Content. A message from the Board Chair - He kōrero mai i te Kaitiakitanga. A message from the Chief Executive - He kōrero mai i te Pou Ahorangi

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2 MIHI E RUA TAU RURU E RUA TAU WEHE E RUA TAU MUTU E RUA TAU KAI NŌ REIRA, TĒNĀ TĀTOU E HUI AKE I RARO I TE KOROWAI O TE TUHINGA KŌRERO MŌ NGĀ TAU RUA MANO TEKAU MĀ WHĀ RUA MANO TEKAU MĀ RIMA NAU MAI, PIKI MAI, WHAKATAU MAI, TĒNĀ KOUTOU, TĒNĀ KOUTOU, TĒNĀ KOUTOU KATOA KA TAU!

3 Content A message from the Board Chair - He kōrero mai i te Kaitiakitanga A message from the Chief Executive - He kōrero mai i te Pou Ahorangi Te Rau Matatini Priorities - Ngā mea nui o Te Rau Matatini Board of Trustees - Ko mātou Tumuaki Board of Directors - Ko mātou Rōpū Kaitiakitanga Executive Team - Ko mātou Rōpū Whakahaere Advisory Groups - Ngā Rōpū Kaitiaki Our Workforce Programme for Māori Mental Health Hauora Hinengaro Māori Māori Nursing Ngā Neehi Māori Youth Rangatahi Addiction Te Hau Mārire Research and Evaluation Rangahau Training and Education Te Hau Māia Suicide Prevention Waka Hourua Organisational Development Whakawhanake Te Rau Design Financial Report matatini 1

4 Mihi Kia ngātahi te waihoe Tāhuri te kei o tō waka, whatiwhati ngaru Haere ki tua, papapounamu te moana E topa, e rere ki uta. HE KŌRERO O TE KAITIAKITANGA - A MESSAGE FROM THE BOARD CHAIR Acknowledgement to those involved in our journey Without the knowledge, commitment and dedication demonstrated by great Māori leaders, the Māori health sector would be a lot different. Therefore it is fitting that acknowledgements are firstly given to the influential Māori health leaders who passed away this year. Ngā mihi mahana ki a Putiputi O Brien, Paraire Huata, Papa Huatahi rātou ko Erima Henare for your life-long dedication to making Aotearoa a healthier place for Māori. Ka hinga atu he tētēkura, ka aramai he tētēkura - As one fern frond dies, another is born to take its place. New and established partnerships have enabled the delivery of extensive programmes for enhancing clinical and cultural competency. The programmes created for Māori by Māori express improvement in the sector, as we continue toward our goal of being the centre of excellence for Māori workforce development. This is evident through rangatahi involvement with the creation of publications such as Hīkaka te Manawa. Developing the Māori mental health sector with knowledgeable leaders for the future is a primary focus. As Chair of the Board of Directors it is my role to ensure that our group have oversight into the business decisions, to provide opportunities for our people. Significant highlights It is with great honour that I present the Te Rau Matatini Annual Report. It is exciting to witness Te Rau Matatini thriving and continuing to provide opportunities for the Māori Mental Health and Addiction workforce. The dedication to our people truly reflects our position as the National Māori Workforce Development centre. Rising to the Challenge Mental Health and Addiction Workforce Development Te Rau Matatini have programmes and initiatives guided by the Ministry of Health - Rising to the Challenge - Mental Health and Addiction Workforce Development publication. Some programmes have been contracted to be jointly delivered by the five Mental Health and Addiction Workforce centres; Te Pou o te Whakaaro Nui, Le Va, Matua Raki, The Werry Centre and Te Rau Matatini. This group is able to accomplish optimal incorporation of the national Mental Health and Addiction workforce development programmes. 2 Te Rau Matatini Annual Report

5 There are 100 actions within Rising to the Challenge including: improve mental health and well-being, physical health and social inclusion for people with mental illness and addiction issues encourage more effective use of resources enhance integration of Mental Health and Addiction services reduce disparities in health outcomes improve access to and reduce waiting times for Mental Health and Addiction services Whānau Ora Te Rau Matatini has developed a Whānau Ora Approach document specific to Mental Health and Addiction which will contribute to the further development and implementation of Whānau Ora initiatives. This framework has been informed by the Whānau Ora Workforce: A literature review, and advice given from all five Mental Health and Addiction workforce centres. Māori cultural and clinical leaders from District Health Boards and non-government organisations also had input. Our organisation work plan continues to be influential and updated each financial year as deliverables are completed. Suicide Prevention for indigenous communities Waka Hourua is a direct response to the New Zealand Suicide Prevention Action Plan released by the Ministry of The next financial year provides a platform to embed new Te Rau Matatini programmes into further workforce development for our kaimahi, and most importantly for our future leadership. The Hui-a-rohe completed earlier this year will help to influence the next Rising to the Challenge document. He Korowai Oranga This high level Māori Health strategy framework supports the Ministry of Health and District Health Boards to deliver a health system which works for all New Zealanders. It has aspects of Te Tiriti o Waitangi, Rangatiratanga and Māori aspirations and contributions woven into it. Health. The suicide prevention programme is a Te Rau Matatini and Le Va partnership to address the high numbers of suicide among indigenous communities (a high risk population). The programme is overseen by the National Leadership Group which is chaired by Professor Sir Mason Durie. The National Leadership Group launched the Community Funding programme with the Strategic Research Agenda to evaluate the process. Waka Hourua has great ambitions to ensure that whānau and Pasifika families feel well supported in developing their own prevention programmes. The challenges of suicide and suicide This framework determines how Māori mental health workforce development deliverables will be approached. Te prevention are many and the Waka Hourua team are prepared. Rau Matatini continue to use He Korowai Oranga as a guide to enhance Whānau Ora, Wai Ora and Mauri Ora for all Māori in the mental health sector. Waka Hourua has great ambitions to ensure that whānau and Pasifika families feel well supported in developing their own prevention programmes matatini 3

6 The future looks positive with experienced and competent people joining our team. Without dedicated staff members it would be impossible for Te Rau Matatini to accomplish everything it has done thus far. Further Acknowledgements It is with great pleasure that Te Rau Matatini can announce that Kīngi Tūheitia is the official patron for Healing Our Spirit Worldwide The Seventh Gathering. The Gathering is being held in Waikato and the pōwhiri has been blessed to take place at Tūrangawaewae marae. This is a special opportunity with great pleasure that the Board confirmed her role in the organisation. Marama has a background in nursing and general management in PHARMAC. Her expertise in health and leadership is hugely beneficial for the organisation. The future looks positive with experienced and competent people joining our team. for Te Rau Matatini as it allows our whakawhanaungatanga with Waikato-Tainui to strengthen. Without dedicated staff members it would be impossible for Te Rau Matatini to accomplish everything it has done thus Previous Co-Leader of the Māori Party and Minister for Disability Issues, Dame Tariana Tūria played a vital role in not only the enhancement of disability services, and the launch of Te Whakaururoa in 2009, but also the social service welfare policy Whānau Ora. Acknowledgement is expressed around her integral role with Whānau Ora and how it has provided a great foundation for Māori. This will continue to have great influence throughout the coming years. Dame Tariana was far. Mihi nui ki a koutou katoa for your constant dedication to ensuring change is made for Māori workforce development. I would also like to take this opportunity to thank all the Board members for your unceasing dedication to ensuring that Te Rau Matatini reaches new levels of excellence. The Board is supported and guided by Te Puea Winiata and the Trustees of our shareholder. We are thankful for the insights that the Trust is able to offer myself and the Board. a great advocate in the parliamentary space and we will continue to celebrate her mahi through our mahi. In closing, I would like to acknowledge Professor Sir Mason Durie. His succinct comments on our debates and discussion Nau mai, haere mai ki ngā kaitiakitanga hou, ko Fiona Pimm (Deputy Chair) rāua ko Eugene Berryman-Kamp. We are encapsulates hours of our out loud thinking easily and understandably. very lucky to have them both. They have proven to be great additions to the Board of Directors as their knowledge in health, through District Health Board positions and other health entities, provides great insight for the future of our organisation. Nau mai, haere mai ki te Pou Ahorangi hou, Marama Parore. After several months of being interim-chief Executive it is Kura Denness Chair, Board of Directors 4 Te Rau Matatini Annual Report

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8 Kua tawhiti kē tō haerenga mai, kia kore e haere tonu. He tino nui rawa o ōu mahi, kia kore e mahi nui tonu. You have come too far, not to go further, You have done too much, not to do more. Tā Hemi Henare (Ngāti Hine, 1989) HE KŌRERO O TE POU AHORANGI - A MESSAGE FROM THE CHIEF EXECUTIVE Our vision for the future Te Rau Matatini strategic focus is underpinned by Māori workforce development, education, clinical and cultural Enhance Māori Cultural aspects of the Workforce; Grow your own Māori Strategy; Improve Education Pipeline for Māori; Build Māori Leaders; and Improving Māori Retention. capability and capacity for the advancement of our people. This vision aligns with our goal to be the centre for excellence for Māori workforce development by Te Rau Matatini is able to use the data collected to develop these key priority areas, supporting solutions to promote positive sector growth. Highlights from July 2014 to June 2015 Since the last Annual General Meeting, the financial year has been full of growth for Te Rau Matatini. We continue to develop new partnerships to provide a strong voice in Māori mental health and workforce development. Our partnership with the International Indigenous Council, Te Rūnanga o Kirikiriroa and Le Va reflect the importance of enhancing clinical and cultural leadership, and ensuring that Te Rau Matatini has a positive contribution to make in Whanau Ora. In the past year Te Rau Matatini has renewed our commitment to engaging kanohi ki te kanohi with our people. We organised seven Māori Mental Health and Addiction regional hui throughout the country. Each hui enabled participants to express their views about current sector workforce The New Zealand Institute of Business provided in-house training for 13 of our staff members to complete a Diploma in Project Management. The 100% success rate sees Te Rau Matatini kaimahi able to put their new found knowledge into practice. A snapshot of current programmes at Te Rau Matatini Healing Our Spirit Worldwide The Seventh Gathering is happening in November 2015, Te Rau Matatini staff are focussed on ensuring that attendees feel welcome to our Gathering and are inspired by the speakers and performances. The Gathering s programme contains 300 presentations and performances sharing indigenous knowledge, wisdom and insight. development. The hui identified key challenges within the sector and solutions to address. Some key priorities taken from the hui were: 6 Te Rau Matatini Annual Report

