Karakia TĪMATAnga: AN OPENING prayer

Karakia TĪMATAnga: AN OPENING prayer. Tukua te wairua kia rere ki ngā taumata Hai ārahi i ā tātou mahi Me tā tātou whai i ngā tikanga a rātou mā Kia mau kia ita Kia kore ai e ngaro Kia pupuri Kia whakamaua Kia tīna! Tīna! Hui e, tāiki e! Allow one’s spirit to exercise its potential To guide us in our work as well as in our pursuit of our ancestral traditions Take hold and preserve it Ensure it is never lost Hold fast. Secure it. Draw together! Affirm!.

1.mp3. OUTLINE. SUICIDE & MĀORI: A BRIEF HISTORY THE INEQUITY OF SUICIDE REDEFINING SUICIDE: A WHĀNAU MĀORI ISSUE SUICIDE THROUGH THE LENS OF TE TIRITI DRIVERS FOR EQUITY: WHAT HAS BEEN DONE SO FAR? DRIVERS FOR EQUITY: LOOKING FORWARD.

2.mp3. SUICIDE & Māori: a brief history. Suicide was a part of pre-colonial Māori society, but mostly as a ritual act (Skegg et al., 1995) Official suicide statistics begin in 1889, delineated by ethnicity from 1931 (Hirini & Collings, 2005) Māori suicide rates doubled (females) and trebled (males) from 1957 – 1991 (Kingi et al., 2017) Data is unreliable due to colonised understandings of ethnic classification.

3.mp3. THE INEQUITY OF SUICIDE. Indigenous suicide exists in a confluence of social, cultural, historical and economic factors (Lawson-Te Aho, 1997) Māori experience disparities in health outcomes across the board, including access to quality health care (Medical Council of New Zealand, 2019) Indigenous suicide is the end result of systematic negation, oppression and humiliation (Durie, 2001).

4.mp3. THE INEQUITY OF SUICIDE. Suicide rates among Māori are almost double that of non-Māori (Ministry of Health, 2019b) Māori have less access to health determinants such as education, employment, secure housing and social support (Ministry of Social Development, 2006) Differences in socioeconomic status have accounted for over 20% of the difference in morbidity rate between Māori and non-Māori (Smith & Pearce, 1984) Māori experience more difficulty accessing healthcare (Sadler et al. 2004) Māori are less likely to receive quality care and more likely to experience adverse events (Davis et al., 2006) Māori almost twice as likely as non-Māori to avoid healthcare because of cost (Shoen & Doty, 2004) 34% of Māori reported experiencing discrimination within the healthcare system (Harris et al., 2006) Cultural wounding of colonisation: disconnection from identity, whenua and whanau as risk factors for suicide (Duran & Duran, 1995).

5.mp3. REDEFINING SUICIDE: A WHāNAU MĀORI ISSUE. Suicide is shaped by spiritual, cultural and scientific beliefs (Durie, 2017) Conceptions of suicide are still entrenched in westernised understandings of the individual and disease models. These understandings don’t work for te ao Māori, which understands the individual as linked to whānau (Pitama et al., 2007) Kaupapa Māori sees whanaungatanga as primary source of resilience, strength and identity Indigenous suicide is not an individual problem, it is a collective responsibility.

6.mp3. SUICIDE through the lens of TE TIRITI. Te Tiriti made explicit and implicit commitments to Māori health and protection (Kingi, 2007) A responsibility to equal rights and parity of outcomes An implicit obligation to equity, provision of resources and approaches that close inequitable healthcare gaps Tino rangatiratanga: the right to self-determination over health and wellbeing Control over Kaupapa Māori solutions to suicide Partnership and participation: whānau Māori included in decision-making and implementation of appropriate initiatives (Medical Council of New Zealand, 2019) A promise to allow Māori to define suicide and associated interventions on their own terms, and a commitment to resourcing this.

7.mp3. DRIVERS FOR EQUITY: WHAT HAS BEEN DONE SO FAR?.

8.mp3. DRIVERS FOR EQUITY: WHAT HAS BEEN DONE SO FAR?.

9.mp3. DRIVERS FOR EQUITY: WHAT HAS BEEN DONE SO FAR?.

10.mp3. DRIVERS FOR EQUITY: LOOKING FORWARD. Cultural competence vs. cultural safety (Pitama et al., 2007) A return of power to the patient – tino rangatiratanga (Dickson et al., 2022) Whānau have a key role in interventions and recovery Reducing economic and cultural barriers to treatment Accountability and self-reflection of biases at individual and organisational level Respecting Māori ways of knowing and being.

11.mp3. DRIVERS FOR EQUITY: LOOKING FORWARD. Suicide is understood as a collective issue, inseparable from wider social and cultural inequities Suicide is a collective responsibility requiring whānau -based approaches Suicide exists in a hauora health matrix: spiritual, familial, historical, environmental.

Karakia Whakamutunga: A closing prayer. Kia tau ngā manaakitanga a te mea ngaro Ki runga ki tēnā, ki tēnā o tātou Kia mahea te hua mākihikihi Kia toi te kupu, toi te mana, toi te aroha, toi te reo māori Kia tūturu, ka whakamaua Kia tīna! Tīna! Hui e, tāiki e! Let the strength and life force of our ancestors Be with each and every one of us Freeing our path from obstruction So that our words, spiritual power, love, and language are upheld; Permanently fixed, established and understood! Forward together!.

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