009, the number of Māori secluded during this period has increased by 47 percent.

"The report recommends a concerted effort to introduce kaupapa Māori approaches into inpatient mental health settings to achieve equitable outcomes for Māori.

"Taking an approach grounded in te ao Māori provides an opportunity to address those harms to individuals and their whānau, instead of compounding them.

"This approach can be as simple as sharing kai with whaiora who are distressed (manaakitanga), using karakia to whakawātea or clear the energy of a tense situation (wairuatanga), or creating familial connections through whakapapa and whanaungatanga," says Carlton.

"We found extensive qualitative evidence that kaupapa Māori approaches contribute to lower rates of seclusion and restraint, by effectively de-escalating high-risk situations. This means less risk of harm to kaimahi as well," says Carlton.