9 Waka Hourua is the National Māori and Pasifika suicide prevention programme is designed to support communities with tools, knowledge, skills and resources to prevent suicide. Acknowledgements to those involved in our journey Thank you to all of the sector funders; reference groups; working group members; provider networks; students and training institutes; and all others who continue to ensure Te He Ara Toiora, an innovative programme based around using new technology to reduce Māori childhood obesity, has launched its online portal. This programme marks a change in Rau Matatini demonstrates our commitment as a Leader with an integral role to play in Māori mental health workforce development. the way content is delivered to our tamariki me ōna rangatahi. The portal is designed for kōhanga reo and kura kaupapa programmes for Iwi kainga o Waiwhetu. The Board of Trustees and the Board of Directors, provide guidance around strategies and business development We acknowledge after many years of service and dedication Te Hau Mārire is making significant headway for Te Rau Matatini with a focus on a whānau-centric model and the Māori Addiction Workforce. Programmes are being created to bring the issues of addiction into a space easily identified and accessed for Māori impacted by addiction-related harm. Using to Te Rau Matatini the retirement of Papa Tunu Walker, our kaumatua. He now joins the list of kaumātua who have come through our doors and made this organisation what it is today. Kei te mihi ki a Papa Tunu mō tō mahi whakaihi i ngā wā katoa. Mei kore ake koe hei manaaki i a mātou. the Hui-a-rohe to gain information from kaimahi in the sector provides a Māori voice to influence the next Rising to the Challenge mental health strategy. Last but not least, thank you to my team for your remarkable dedication, hardwork and commitment to ensure that Te Rau Matatini takes our learning from our whakapapa with an eye Huarahi Whakatū continues to provide the only dually accredited Professional Development and Recognition on the future to support whanau to Mauri ora Flourishing Whanāu. Programme (PDRP), specifically tailored for Māori by Māori Nurses, operating outside of District Health Boards. This programme has a philosophy of enhancing the dual competency (clinical and cultural competency) of Māori registered nurses and increasing the intake of new nurses into the sector. The clinical competencies are drawn from the Nursing Council of New Zealand, whereas the cultural competencies are informed by Te Ao Māori. Marama Parore Pou Ahorangi Chief Executive Māori Rangatahi and Addictions is a publication created by Te Kīwai Rangahau, the research and evaluation division of Te Rau Matatini. The publication highlights key evidence for factors leading to substance use and abuse by rangatahi. This evidence is useful for changing this situation identifying that rangatahi need support achieved by involving them in workforce initiatives and service delivery to meet their needs matatini 7

10 NGĀ MEA NUI O TE RAU MATATINI - TE RAU MATATINI PRIORITIES Our purpose To provide a strategic focus for workforce development solutions and advancement of indigenous wellness. This strategic focus aims to improve the quality, utility and relevance of workforce development and training programmes Our vision To contribute as a leading organisation with a strategic focus on becoming the centre of excellence for Māori workforce training, education and capability-building solutions for the advancement of indigenous wellness. and strengthen Māori health leadership development. In doing so allows the strengthening of responsiveness to services for Māori. Whakaahua 1 Ngā tamariki o Te Ara Whānui kei Waiwhetu marae mō te whakanui o He Ara Toiora 8 Te Rau Matatini Annual Report

11 KO MĀTOU TUMUAKI - BOARD OF TRUSTEES The Trust Board was established in 2002 as an independent not-for-profit legal entity (hosted by Massey University). The functions Meet the objectives of the Board of Trustees Provide kaitiakitanga to Te Rau Matatini and the kaupapa The Trust comprises of experts in Māori health, Māori mental health, mental health, addiction, education and Māori development perspectives. The Trust provides quality, relevance and a strong reputation which supports the strategic direction for Te Rau Matatini. Act diligently as the shareholder of Te Rau Matatini Ltd Contribute to the Strategic Direction and statement of Intent Promote the kaupapa of Te Rau Matatini Provide quality assurance to the work of Te Rau Matatini. The Trust Te Puea Winiata Chair (Ngai Tamarawaho, Ngāti Ranginui) Chris Webber Deputy Chair (Ngāti Toa Rangatira, Te Ati Awa, Ngāti Raukawa) Rocky Hudson (Ngāti Ruanui, Ngā Ruahine, Whakatōhea) Eugene Davis (Ngāti Haua) Ellen Norman (Muriwhenua, Ngāti Kuri, Ngāti Kahu) Monica Stockdale (Ngāti Kahungunu) Kim Whaanga-Kipa (Rongowhakaata, Ngāti Kahungunu, Te Atianga-ā-Mahaki) matatini 9

12 KO MĀTOU KAITIAKITANGA - BOARD OF DIRECTORS Te Rau Matatini Ltd is an independent not-for-profit limited liability company established in 2005 by the Trust Board. The Directors Kura Denness Chair (Te Ati Awa) Fiona Pimm Deputy Chair (Ngāi Tahu) John Walters (Te Aupouri, Te Rarawa, Ngāpuhi) Ana Sokratov (Ngāpuhi, Te Rarawa, Te Aupouri) Barry Bublitz (Ngaitai ki Tamaki, Ngāti Kohua, Tangahoe Taranaki ki Tonga) Donovan Clarke (Waikato, Ngāti Te Ata, Ngāti Hine) Eugene Berryman-Kamp (Te Arawa) The Board of Directors acknowledges the contribution of exofficio member: Board Policies The Board of Directors and management utilise a number of policies and a governance manual. Board Meetings Board meetings are scheduled quarterly, 12 months in advance. The Chairperson and Chief Executive develop the agenda for each Board meeting with papers distributed in advance. The Board of Directors and Board of Trustees hold quarterly joint meetings. Board Committees The Board of Directors maintains two sub-committees. The Audit and Risk Sub-Committee comprises three members and Chairperson (ex-officio member). The Nominations and Corporate Governance Sub-Committee comprises four Materoa Mar (Ngāpuhi, Ngāti Porou, Ngāti Whātua) until October 2014 members. The responsibilities Company vision Leadership and stewardship Strategy and performance Legislative compliance Risk management Resource procurement Chief Executive s appointment and performance 10 Te Rau Matatini Annual Report

13 KO MĀTOU RŌPŪ WHAKAHAERE - EXECUTIVE TEAM The Executive Team Professor Sir Mason Durie Senior Advisor (Rangitāne, Ngāti Kauwhata) Marama Parore Chief Executive, Pou Ahorangi (Ngāti Whātua, Ngāti Kahu, Ngāpuhi) Tunu Walker Kaumatua (Tainui, Ngaiterangi) Lucy Bush Kaumatua (Ngāpuhi) The Delegation Framework The Board of Directors have delegated the conduct of the day to day affairs of Te Rau Matatini to the Pou Ahorangi. The Pou Ahorangi is responsible for implementing the decisions of the Board. The Pou Ahorangi has the sole authority for employment and personnel matters as specified in the Board Policies. Leigh-James Henderson Service Development Manager (Ngāi Tuhoe, Ngāti Kahungunu) Dr Kahu McClintock Research Manager (Waikato / Tainui, Ngāti Mutunga, Ngāti Porou) Maria Baker Workforce Innovation manager (Ngāpuhi) Lois Moran Education and Training manager (Japanese) Te Rau Matatini employees 60 permanent staff to deliver their core work programme, and specialist or experts for one-off projects. Te Rau Matatini also houses Te Hau Māia Private Training Establishment and Te Rau Design a specialist Māori contemporary design agency. Cecilia Kim Company Accountant (Korean) Sonya Rimene Programmes and Relations manager (Ngāti Kahungunu, Rangitāne, Te Arawa, Ngāi Tahu) Te Kīwai Rangahau is the Research and Evaluation arm of Te Rau Matatini. Located in Kirikiriroa, Hamilton, housed within Te Rūnanga o Kirikiriroa, Hamilton, and the office was officially The Executive Team acknowledges the contribution of the opened in October ex-officio members: Kamielle Tauaneai Corporate Services Manager (Muaupoko, Waka Ahitereiria) until 21 August 2015 Maraea Johns National operations Manager (Tūhoe) until 4 January 2015 There are currently five teams within Te Rau Matatini: Chief Executive Office Workforce Innovation Business Management Group Training and Education Research and Evaluation matatini 11

14 NGĀ RŌPŪ KAITIAKI - ADVISORY GROUPS Te Rau Matatini acknowledges the members of our Committee and Reference Groups who have provided valuable support and advice which guide our programmes. Henry Rongomau Bennett Foundation Committee Professor Sir Mason Durie, Dr Pam Bennett, Clive Banks, Te Rina Moke, Maaka Tibble, Te Puea Winiata, Rozi Pattison, and Patricia Siaosi. Henry Rongomau Bennett Advisory Panel Dr Diana Rangihuna, Dr Mark Lawrence, Dr Matthew Shepherd, Charlizza Harris, Dean Rangihuna, Hamiora de Thierry, Joanne Henare, Parewahaika Harris, Paula-Mauri Mokomoko, Pikihuia Pomare, Riripeti Haretuku, and Andre McLachlan. He Ara Toiora Dr Mason Ngāwhika, Leonie Matoe, Darrio Penetio-Hemara, Callie Corrigan, Roy Hoerara, Tim Corbett, and Te Rae Ngaheke. Te Hau Mārire Dr Vicky MacFarlane, Annette Harris, Eugene Davis, Louise Leonard, Maynard Gilgen, Moe Milne, Phyllis Tangitū, Taipū Moana, Terry Huriwai, and Tania Wilson. Topatopahia te Rere o te Waka Terry Huriwai, Donna Blair, Claire Aitken, Maureec Ngawaka-Nathan, and Eroni Clark. 12 Te Rau Matatini Annual Report

15 Whānau Ora Terry Huriwai, Moe Milne, Manase Lua, Tania Wilson, Novi Marikena, Denise Kingi-Uluave, Tuta Niho Niho Haereroa, Aroha Noema, Joanne Henare, Dallas Hibbs, Sharon Henare, and Patricia Siaosi. Waka Hourua Māori Rōpū Dr Candy Cookson-Cox, Rose McClutchie, Kelly Te Rinii, Phoenix Rūka, Eru Kapa-Kingi, Rebecca Hooker, Joanne Aoke, Michael Nāera, Emma Kūtīa, Danielle Oaks, Peta Rūha, Witī Ashby, and Byron Perkins. Waka Hourua - Strategic Research Agenda Dr Linda Nikora, Dr Te Pora Emery, and Dr Mele Taumoepeau. Huarahi Whakatū Tish Siaosi, Devi Ann Hall, Hineroa Hakiaha, May Hart, Ruelle Khan, Candy Cassidy, and Ronald Baker. KO MĀTOU RŌPŪ TUAKANA / TEINA - OUR STRATEGIC PARTNERSHIPS AND RELATIONSHIPS Te Rau Matatini has established working relationships with various Government, Non-Government, Tertiary Education centres; Health Workforce centres; National Māori providers and other Mental Health sector organisations. Expanding Te Rau Matatini networks throughout the country allows further influence on all matters Māori. As policies, best practice and innovative programmes are being established it enhances the input from Māori for Māori. Te Rau Matatini appreciates and gives thanks to all strategic partnerships throughout the country that have been established over the years. The organisation continues to flourish and moves closer to becoming the lead organisation for Māori Health Workforce Development. Identifies the range of stakeholders Te Rau Matatini engage with throughout Aotearoa matatini 13

16 Whakaahua 2 Professor Sir Mason Durie providing insight into Māori Health OUR WORKFORCE PROGRAMME FOR Māori Mental Health Hauora Hinengaro Māori Māori are disproportionally represented in Mental Health statistics. Due to the disproportionate use of services by Māori it is important to ensure health care and services are delivered appropriately within communities, and are effective. Te Rau Matatini is focused on strengthening Māori health leadership because it is essential in supporting health services and continuity of quality improvement of health care. Fostering Māori leadership is also important for ensuring the delivery Whānau Ora Framework The Whānau Ora Framework is an interagency approach to provide health and social services to build the capacity of all whānau in need. It empowers whānau as a whole rather than focusing separately on individual members and their difficulties. Enhancing the presence of Māori health leadership in influential areas through the Whānau Ora Framework, ensures the future development of effective services, underpinned by whakaaro Māori (Māori ideologies). of health care is culturally responsive for Māori within our communities. Therefore effective Māori health leadership and culturally responsive services are mechanisms to reduce the numbers of Māori tāngata whaiora. The Whānau Ora Approach document specific to Māori Mental Health and Addiction, contributes to the further development and implementation of Whānau Ora initiatives. This Framework was informed by the Whānau Ora Workforce: Te Rau Matatini is focused on increasing the number of Māori entering into the Mental Health and Addiction workforce; working alongside the Ministry of Health, Health Workforce New Zealand, District Health Boards and Non-Government organisations around the country. This ensures tailored A Literature Review coupled with advice provided through a collaborative approach; led by Te Rau Matatini and supported by Matua Raki, The Werry Centre, Te Pou o Te Whakaaro Nui and Le Va. programmes are available for the next wave of leaders in mental health. Te Rau Matatini has supported the Whānau Ora Framework, Te Hau Mārire and the Henry Rongomau Bennett Foundation and its scholarship programme to empower individuals, whānau, hapū and iwi to strengthen Māori health leadership. The document A Mental Health and Addiction Workforce Framework: A Whānau Ora Approach was launched at the National District Health Board Family / Whānau Advisors Annual National Hui 5 November, at Wellington Hospital. Since the launch, the Family / Whānau Advisors particularly from the 14 Te Rau Matatini Annual Report

17 Northern Region District Health Boards, have been supported by Te Rau Matatini to implement Whānau Ora as contributing to best practice when working with Māori. Henry Rongomau Bennett Foundation Leadership among Māori is an achievement which is always significantly celebrated as role models for Māori are important. The leadership experienced by Henry Rongomau Bennett Understanding best outcomes and implementing best practice for whānau involves knowing how whānau, hapū and iwi operate. The Whānau Ora Framework reflects this through the use of whakaaro Māori and expert advice, allowing the development of effective services to establish influential change. Te Hau Mārire Te Hau Mārire: Addiction Workforce Strategic Framework for people working with Māori experiencing addiction-related harm ( ), brings together the knowledge and experiences of Māori in the addiction treatment sector. This guides the development of a competent workforce that will contribute to the minimisation of addiction-related harm and achievement of Whānau Ora. is no exception. In early 2011, the Henry Rongomau Bennett Foundation was launched. The Foundation manages a range of programmes, including the scholarships, to meet the goals of developing leadership pathways for existing and emerging leaders, and facilitating Māori leadership networks in health. Utilising the HRB Foundation as a tool to foster and nurture new and current Māori leaders, guarantees the development of effective services in the future which appreciate how Māori understand, think and work. Working closely with the HRB Foundation to provide access to scholarships expresses the dedication to best outcomes and Whānau Ora for Māori. Henry Rongomau Bennett Scholarship Identifying that leadership among Māori is a mechanism to enhancing the lifestyle of all whānau, in 2001 the Henry Te Hau Mārire aims to be a comprehensive strategy which will enable the Addiction Workforce to flourish and grow in capacity and capability, while still maintaining diligence around remaining responsive to the needs of Māori with addictions. Te Hau Mārire recognises that Māori are the highest users of addiction services in Aotearoa, and as a result, the strategic framework advocates to ensure this population is provided with adequate services to assist in the reduction of addictionrelated harm. Rongomau Bennett (HRB) Scholarship Programme (named in honour of the first Māori psychiatrist) was established to encourage young Māori psychiatrists to continue their studies. In recognition of the concepts of mental health beyond psychiatry, the scope of the scholarship programme was extended. This included other mental health disciplines, such as psychology, nursing, addiction and public health. As the importance of Māori leadership in health was increasingly recognised, the Committee overseeing the HRB Scholarship On behalf of the Ministry of Health, the development of Te Hau Mārire is in collaboration with other influential members of the addiction treatment sector; Matua Raki, The National Addiction Workforce Programme, The Werry Centre for Child and Adolescent Mental Health, and Te Pou o te Whakaaro Nui. Te Rau Matatini would like to thank the respective organisations who released staff to attend meetings and teleconferences as part of the reference group. As past service users, family members, practitioners, and leaders in the addiction sector, the reference group brought a vast range of knowledge, skills and experience. Programme moved to align the scholarships to support the development of Māori leadership in the health sector. The Henry Rongomau Bennett Scholarship Programme has been a successful mechanism to increase the level of Māori participation across the Health sector. Recognising that this approach works for Māori, expresses the fundamental value of scholarships to develop new Māori leaders. The purpose of the scholarship is to develop and build Māori Leadership and excellence in health with competence in clinical aspects and Te Ao Māori matatini 15

18 In 2015, 15 candidates were selected, consisting of seven undergraduate and eight postgraduate recipients. As at 30 June 2015 all recipients have accepted the scholarship and 14 The outcomes for the Henry Rongomau Bennett Māori Leadership in Health Scholarship Programme towards 2030 are to: first payments have been successfully completed. Continue to improve academic outcomes for recipients A list of study fields being pursued in 2015 are: Increase numbers of existing and emerging leaders enrolling and completing undergraduate and postgraduate Bachelor of Medicine and Surgery Postgraduate Certificate in Health Science Masters of Science Masters of Health care Postgraduate Dip in Psychology (Clinical) Bachelor of Nursing studies (certificate, diploma or degree level) in selected discipline relevant to Māori and health Increase the support and promotion of Psychiatry as a specialty to medical students Increase the number of Māori Psychiatric registrars and Māori Psychiatrists by at least ten. Doctorate Clinical Psychology Doctoral of Philosophy Postgraduate Dip in Clinical Pharmacy. Maintaining contact with scholarship recipients allows Te Rau Matatini to observe future leaders with great potential to initiate change in the sector. Whakaahua 3 Māori Nursing 16 Te Rau Matatini Annual Report

19 HENRY RONGOMAU BENNETT SCHOLARSHIP RECIPIENT 2015 Mihi Ko Te Rarawa, Ko Ngāti Kahu ngā iwi Ko Te Ōhaki, Ko Paatu ngā Marae Ko Whangatauatia te maunga Ko Wairoa te awa Ko Karirikura te moana Ko Derryn taku ingoa Derryn was born and raised in Auckland and is the eldest of five children, one of which is her twin sister, Chloe. During her family moved to Northland and live in Ahipara in the Far north which is Derryn s turangawaewae. It is also Whakaahua 4 Henry Rongomau Bennett scholarship 2015 recipient, Derryn Manga This trip inspired her to travel to Otago University to partake in the First Year Health Sciences course with the hope of getting into medical school. After being unsuccessful first time around; Derryn decided to finish her degree in Physiology, whereby she graduated with the Bachelor of Science at the end of Derryn gained entry into medical school at Auckland as a postgraduate student and now she is currently in her third year for medicine. She is also a proud recipient of the Henry Rongomau Bennett scholarship, which she received earlier this year. Derryn is thoroughly enjoying her career so far and wishes to return to work in the Far North as a medical professional in the future. where her father and paternal grandfather originated from. Whilst in Ahipara Derryn was able to meet the people and see the places that influenced her father and grandfather s life. Derryn s mother identifies as Pākehā, however her maternal grandfather is of Ngāi Tahu descent. Derryn attended Ahipara Primary school for three years and Kaitaia College for one year. The time spent at Ahipara School was one of the best experiences of her life, and she is proud to say she was a member of the Ahipara Community Problem Solving (CmPS) team. After leaving Ahipara to return to Auckland where Derryn attended Botany Downs Secondary College. She was fortunate to be selected for the Otago on Campus Experience, which was a life-changing event matatini 17

20 Tohu Hiranga Excellence and Innovation Awards The Excellence and Innovation Awards aim to acknowledge and recognise excellence in Māori health, Mental Health and The Award also recognises and encourages the development of innovative approaches to achieving best outcomes for Māori in the mental health sector. Addiction area (individuals, groups and organisations) and encourage the development of innovative approaches to achieving best outcomes for tāngata whaiora and whānau. The specific objective is to recognise and endorse professional achievements, and high levels of Māori excellence by awarding the Harry Pitman (Māori Addiction Services) and Tā Tātou Mahere Korowai Awards The Tā Tātou Mahere Korowai Guidelines provide a model for Mental Health, Addiction and Whānau Ora Services to develop services which reflect the perspectives and aspirations of rangatahi and, by doing so, meeting the needs of rangatahi. Bob Henare (Māori Mental Health) Excellence and Innovation Awards, and the Tā Tātou Mahere Korowai Awards. Harry Pitman Awards The Harry Pitman Award recognises existing and emerging leadership in the Alcohol and other Drugssector and the work aimed at minimising addiction-related harm to Māori. Transformation, innovation and best practice in the AOD sector requires strong Māori leadership. Bob Henare Awards The Bob Henare Award was created to acknowledge and support the professional achievements and high level of excellence of rangatahi Māori (under 25 years) working in Māori mental health. Whakaahua 5 Healing Our Spirit Worldwide Rangatahi 18 Te Rau Matatini Annual Report

21 Healing Our Spirit Worldwide The Seventh Gathering In association with the International Indigenous Council, Waikato Tainui, Te Wānanga o Aotearoa and Waikato Kenya, Mila, Australia and Aotearoa. The event received over 400 abstracts, and will provide presentation from over 300 delegates. University, Te Rau Matatini are leading the 2015 Healing Our Spirit Worldwide - The Seventh Gathering from November. The overarching theme for The Gathering is Mauri Ora meaning life force, a positive state of being, a continuous energy flow, life, good health and vitality. Mauri Ora is about the 400 Abstracts 300 Delegate presentations health and well-being of indigenous communities flourishing in positive directions. 230 International presenters 21 New Zealand key notes 13 Themes Within the theme of Mauri Ora, there are key aspects which celebrate indigenous innovations. The aspects focus on leadership, solutions, potential and the future of programmes The purpose of The Gathering is for Indigenous peoples across the world to come together to share their strength, hope, and wisdom as they face community health, governance, and substance abuse issues. It provides a forum to discuss solutions and to connect and learn from other peoples to heal the spirit, heal the earth, and sustain cultural practices for the next generation. for indigenous populations, worldwide. These four aspects within the Mauri Ora theme for The Gathering, are strengthsbased and forward focused in their approach. Healing Our Spirit Worldwide - The Seventh Gathering is about building the capacity of indigenous leaders, highlighting and celebrating indigenous solutions, and realising indigenous potential for healthy flourishing futures. The Gathering will be connecting over 1,500 delegates and their communities from 17 countries. Delegates are coming The Gathering will also host an international creative arts village and a cultural performance stage. from Canada, United States of America, Hawaii, China, Whakaahua 6 Healing Our Spirit Worldwide (HOSW) International Indigenous Council (IIC) members matatini 19

22 HAUORA HINENGARO - MĀORI MENTAL HEALTH Whakaahua 7 Māori Mental Health nurses attending a workshop to discuss future innovations There is a disparity in health outcomes for Māori. Māori tāngata whaiora using mental health services are no different. Mental Health is one of the high priority areas for whānau and families around Aotearoa because the mental health of one member in the community can impact their wider whānau. Appropriate care and understanding of resources and services available for tāngata whaiora have been identified as mechanisms to improve health outcomes, and reduce health inequalities of Māori tāngata whaiora. Discussions were initiated with tāngata whaiora and whānau to develop important relationships to work in collaboration with the five Mental Health Workforce Development centres. This led to identifying priority areas in mental health which needed to be addressed within communities. A range of development and delivery resources and programmes for the community have been identified and supported. These include: Part A Workforce programme, Kia Pūmau te Oranga Wānanga, Hui-ā-Rohe, Tāngata Whaiora and Best Practice Framework. The overall aim of each programme is to provide tāngata whaiora with adequate support to achieve Whānau Ora and Pae Ora. Assessing Effectiveness Co-existing Problems Drivers of Crime E-learning Evaluation of Sensory Modulation Knowledge Exchange, Transfer, Information Use, Information Leadership Leadership Development Māori Youth Mental Health Regional Workforce Collaboration Seclusion and Restraint Talking Therapies Evaluation Workforce Development and Service Improvement Workforce Stock-take Working to top of scope Working with Māori. Each of these components reveals an area where 20 Te Rau Matatini Annual Report improvement is required to allow the development of whānau, hapū and iwi. Through improvement in these areas, Māori are provided the opportunity to develop leaders and flourish within their communities, as well as the Mental Health and Addiction workforce.

23 Kia Pūmau te Oranga wānanga In April, Ngāti Hine, Moe Milne, Tukaha Milne and Koha Aperahama delivered the Kia Pūmau te Oranga wānanga. This was held at Otiria Marae, Moerewa Northland. The wānanga was designed for both Māori and non-māori health professionals, and students to discuss the protection of lifelong well-being for our whānau and those experiencing mental illness and addiction. Developing Māori and non-māori health professionals to use and understand tikanga when working with Māori, ensures that service delivery is tailored for each whānau or tangata whaiora according to their requirements. Hui-ā-Rohe In understanding the workforce development requirements, as recognised by those working the front-line, Te Rau Matatini is able to advocate for and influence change in the Māori Mental Health sector. To determine what this valuable information is, a series of seven Māori Mental Health and Addiction forum were facilitated in Te Tai Tokerau, Tāmaki-Makau-Rau, Midlands, Manawatu, Te Whanganui-ā-Tara, Te Tau Ihu and Ōtautahi. Each hui provided great insight from the perspective of sector kaimahi, where they expressed their own experiences on how to facilitate change in workforce development, innovative ideas and concepts, as well as addressing any issues which came to The kōrero (discussion) during the three day wānanga included light. important topics such as: These hui were successful and the facilitators were able Pregnant māmā, pēpi and whānau The importance of physical activity to ones well-being utilising Te Ao Māori Mahi-ā-Atua to gather vast amounts of important data. After all hui were completed the information was collated, analysed and placed into a feedback report document outlining requirements for the Māori Mental Health sector. Tāngata Whenua based models of practice with examples of whānau transformation The use of Te reo me ōna tikanga, marae and whenua Key priorities identified by kaimahi for sector development included: Being in and between two worlds as a Māori Psychiatrist Traumatic brain injury and the impact upon wairua of whānau Solution focused strategies for and with Māori workforce development strategies Aspirations of Māori medical students, and leadership. Enhance Māori Cultural aspects of the Workforce Affirmative Māori Recruitment Strategies Grow your own Māori Strategy Improve Education Pipeline for Māori Tailor Workforce Development programmes for Workforce Build Māori Leaders The wānanga proved to be insightful as it provided a safe place for people to inspire and share challenging experiences when working with Māori in the Mental Health and Addiction sector. The richness of the kōrero captured provides valuable Build Māori Mental Health and Addiction nursing Workforce Build Unregistered Māori Mental Health and Addiction Workforce Improving Māori Retention. insight into how those working with Māori in the Mental Health and Addiction sector can ensure programmes and approaches encapsulate the wairua (essence) of tāngata whaiora and whānau. This in turn results in developing programmes dedicated to the enhancement of whānau, ensuring that best outcomes are identified and positively influence the future of the Māori health system. Developing the key areas identified by sector kaimahi will provide incentive for Māori who are contemplating on working in the Māori Mental Health sector. As those who contemplate entering the workforce are persuaded by new changes to the system, workforce numbers are increased with newly qualified kaimahi. This also reflects the retention rate of kaimahi, and reinforcing a strong succession strategy for the sector matatini 21

24 Tangata Whaiora A literature review has been completed on tāngata whaiora and chemical restraint techniques used on Māori during admittance into acute units. This review has highlighted what chemical restraint means in Aotearoa, and presents the limited attention given to the way medications such as Clozapine are foster therapeutic relationships with Māori, to reduce the use of seclusion techniques. This partnership is recognised as a means to influence change for whānau and communities. Continuing to work alongside Te Pou o te Whakaaro Nui as well as Te Ao Māramatanga will strengthen further the understanding of the seclusion and restraint work. used in the treatment of mental illnesses, and subsequent behaviours. Understanding that the negative side effects of Clozapine result in 30 years being reduced from a patient s life (taking into account that Māori already have a lower life expectancy rate than that of non-māori) working with sector Developing strong and trusting relationships in the sector to gain insight and understanding through kaimahi and other organisations is important for sharing and analysing data findings. This was expressed when Ngā Hau e Whā: partners to understand alternative approaches for Māori is a high priority. Māori are the highest users of Mental Health services in Aotearoa, strategies to reduce the instance of health professionals opting for chemical restraint as a primary restraint technique, as well as improving mental health professional competency with medication prescribing, management and monitoring; have been discussed with the Māori Pharmacists Association. Working with the Māori Pharmacists Association, a proposal to co-investigate the impact of second generation antipsychotics on the well-being of Māori has been developed. It is important to note the stories among the Mental Health sector of increased mortality rates of Whakaahua 8 Hui a Rohe, Kirikiriroa National Consumer Group invited Te Rau Matatini to discuss findings from He Kai i te Rangatira, He Korero a report completed by Maria Baker (Te Rau Matatini). Baker s report was constructed following a consumer led hui to find solutions to breaking down restrictive practice of Māori (i.e. high use of Mental Health Act; seclusion and restraint). Specific recommendations from the report included the need for a national Māori consumer voice; follow-up hui with other consumer, and better sharing of available resources developed by and for consumers. tāngata whaiora since the introduction of medications, such as Clozapine. Making a Stand for Change was the follow-up hui held at Tainui College, (Hopuhopu, Ngaruawahia) September 30. Participants A small study completed among Māori Mental Health Nurses employed in acute inpatient mental health units, in partnership with the Māori Caucus of Te Ao Māramatanga, is proving insightful. The study highlights strategies of Māori staff in acute mental health units applying traditional Māori approaches to attended from areas as far as Northland to Dunedin, with 80% of the participants having tāngata whaiora experience. Others who attended were whānau of loved ones with serious mental illness. This follow up hui was designed to further encapsulate information from those with tāngata whaiora experience, and use it to create new, less restrictive mental health models of care. 22 Te Rau Matatini Annual Report

25 Best Practice Framework Te Hau Mārire created a document with the intention to provide information surrounding Best Practice for mental health services for Māori. It was revealed that an assertive indigenous response to increasing Māori Mental Health will involve the recognition of success within Māori Mental Health services, and of Māori health professionals. The development Establishing and strengthening connections between whānau, hapū and iwi is also recognised as being important when developing programmes for communities. This is because whakawhanaungatanga is integral to Māori cultural values, practices and models. During the programme construction, identifying the answers to a list of key factors will help to determine how effective the programme will be. of a Best Practice Framework to underpin the design of future programmes and services for Māori, interrelates with the continual strive for excellence and the enhancement of the Māori mental health workforce. Does the programme make a difference for Māori? Does it assist tāngata whaiora in feeling comfortable with the service provided? Is there an improved sense of support and understanding Evidence suggests that effective Māori mental health services operate in accordance to specific elements of Te Ao Māori (the Māori worldview). These elements are based around the desire to enhance well-being for whānau, hapū and iwi. As priorities for the affected whānau? Are relationships strengthened between the Māori health professional and the tangata whaiora, whānau and/or employers? differ from whānau to whānau around Aotearoa, a locally led Māori mental health solution has been recognised as the most effective approach. Tailoring to the corresponding community and their requirement for support and resources encourages an increase in service / programme buy-in and utilisation. Whakaahua 9 Making a Stand for Change attendees matatini 23

26 Whakaahua 10 Hemaima Hughes, President of Te Kaunihera NGĀ NEEHI MĀORI - MĀORI NURSING There is a strong focus on supporting qualified Māori health practitioners that have a dual competency within the health sector. Māori nursing is a prime example of why it is important to ensure Māori are trained in providing care within rural Māori communities. The unique set of skills and experience Māori nurses bring to their role provides them with a different approach to working with clients. Māori nurses tend to focus on the person and their whānau (Barton & Wilson, 2008), which fosters the connection of their nursing care with Māori cultural values and principles. Nurses work in fast paced environments where no day is ever the same. Success in this career requires enthusiasm to learn, the ability to communicate well and recognise the values of others, as well as prioritise multiple demands. The role of Māori Increasing the number of Māori health professionals has been recognised as an important factor which improves Māori patient access to health services and their experiences of holistic care (Ratima et al., 2007). nurses is more than providing care as they also play a crucial role in shaping the way health and social services respond to people with mental health or addiction issues (Ministry of Health, 2012), as well as providing support for Māori whānau to achieve Whānau Ora (Te Puni Kōkiri, 2013). To ensure Whānau Ora is achieved for Māori whānau, hapū and iwi throughout Aotearoa, more effort is required to improve the workforce of Māori mental health nurses. However, over the last decade Māori registered nurses have struggled to exceed 7% of the overall registered nurses workforce. Te Rau Matatini recognises the importance of Māori nurses, their role in the community and their service delivery, and has a strong focus the on recruitment and retention of Māori nurses. 24 Te Rau Matatini Annual Report

27 Growing our Workforce strategy Partnering with the Māori Caucus of Te Ao Māramatanga to facilitate a series of regional hui, and developing the Māori Mental Health Nursing: Growing Our Workforce, proved to be an innovative approach to establishing a Best Practice guideline. Te Ao Māramatanga are recognised as one of the largest Māori registered health professional groups in Aotearoa. Although the partnership produced a great guideline for Māori nurses, challenges remain around increasing Māori Mental Health Nursing: Growing Our Workforce was blessed by kaumātua and launched at Te Whare Mārie, Kaupapa Māori Mental Health services (Capital & Coast District Health Board) in August Since then, 500 copies have been distributed to key stakeholders such as the Chief Nurses Office, Ministry of Health, Executive Directors of Nursing (District Health Boards), Directors of Mental Health Nursing, Māori Nurse Leaders, Māori Mental Health nurses, Māori nursing students and others. recruitment and retention of the Māori nursing workforce to effectively meet the health needs of Māori. As achieving a higher recruitment and retention rate for Māori Mental Health nursing in order to help whānau achieve To address the issue of recruitment and retention, a range of initiatives for enhancing Māori nursing development over the years have been facilitated. One initiative is through the message Every whānau should have a Māori nurse. The aim for this is to increase access for all whānau to Māori nurses and assist whānau, hapū and iwi to increase the workforce numbers, capacity and capability of Māori nurses who work across the health and disability sector. Whānau Ora is the priority for Māori nursing.utilising the feedback received from the sector provides enough detailed information to enhance the current system, capacity and capability of the Māori Mental Health nursing workforce. Huarahi Whakatū Professional Development and Recognition Programme (PDRP) Huarahi Whakatū PDRP is the only Māori professional development programme in Aotearoa. Utilising Te Pae Māhutonga (Durie, 2009) as the guiding framework for Māori Health Promotion, six core elements necessary for growing and supporting the ongoing development of the Māori mental health nursing workforce are identified. These core elements are: The programme is coordinated by a Māori registered nurse, guided by a cultural and clinical governance board with access to mentors and Māori Assessors. Since its establishment it has maintained its relevancy as a professional development recognition programme, based on dual competency for Mauriora: Specialised and uniquely distinctive Māori mental health nursing practice Toiora: Supporting Māori mental health nursing excellence Waiora: Protective and nurturing practice environments Māori Registered Nurses in Aotearoa. In October 2014, the programme received its second accreditation by the Nursing Council of New Zealand, which validates it for another five year period. Te Oranga: High quality, relevant Māori mental health nursing training pathways Ngā Manukura: Strategic, connected, and sustainable leadership Te Mana Whakahaere: Self determined pathways. The Huarahi Whakatū framework is specifically tailored for Māori Registered Nurses to enhance their cultural and clinical competencies. This framework contains the six domains of Māori cultural competencies, as well as the expected domains of practice as outlined by the Nursing Council of New Zealand. Alongside Te Pae Māhutonga, Māori Mental Health Nursing: Growing Our Workforce enhances the understanding of, and Within this framework nurses are able to apply for four levels of practice: the confidence in the unique contributions made by the Māori mental health nursing workforce. Puna Whakato (Competent) Puna Whakatau (Proficient) Puna Rahi (Expert) Puna Rangatira (Leadership) matatini 25

28 The programme is applicable to the majority of domains where Māori registered nurses may be employed. Examples include: primary care; youth heath; public health; Mental Health and Addiction; Hauora Māori; school nursing and Māori nurse lecturers (within undergraduate and postgraduate nursing education). The majority of nurses who participate and show the most interest in the programme are already within the Mental Health and Addiction sector. 22 Māori nurses have Telenursing has been identified as an effective way to ensure Māori have access to Māori nurses 24/7. Enhancing the clinical competencies of Māori nurses, while they utilise their cultural competency, allows Māori access to services they understand. This is a crucial point of difference as most rural areas have little access to effective nursing for Māori populations. Ngā mihi mahana ki a mātou tuakana, ko Medibank. Mei kore ake koutou hei tautoko me awhina i a mātou. successfully completed the programme this year, with 18 of those being within the Mental Health and Addiction sector and four in other sectors. Using technology to enhance access for tāngata whaiora and whānau to achieve Whānau Ora, also influences the recruitment number of Māori nurses and the services being Haidee Renata (pictured second from left) is the first Māori Mental Health nurse at the Waitematā District Health Board Mental Health services, and acute inpatient Mental Health services to complete the programme. Haidee has achieved Te Puna Whakatau. delivered to Māori. As technology becomes increasingly utilised throughout the 21st Century, more Māori in rural areas will become increasingly reliant on it for medical care. By ensuring that nurses, both culturally and clinically competent, are given opportunities to excel, the health of Māori in rural areas will enhance and reflect the services provided. Having the programme also accepted within District Health Boards is important as they contribute to the majority of employed registered nurses. They are also key allies to ensure Māori Registered Nurses receive professional development hours in order to complete their portfolio, as well as receive contractual remuneration payments when nurses achieve: Puna Whakatau, Puna Rahi and Puna Rangatira in Pūkenga Haumanu (clinical). Currently the Huarahi Whakatū programme is accepted in the following District Health Boards: Northland, Waitemata, Counties Manukau, Lakes, Tai Rāwhiti, Whanganui, Wairarapa, Capital & Coast, Hutt Valley, Nelson-Marlborough, and Southland. Medibank Telenursing Te Rau Matatini takes this opportunity to appreciate the contribution Medibank made to providing Telenursing Scholarships for Māori nurses. Telenursing is the use of telecommunications and information technology for the delivery of nursing services. Medibank s assistance ensures Māori nurses are afforded adequate opportunities to excel within Māori nursing through new technology. 26 Te Rau Matatini Annual Report

29 Whakaahua 11 Left: Gina Chaffey-Aupouri MEDIBANK TELENURSING SCHOLARSHIP 2015 RECIPIENTS Gina Chaffey-Aupouri Gina has worked as a Registered Nurse for 20 years in her community. Currently employed at Te Whare Hauora o Ngāti Porou as a rural health nurse, Gina s role is focused on bringing nursing services to patients. Gina believes telenursing will add value to rural based nursing, particularly enabling access to information and expertise in difficult situations. Māori health Logan Murray Logan is currently studying at Otago University completing his postgraduate Certificate in Health Science (Mental Health) after the successful completion of his Bachelor s Degree in Health Science (Nursing). Logan comes from an extended whānau with strong Māori values and active involvement in the community. is a holistic field of practice which requires a set of skills and knowledge to empower each whānau to make clear decisions about their health. Telehealth will provide a mechanism to help break down the barriers associated with distances between the patient, whānau, and health services, and the resources needed to ensure attention to key health issues. Since graduating in 2006 as a registered nurse, Logan has worked in most areas of nursing where he has gained a lot of people and professional experience. Logan s portfolio of experience includes working in Māori Mental Health, acute inpatient and community mental health, medical and surgical nursing and most recently in immigration detention in Australia. Logan became interested in Telenursing after his exposure during work on the remote Christmas Island in Australia. Through this experience, he realised that telenursing and telemedicine was a successful practise when in remote areas matatini 27

30 RANGATAHI - YOUTH Whakaahua 12 Toitū Hauora Māori Rangatahi attendees. Te Rau Matatini has established a strategy to incorporate rangatahi throughout the work of Te Rau Matatini. Māori rangatahi are over represented in correctional statistics and have been identified as less likely to transition into higher education which results in poorer life outcomes than those who continue on to higher education. Therefore, developing programmes and initiatives which support the recruitment and retention of rangatahi within the health workforce is important. As rangatahi are also tāngata whaiora, incorporating rangatahi advisors and opinion leaders to assist in the development of innovative approaches helps to provide effective health resources and programmes to other rangatahi. This is evident in the range of consultation hui and health career pathway resources. Fostering a Rangatahi voice In October 2015, a strategy was established to identify and enable a rangatahi perspective throughout the work of Te Rau Matatini. Initial planning sessions involving the team looked at how to foster this rangatahi voice. This work has a focus in on Suicide Prevention and Cyberbullying. Approaches of interest to the team will include good codesign principles, leadership and safety. Other existing knowledge and expertise on staff includes Dr Kahu McClintock who has developed a model for Children Adolescents Mental Health Service (CAMHS) delivery, and culturally appropriate clinical assessments. Dr McClintock has also recently published a joint literature review on Rangatahi Māori and Addictions. This review identifies that Māori youth The increased focus on recruitment, retention and innovative approaches to incorporate rangatahi perspectives is essential to supporting and strengthening the future Māori health workforce of Aotearoa. are over represented in both binge drinking and other problem drug use data. Broader factors relating to the ongoing impacts of colonisation continue to create these negative statistics. 28 Te Rau Matatini Annual Report

31 A rangatahi focused project running during 2015, Ka Hao te Rangatahi, included a scope of action indicated by key advisors knowledgeable in youth and rangatahi issues and service provision. This initiated a literature review which identified a lack of recent information about rangatahi Māori, with little presentation of data from quantitative based surveys and systems reporting that identifies Māori youth separately from all youth in Aotearoa. A concurrent research process identified the critically high rate of young Māori (aged years) incarcerated by the Justice system each year, revealing that 50% of prison inmates are Māori. National consultation on rangatahi workforce development The need to focus on rangatahi, their engagement in health training, education and qualifications were emphasised in the consultation hui with Māori Mental Health and Addiction Services and workforce. Consultations took place during February 2015 in Whangarei, Auckland, Hamilton, Palmerston North, Wellington, Nelson, and Christchurch. The comments from the hui specific to rangatahi Māori highlighted the nationwide issue of the lack of Māori staff (nurses and doctors), and too few young Māori entering health career pathways. Recommendations to address this included: Growing the capacity and capability of the Māori Mental Health and Addiction Workforce through wānanga/e learning to reiterate the importance of Dual Competency. An increase in rangatahi and kaimahi support to join the workforce can be achieved through providing more educational pathways, Increasing the number of Māori in strategic positions dealing with policies, strategies and recruitment, through highlighting the educational pathway for kaimahi and other Māori; Envisioning the Māori workforce will be youthful, resilient and full of excellent role models for rangatahi (youth), who can follow the clearly defined career pathways to governance roles, and Developing a comprehensive educational pipeline tailored specifically for rangatahi. The education pipeline will provide an array of career pathways in Te Ao Māori, Clinical and Community based mahi (work). This approach will offer a clear understanding of how to achieve certain career pathways. Māori Health Career Pathways Developed for Rangatahi, by Rangatahi A series of print and online resources have been designed to support rangatahi to pursue a career in Mental Health. The Creating clearly defined career pathways and support for school leavers moving into the Health Sector, Creating a comprehensive educational pipeline tailored specifically for rangatahi. The education pipeline will provide an array of career pathways in Te Ao Māori, Clinical and Community-based mahi (work). This approach will offer a clear understanding of how to achieve certain career new resources have been designed to reduce the lack of clear information regarding pathways for rangatahi seeking to enter into a Mental Health career. Mental Health Career Pathways resources provide information about 13 career pathways in Mental Health. Each Pathway outlines qualifications rangatahi will need to achieve at secondary school and tertiary education if they wish to begin their journey toward their chosen career. pathways, Tailoring Māori workforce programmes to ensure there is an increase in the amount of relevant courses/practice development for Māori in the workforce, Increasing cultural competency of the workforce, Increasing funding opportunities to enable relevant study and training schemes, which will highlight and improve the academic pathways of Māori education, as well as tackle the attrition rate of Māori from academic learning, These resources also provide descriptive information about the role of each career, expected salary and future job prospects to ensure rangatahi are able to make an informed decision about the career they wish to embark on. Mental Health Career Pathways also provides information regarding the types of support rangatahi are able to access while studying toward their desired career. This ensures they are able to complete their qualifications and enter into the mental health workforce. These resources were released in mid October matatini 29

32 The next focus will be on a series of resources based around career progression once rangatahi have entered a Mental Health career. This will focus on clinical pathways, scopes of practice and career change. These resources will be available from December Kia Ora Hauora National Māori Health Career s Programme Kia Ora Hauora Supporting Māori into Health is a national programme established in 2008 to increase the overall number of Māori working in the health and disability sector. The programme has a national base within Auckland, and four regional co-ordination centres in Northland, Rotorua, Wellington and Christchurch. Through this discussion document key actions and intervention points will be identified to lift Māori achievement in Sciences, and assist in increasing numbers of rangatahi who can pursue tertiary level health qualifications. Tā Tātou Mahere Korowai Guidelines Tamariki and rangatahi are key to the future well-being of Te Ao Māori and more broadly Aotearoa New Zealand. Health services play an important role, and rangatahi know what type of health services they prefer. It has been identified that services which are holistic, recognise the influence of their relationships with whānau and school friends; are confidential, non-judgemental, free or affordable; locally delivered, youthfriendly, and offer a range of services that are easy to access, are what rangatahi are looking for. Te Rau Matatini is the National Non-Government Organisation partner for Kia Ora Hauora, providing opportunities for partnership and an alignment of strategic objectives. Kia Ora Hauora currently has 3,867 Māori students engaged in its programmes. Improving Māori student achievement in Science Joint Project with Kia Ora Hauora A discussion document has been created for the Kia Ora Hauora Expert Advisory Group on Māori achievement in sciences from Years The discussion document is based on a recent literature review, completed by Te Rau Matatini. Tā Tātou Mahere Korowai provides a model for Mental Health, Addiction and Whānau Ora services to infuse the views and aspirations of rangatahi, ensuring services are meeting their needs. As Whānau Ora encourages health services to place whānau at the centre of service delivery, these guidelines actively recognise the importance of incorporating rangatahi in the planning and delivery of services for young people. The use of korowai represents (when based on Māori cultural values) how services can wrap around whānau, tamariki and rangatahi to support and increase well-being and resiliency. The literature identifies the National Certificate in Educational Achievement (NCEA), and other current barriers / enablers key to Māori engagement and progression on health qualification pathways. Māori experiences in schools may either support and enable their engagement in science, or be barriers to Māori success in science. Some elements are summarised within tables outlining enablers for education in science, disablers of knowledge and positive learning experiences of science, some commonly held perceptions and misunderstandings about Māori engagement and success in science and; the elements which support Māori and others to be science choosers, or those who continue on with science studies, into qualifications needed for health pathways and professions. 30 Te Rau Matatini Annual Report

33 I was inspired by watching our rangatahi and kaumatua work together TĀ TĀTOU MAHERE KOROWAI AWARD RECIPIENT Whakaahua 13 Scholarship recipient Maureec Ngawaka-Nathan The Tā Tātou Mahere Korowai Award was created to support Child and Adolescent Mental Health, Addiction, and Whānau Ora service providers to establish Rangatahi Advisory Groups. It has also informed strategic development for the entire organization. I don t think we expected this when we commenced the project...or at least I didn t. The Tā Tātou Mahere Korowai Guidelines provide a model for Mental Health, Addiction and Whānau Ora Services to develop services which reflect the perspectives and aspirations of rangatahi, meeting the needs of rangatahi. Another highlight was in how much our rangatahi valued the input and support of kaumatua in them carrying out their mahi. I was inspired by watching our rangatahi and kaumatua work together with staff in clinical and clerical positions acting as Below is an excerpt from a conversation between Maria Baker and Maureec Ngawaka-Nathan about providing feedback on their servants. To me it was a microcosm of how our sector would ideally work in a more Whānau Ora friendly world. the programme. What will be important for you and the team to continue on What do you think are the key highlights Tā Tātou Mahere has with this investment? provided in regard to the establishment of rangatahi experts in your service? Finding the financial means to continue these roles (i.e. rangatahi and kaumātua) with remuneration which recognises One of the highlights for me has been coming to the realisation that the expertise of our rangatahi can inform so many more areas than just cold-face delivery in youth services. Their guidance and recommendations had implications for us at an the value of their expertise and support, and convincing our funders. Generally speaking these are not areas of knowledge and experience upon which they place much value. We re just so grateful that organisations like yours do. operational and policy level, guided service development in our pākeke teams, and produced changes in wider HR [Human Resource] processes matatini 31

34 Hīkaka te Manawa Through a shared vision of improving the mental health and well-being of rangatahi Māori, Te Rau Matatini and the Mental Health Commissioner produced a document outlining strategies and priorities for Mental Health and well-being services for rangatahi Māori. This strategic document was The report s recommendations advocate for future development of services which build on the strengths of rangatahi and provide solutions to the common challenges, to maximise rangatahi development and whānau inclusion. It also recommends that lessons learned for improving outcomes for rangatahi are applicable to all youth services and cultures. released by consistency with introduction of Professor Sir Mason Durie at Te Rūnanga o Kirikiriroa in March 2015, presenting a primary focus on four recommendations (Funding and Planning, Workforce, A model / philosophy for services for rangatahi, and Conduct disorder) of ensuring mental health and well-being services for rangatahi Māori are sufficient and efficient. Rangatahi groups such as Te Ahurei a Rangatahi provide the foundation for youth to participate in and mould their future into something they can be proud of. This was evident during the document s release when stories were shared from rangatahi about their background and the aspirations they had for the future. Understanding the pathway that rangatahi are striving toward initiates the discussion around what needs to The Hīkaka te Manawa: Difference for Rangatahi was created with the assistance from 21 services throughout Aotearoa, all be done to achieve their goal. This is important for the future of Aotearoa and the well-being of Te Ao Māori. dedicated to the advancement of rangatahi mental health and well-being. Through the process of identifying success factors of services which are supporting improved outcomes for rangatahi, this information has been collated and disseminated throughout the sector. As well as providing success factors, it also highlights common challenges met within Mental Health and Addiction services, enabling the necessary change to be identified and advocated for. Whakaahua 14 Rangatahi 32 Te Rau Matatini Annual Report

35 Taitamariki Substance Misuse Prevention Services The Taitamariki Substance Misuse Prevention service is an initiative funded by the Ministry of Health to reduce substance misuse among Māori aged 10 to 13 years, and their whānau. The service model uses an indicated and selective prevention approach by targeting those taitamariki (young people) considered to have a high level of risk for developing substance misuse. The prevention service aims to engage with taitamariki to strengthen protective factors and reduce the Literature review There is a current focus on informing the issue of a major shortage of trained and qualified Māori health workforce, nationally. Nationwide people are asking how do we get more Māori youth into health workforce careers and professions? A literature review currently being redrafted for final peer review identifies the barriers and enablers which are key to Māori engagement, progression with sciences and other training on the Health qualifications pathways. risks of developing substance misuse problems. The literature review collates evidence from existing strategies Ongoing monitoring and evaluation are a key component of this initiative. The evaluation assesses whether the prevention services have played a role in preventing taitamariki from developing mental health and addiction problems. Investments in prevention, early intervention and improved access to health services for children and youth are the key focus areas. and programmes which can contribute to changes and enhance the recruitment and retention of Māori into health careers. Presently the pathways are not well mapped out, and a critical shortage of qualified teachers of science and health sciences in secondary schooling, who are also bi-culturally aware and able to mentor young Māori students to success, is an ongoing issue. The science curriculum in New Zealand Two workshops were scheduled to be held. The final workshop was not delivered on the request of the Ministry of Health. On 8 October 2014 the first workshop was held in Wellington with 17 attendees from Ngā Kete Mātauranga, is not Māori inclusive and neglects to recognise Mātauranga Māori (knowledge) in the domains of Pūtaiao (science), Whānau Ora (family well-being) or Hauora (health). The review hopes to address these issues with key recommendations. Maketu Hauora, Te Whānau O Waipareira Trust, The Werry Centre, The Ministry of Health, and Te Rau Matatini. Whakaahua 15 Rangatahi matatini 33

36 TE HAU MĀRIRE - ADDICTION Whakaahua 16 Left to Right: Rod Jefferies (IIC Chair), Tio Sewell, Tima Tuinasau and Barry Bublitz There is a key focus on promoting growth in capacity and capability within the Mental Health and Addiction workforce, while remaining responsive to the needs of Māori with addictions. In order to increase the capacity of the Mental Health and Addiction workforce Te Rau Matatini has recognised that scholarships are an essential part of ensuring the future workforce will flourish. Key strategic areas have been identified where scholarships needs to be focused to Through providing increased access to scholarships and strategic frameworks for those who are pursuing a career in Māori Mental Health and Addiction, Te Rau Matatini can observe and influence the calibre of those soon to enter the Mental Health and Addiction workforce. This has great implications for tāngata whaiora as the next wave of kaimahi are demonstrating expertise which will provide fantastic strategies, models and programmes for the future. bring about maximum opportunity for those interested in pursuing careers within the sector. A range of research and work based scholarships are provided through the Topatopahia te Rere o te Waka scholarship programme. These scholarships are designed to assist Māori into Mental Health and Addiction careers. It has been estimated one quarter of Māori experience substance misuse and other addictions in their lifetime, therefore it is important to ensure the services are responsive to the needs of Māori with addictions. Te Rau Matatini was involved in the development of Te Hau Mārire: Addiction Workforce Strategic Framework for people working with Māori experiencing addiction-related harm ( ). This guides the development of a competent workforce that will contribute to the minimisation of addiction-related harm and achievement of Whānau Ora. 34 Te Rau Matatini Annual Report

37 Hoe Tahi Alcohol and Other Drug Addiction Scholarships TOPATOPAHIA TE RERE O TE WAKA SCHOLARSHIP RECIPIENTS 2015 Whakaahua 17 Hoe Tahi scholarship recipient, Kim Laurence Kim Laurence is a recipient of the scholarship for This scholarship supported her training in working with addiction in a real-time. The support of Te Rau Matatini and the Higher Ground Drug Rehabilitation Trust, provides Kim with confidence that her practise in the field of addiction will continue to develop with her experience. As a paid placement in a field of personal Kim plans to develop her skills in working with addiction. She also understands that developing her knowledge and respect of Te Ao Māori will provide further understanding into her role. interest, this scholarship enables Kim the opportunity to focus on her practise without the stress finding additional part-time employment. Kim considers herself very fortunate for the opportunity that the Te Rau Matatini scholarship enables her to achieve in order for her to focus on her experience and development in the addiction field. The future is looking promising for Kim as she anticipates Kim hopes to continue working for Higher Ground following the end of the scholarship, with a role working with residents within the clinical team. However, if this is not possible she is confident that the skills and experience she has gained will show promise of opportunity within other addictionrelated programmes. Kim plans to register with the New Zealand Association of Psychotherapists (NZAP) upon completion of her studies, and the Addiction Practitioners Association Aotearoa New Zealand (DAPAANZ), as a Māori Psychotherapist. Kim s aim is to work effectively with a wide range of clientele, specialising in working with Māori, whānau and communities matatini 35

38 Hoe Rua Work-based placement Whakaahua 18 Hoe Rua scholarship 2015 recipient Kruz Adams-Noda Kruz Noda Adams was the recipient of a one year placement at Te Puna Hauora ki Uta ki Tai in a leadership role where he helps facilitate the Tuakana/Teina Rangatahi Advisory Group with the other youth leaders. He also has the opportunity to network and liaise with other Rangatahi Advisory Groups. Kruz s scholarship contract ended in June however he was Kruz has learned a lot about the Mental Health and Addiction sector in Aotearoa during his placement and course. With his new found knowledge Kruz is able to identify contributing factors leading to Mental Health and Addiction; and how co-existing problems impact on service consumers and their whānau. given the opportunity to stay. He currently works as a part-time employee as he is also attending Polytech to obtain a level 4 certificate in Mental Health. The level 4 qualification can be Kruz is grateful for this opportunity and he hopes that in the future, other young people a given similar opportunities. added to the Whānau Tū Whānau Ora training he received at Ngā Mataapuna Oranga. This placement has given Kruz the chance to experience what is like to work in the Mental Health and Addiction sector. Working for Te Puna Hauora ki Uta ki Tai has given him knowledge to further his career in the Health sector. Kruz has found this time inspirational as it has given him insight into his future aspiration of becoming a registered nurse, with the intention of working in the addiction field. Once Kruz has completed his Level 4 certificate he will attend his nursing studies, while working part-time as a Healthcare Assistant in mental health. 36 Te Rau Matatini Annual Report

39 Hoe Whā Post Doctoral Research in Problem Gambling Whakaahua 19 Hoe Whā scholarship 2015 recipient Dr Anne Macaskill Dr Anne Macaskill has now completed a large portion of the planned experiments for this research project. In 2015 she has been travelling to share her findings and to develop connections with other gambling researchers. In July, Anne visited Australia, where she visited gambling researchers at Sothern Cross University in Coff s Harbour, New South Wales. She also visited Lewis Bizo at University of New England suggested that offline wins might be aversive or unpleasant because people might feel frustrated that they just missed a win. However, counter to this, Anne has found that participants prefer to gamble on machines that produce off-line wins. She thinks that it is important to look at off-line wins as previous research has tended to focus on older style near win events that are less likely to occur on current multi-line slot machines. Armadale campus. Dr. Bizo is a member of the advisory panel for her fellowship. This was a very productive visit as Anne was able to join the new University of New England gambling research group as a collaborator, and planned some research work with Lewis. This will involve conducting some follow up research replicating and extending an interesting finding from his lab, and working together on a journal article for submission. During Anne s trip, she also presented on research from her fellowship project at the Australian Learning Group Conference. This was a great chance for her to get a sense of the relevant research being conducted in Australia. Anne has also been pleased to be asked to become an editorial board member for the journal Analysis of Gambling Behaviour. This is a new journal, which is becoming increasingly established and publishing very interesting research. Anne recently completed data collection for a set of experiments following up on this result where she hopes to better understand the effects of offline wins. Anne has previously found that participants respond to offline wins as if they provide information about the likelihood that a win will occur in the future. In that study, participants could wager on one of three lines on a simulated multi-line slot machine. If they bet, for example, on Line 1, and then there were five matching symbols on Line 3 (an offline win) they were then a little more likely than usual to wager on Line 3 on the next spin - acting as if that line might currently be lucky. This has not been demonstrated previously to her knowledge but it fits in with a body of research showing that people often think that pokie outcomes can be predicted in some way even though, in truth, they are completely random and unpredictable. At the New Zealand Association for Behaviour Analysis conference in Christchurch, Anne presented data from a project investigating off-line wins. An off-line win occurs when a combination of winning symbols occurs on a pokie line on which the gambler did not wager. One recent paper matatini 37

40 Whakaahua 20 Rangatahi from the Rongoatea programme, Te Runanga o Kirikiriroa. RANGAHAU - RESEARCH AND EVALUATION All programmes conducted through Te Rau Matatini are evaluated to assess effectiveness for the intended audience. Te Kīwai Rangahau (Te Rau Matatini Research and Evaluation group) conduct these evaluations through quantitative and qualitative approaches to ensure data can be accurately represented and disseminated throughout the sector. As programmes or literature are evaluated it allows insight into new and innovative approaches to Māori well-being, whether it be for rangatahi or kaumātua. Each programme has a set of achievements and deliverables it needs to meet in order to be evaluated as a success. Toro Mai tō Ringa Earlier in 2015 Te Kīwai Rangahau, carried out an online survey with New Zealand Infant Child and Adolescent Mental Health Services (ICAMHS), about the Māori ICAMHS resources available through the Toro Mai tō Ringa website ( com). The results show that there is room for improving awareness of the Māori ICAMHS resources available on the Toro Mai To Ringa website, with only 30.4% of respondents knowing about them. It is encouraging though that 100% of the respondents who were not aware of the resources prior to the survey were interested in learning more about them. Further to that, 83.3% of all the people who responded were interested in learning about future ICAMHS resources and research that Te Rau Matatini might develop. Respondents also suggested other ICAMHS resources they would like developed such as those that utilised Māori tikanga (customs) and Māori whakaaro (ideas). Hauraki Primary Health Organisation (PHO) The Hauraki PHO is a primarily rural population demography, encompassing the rohe of Hauraki, Coromandel, northern and southern Waikato, as well as parts of Hamilton City; it also umbrellas 26 medical practices. Te Kīwai Rangahau and Hauraki PHO have agreed to collaborate together to facilitate While the sample size was modest, Te Kīwai Rangahau are pleased that there was representation from 5/6 of the District three rangatahi provider forum hui to find commonality and solutions to rangatahi issues, within the PHO region. Health Boards with the highest Māori populations. 38 Te Rau Matatini Annual Report

41 The approach will be three pronged and involve; Working in partnership to support local providers to find commonality and solutions as this affects rangatahi in their communities; Maintain and develop a Kaupapa Māori focus as a priority by all Hauraki PHO partners; and Te Kīwai Rangahau will work with the PHO and its partners to identify workforce development opportunities, as they relate to rangatahi workforce in Hauraki and Waikato. Hua Oranga Outcome Assessment Outcome measures are critical to the development of quality mental health services and for their continuous improvements (Mellsop & Wilson, 2006). Hua Oranga uses a holistic method of outcome assessment and is founded on an existing model of Māori health, Te Whare Tapa Whā: the four dimensions of taha wairua (spiritual), taha hinengaro (cognitive), taha tinana (physical) and taha whānau (family) (Durie, 1994). This framework is an accepted Māori representation of health and was selected as it appeared to be Provider forums were held in Thames (Hauraki) and Kirikiriroa in early June 2015 facilitated by Te Kīwai Rangahau, Te Rau Matatini. Forum data is being analysed, and was presented to participant stakeholders in July. Kaumātua Training Evaluation During the financial year, Te Kīwai Rangahau conducted an evaluation of the Kaumātua Supervision Training Toka Tū Moana. Feedback from Te Kīwai Rangahau assisted in producing key findings, leading to the enhanced understanding of the programme s effectiveness. Te Kīwai Rangahau established that this programme provides kaumātua with an opportunity to improve the influence of positive change, at both a practitioner and managerial level. It is clear that Toka Tū Moana has significant benefits for Māori whānau, hapū, iwi and kaumātua. Participants at the training programme expressed the need for Toka Tū Moana to carry the New Zealand Qualification Authority (NZQA) approval, and obtain official recognition as a programme to be placed on the New Zealand Qualifications Framework. Delivering a kaumātua training programme with national recognition will provide benefits such as increasing the profile of programmes available to Māori. As a result of increasing the programme s profile, more kaumātua are likely to enrol. More enrolments correlate to added opportunities for establishing Whānau Ora throughout the motu; resulting in healthier the most familiar to Māori health service providers. From a Māori perspective, constructing a measure around the model involves assessments of the four dimensions, taking into account the perspective of three key stakeholders: tangata whaiora (consumer), whānau and clinicians. This is constructed within the context of mental health treatment and care. The training model uses a combined face to face and e-learning approach to the administration and interpretation of the Hua Oranga tool and Outcomes and Recording Analysis (ORA) data. A plan is being developed to promote the programme throughout District Health Boards and Regional Workforce Coordination Centres. Outcomes Recording Analysis (ORA) Database The Outcomes Recording and Analysis database is an online tool developed by Te Rau Matatini. The prime function of the ORA database is to generate accurate, timely, comprehensive, and useful Māori mental health service data. The reports created through the ORA database are based on the Hua Oranga Māori Mental Health Outcome Measurement questionnaire sets which are entered and updated by health service providers registered to access the ORA database. Currently, Te Kīwai Rangahau supports Waitemata District Health Board Moko services to ensure the ORA database is functional and purposeful for service users. whānau. This provides incentive for Te Rau Matatini to ensure that the consumers voice is heard by the Ministry of Health and the New Zealand Qualifications Framework matatini 39

42 Māori Rangatahi Addictions Review A widespread review on Māori Rangatahi Addictions throughout Aotearoa was conducted and launched at the 20th Cutting Edge conference in September. The conference was hosted by Addiction Practitioners Association (DAPAANZ). The primary focus was on health and health research in Indigenous communities, broadly defined. Articles can be of interest to many fields, including sociological, psychological, medical, anthropological, experiential, methodological, both qualitative and quantitative in nature. The evidence is conclusive and unsurprising that a great portion (estimated to be over 1/3) of rangatahi Māori, ages 12 to 24, are involved with substance use and abuse. It was also highlighted that some rangatahi express a degree of dependency on alcohol and other drugs. In 2013 the Pimatisiwin Journal ceased publication. In 2015, the Native Counselling Services of Alberta agreed to transfer the Pimatisiwin journal to Te Rau Matatini. It will be known as Te Mauri - Pimatisiwin, International Journal of Indigenous Health and Well-being. Te Mauri - Pimatisiwin will be relaunched at Healing Our Spirit Worldwide The Seventh Gathering, The findings from Te Kīwai Rangahau support earlier research from the Christchurch Health and Development Study (Horwood & Fergusson, 1998), which uncovered substance use November the journal. Dr Kahu McClintock is the leading editor for disorders were the most common mental health issue among young Māori. These affects are arguably established through the intergenerational influences of colonisation, socioeconomic deprivation and age structure. Te Mauri - Pimatisiwin is promoting the sharing of multidisciplinary indigenous knowledge and research experience between researchers, health and well-being professionals, leaders and community members. It is an open-access webbased indigenous publication hosted by Te Rau Matatini. This information will be used as a means to reduce the rate of substance use and abuse by our rangatahi. Identifying the triggers and ensuring that suitable support is received by rangatahi will support our future leaders. This will enhance the sense of self-awareness, and encourage our rangatahi to aim high and achieve personal objectives, once thought to be Te Māuri - Pimatisiwin will publish original, informative and scholarly articles on the broadly defined topic of indigenous health and well-being. Te Mauri - Pimatisiwin will serve as a forum for the clarification and exchange of ideas. It will feature articles on projects which make a significant impact on the understanding of indigenous health and well-being. unattainable. The 2015 Editorial Board Members for Te Mauri - Pimatisiwin Te Mauri - Pimatisiwin - International Journal of Indigenous Health and Well-being The Pimatisiwin Journal of Aboriginal and Indigenous Community Health was a peer reviewed, web-based journal published twice each year by Native Counselling Services of Alberta, in partnership with Te Rau Matatini in New Zealand, Papa Ola Lokahi in Hawaii, and the International Indigenous Council for Healing Our Spirit Worldwide. Journal Mandate The goal of the Pimatisiwin Journal was to promote the sharing of knowledge and research experience between researchers, health professionals, and Aboriginal leaders and community members. The journal provided a forum for this diverse are Members: Chair: Professor Linda Nikora - The University of Waikato Deputy Chair: Barry Bublitz - International Indigenous Council, Healing Our Spirit Worldwide, Aotearoa New Zealand Director Deputy Vice Chancellor Māori Paul Meredith - Victoria University of Wellington Professor Denise Wilson - Auckland University of Technology Dr Sarah-Jane Tiakiwai - Waikato-Tainui College for Research and Development Dr Amohia Boulton - Whakauae Research for Māori Health and Development, Whanganui. population to publish on research process and findings in a cross-disciplinary, cross-cultural setting. 40 Te Rau Matatini Annual Report

43 Whakaahua 21 Rangatahi from Waiwhetu on Petone Beach TE HAU MĀIA - TRAINING AND EDUCATION The Private Training Establishment, Te Hau Māia, formed in 2011 provides all training and education development programmes generated by Te Rau Matatini. The in-house training establishment works closely with whānau related health, education and workforce sectors; with a primary focus of contributing to and maintaining the high rate of programme / qualification completion, and achievement for whānau and non- Māori health professionals, in order to help whānau, hapū and iwi achieve Whānau Ora and Pae Ora. The words Te Hau also represents a connection to the four cardinal winds of the four corners of Aoteāroa as Māori see it: Te Taitokerau (North), Te Taitonga (South), Te Tairāwhiti (East), and Te Taihauāuru (West). Māori Public Health In response to what whānau and stakeholder s want, some programmes have been held on local marae where participants feel relaxed and comfortable. Using this kanohi ki te kanohi (face to face) approach in familiar territory, delivered by Māori through Māori ideologies, develops positive experiences and ensures positive expression between the facilitator(s) and participants. Ensuring services which understand Māori ideologies are created and delivered allows Māori to feel increasingly confident in the understanding and retention of important information, for theirs and their whānau well-being. Dedication to the development of the Māori Workforce is critical for effective services being designed for Māori and non-māori. The overarching vision of Te Hau Māia is To strengthen and further equip the Māori workforce through applied, relevant and accessible training programmes to maximise health gains for whānau. These services equate to having great influence on future programme models and delivery for Māori. The current mainstream environment provides little in the way of adequate understanding of how Māori understand information received from health professionals. Through input from Māori into the types of services required and how they should be delivered, a comprehensive and accurate portrayal provides the ability to tailor programmes for Māori Workforce Development. It is the community and stakeholder voice that allows the step forward to enhancing the standard for all involved in the development of the Māori workforce. Māori public health workforce development is a priority of Te Uru Kahikatea: The Public Health Workforce Development Plan ( ) (TUK). TUK is the national strategy to guide public health workforce development within Aotearoa, over the next 10+ years. The document emphasises a range of actions required to meet immediate priorities, and adopts a future focus which aims to prepare the public health workforce to face future challenges. Since 2005, Te Rau Matatini has been addressing consumer concerns by supporting the Māori Public Health workforce and the wider needs to improve cultural competencies. By developing the cultural competency of Māori and non-māori practitioners, effective assessment models can be developed which in turn reflects on the service provided to whānau and its method of delivery. Effective delivery then equates to an increase in the way Māori absorb and retain important information about specific health and/ or special services. As a result of providing information which works for Māori, more Māori are likely to utilise the services in or around their community, and pass on important information to whānau, hapū and iwi matatini 41

44 The key programmes for improving cultural competencies among Māori and Non-Māori health professionals are: period to ensure sufficient opportunities for the learning outcomes can be applied, and evidence can be both gathered and assessed. Kaitiaki Ahurea Cultural Competency Training: This is an interactive course which builds on the skills of the learners to expand and challenge their understanding. The course is appropriate for new public health practitioners, as well as experienced practitioners wanting to further develop their cultural competencies. The intention of the learning includes the application of Te Ao Māori principles to everyday practice within a public health role, when working with Māori communities. He Ara Toiora He Ara Toiora is an innovative whānau-centric approach to reducing the prevalence of Māori childhood obesity, and promoting healthy living. Working closely with an Advisory group and the local community, Waiwhetu Marae, the programme has been fine-tuned to ensure its effectiveness through a technological method of delivery. The use of interactive smart technologies ensures that whānau can follow instructions via web-based content, which encourages physical Tūhono Tuarā - Māori Public Health Training Programme: activity both indoors and outdoors. This programme has been specifically designed to support Māori working in a public health setting. The programme focuses on increasing public health workforce knowledge and understanding of health promotion, from a Māori cultural context. The provision of tools and skills to the public health workforce is designed to assist the implementation of health promotion activities in Māori communities. The content has been developed around Atua Māori (Māori Gods) and their role in the creation story. Utilising their association with primal movements and activities tamariki, whānau or hāpori can set goals for wellness and enhanced lifestyles. From there individual members can choose their own goals, while whole whānau select Atua Plans. An online portal has been tailored for the Waiwhetu These programmes are conducted throughout Te Waipounamu (South Island) in response to the Ministry of Health identifying the need for more Māori focused programmes to align with southern District Health Boards. Providing these programmes in Te Waipounamu ensures that those working with South Island Māori are more attune to tikanga, Te Ao Māori and whakaaro Māori to provide better opportunities and enhanced understanding. Toka Tū Moana The development and delivery of the 2015 Kaumātua community as it encourages groups of people, be it whānau, hapū or iwi, to set physical activity challenges for other groups to attempt. All whānau members track their progress through individual dashboards which show a summary of their progress. Support is provided by a dedicated coach working in the community and schools, with access to online resources allowing whānau members to progress at their own pace. The challenges set between whānau or community groups allows proactive enhancement of lifestyle, and attempts to reduce the rate of Māori childhood obesity by setting positive examples for children. Supervision Training Toka Tū Moana, at two sites, Ōtautahi (Christchurch) and Tūranganui (Gisborne) saw 15 ākonga (students) participate. Toka Tū Moana aims to develop kaumātua to enhance cultural competencies which result in the contribution to effective leadership development. By enhancing critical thinking and attitudes to allow for successful mentoring, advocacy and cultural supervision, there is a succession plan integrated into communities for The programme has an overarching aim to reduce the prevalence of Māori childhood obesity, and ensure that healthy activities become an everyday occurrence within whānau around Aotearoa. Waiwhetu Marae have been an integral component to the establishment of the programme, as they reveal how the programme will be used by other Māori communities. future kaumātua and Te Ao Māori. This is important for the maintenance of Māori as traditions, customs and language are passed through whakapapa as an intergenerational sharing of knowledge. The programme is designed to take place over a six month 42 Te Rau Matatini Annual Report

45 WAKA HOURUA - SUICIDE PREVENTION Whakaahua 22 Waka Hourua E Tu He Māori is underpinned by the vital concepts Māori communities are bound to; te reo me ōna tikanga, Te Ao Māori, whānau, mokopuna, rangatahi and kaumātua; whakapapa and whanaungatanga, whilst achieving full potential in Te Ao Hurihuri (contemporary Aotearoa). The outcomes foster collective responsibility for Māori suicide prevention, whilst promoting continual Māori development and Māori aspirations in its broadest terms, as important features to Waka Hourua. With the application of Pae Ora, its principles of Whānau Ora, Wai Ora and Mauri Ora are taken into account. The rates of Māori self-harm and completed suicides are the highest in Aotearoa. This requires a strong, proactive and aspirational approach to a serious issue. E Tu He Māori (Stance of Māori) provokes the personal, whānau, and national ideal as tāngata whenua (Indigenous people of this land in Aotearoa), and encourages those in need to stand tall within themselves (their whānau, hapū, Iwi), the Māori culture, and as Māori. Within E Tu He Māori are specific outcomes which focus on mokopuna, rangatahi, wahine and tane. Through these components, a collective, integrated and multi-layered approach is created to support reducing suicide among Māori. The Māori Community Suicide Prevention Programme Ko Au, Ko Koe, Ko Tātou Assisting Māori Community Suicide Prevention programmes to develop, realise and support their own whole-of-community suicide prevention plan is the outcome for Ko Au, Ko Koe, Ko Tātou. This is the suicide prevention programme which empowers Māori community change. Pou Ārahi (community change agents) are provided to assist the implementation of the community programmes. The Pou Ārahi are working in partnership with Kia Piki te Ora and District Health Boards in Northland, Waikato, Tai Rāwhiti, Canterbury and Southland. The approach is rarangahia te taurawhiri tangata, weaving whānau, community leaders and groups together to create safe, sound individual, whānau and community responses to suicide prevention and postvention. Working with communities throughout the country is a big driver for Ko Au, Ko Koe, Ko Tātou. Delivering the prospect for communities to establish their own suicide prevention programmes or tools results in increased buy-in form communities which helps to reflect better statistics for the Māori suicide rate. These programmes have been designed for supporting Māori within their communities through rarangahia te taurawhiti tangata and their own suicide prevention programmes matatini 43

46 The Community Fund The Community Fund (a one-off contestable fund of $2 million) has been established to support community-based suicide intervention initiatives or projects. Māori and Pasifika community groups, whānau, hapū, iwi and Pasifika families registered and applied for the Community Fund online. The Fund being divided into two funding streams: Māori Whānau, Hapū, Iwi, and communities Pasifika families and communities. as they develop, implement and share their own approaches to building resilience and resistance to suicide. If a suicide is completed, the affected community will then have the resources needed to support each other, while also ensuring there is confidence in talking about personal difficulties with family or friends. Examples of programmes working within the community are The Aranui Eagles Rugby League Club and Youth T.E.A.M Trust. These two applicants stood out for their particularly direct and innovative proposals. The Aranui Eagles Rugby As communities respond differently to suicide prevention approaches it is necessary to develop individually tailored approaches for each community. By allowing communities to be a part of the identification process for the tools needed, the chance of success increases. Positive contributions and dedicated engagement from Māori communities allows for effective programmes to be manifested for the community. The number of communities assisted by Ko Au, Ko Koe, Ko Tātou and the Community Fund project is outlined in the tables below. Community Number of initiatives Auckland 12 Tai Te Tai Tokerau 8 Waikato 4 Bay of Plenty 12 Taranaki 1 Tai Rāwhiti 2 Hawkes Bay 3 Horowhenua 3 Wellington 3 Canterbury 3 Otago 2 Community Number of engagements Northland 43 Tai Rāwhiti 64 Waikato 38 Canterbury 23 Southland 58 The project outcomes for Māori and Pasifika communities are designed to contribute to families, whānau and communities being strongly connected to one another through leadership, League Club developed a concept of applying a simple suicide help-seeking message to t-shirts and track pants. The club has evidence of the success of such a project as it already promotes the It s Not Ok message. The club knows it works and getting a suicide awareness message out in this simple way will mean a lot to the members. It is recognised as being able to achieve a lot in the Aranui area by increasing awareness and initiating conversation, among the community. Youth T.E.A.M. Trust also presents a highly innovative case for educating and mobilising Māori and Pasifika hairdressers and barbers to hear their clients stories. Here they have the ability to read the warning signs and use the close relationships they enjoy with their clients to make sure suicide prevention and postvention messages get out into communities. The project focuses on a less obvious role that hairdressers and barbers can have in the prevention of suicide. Giving hairdressers and barbers who work in predominantly Pasifika communities the tools and resources for dealing with suicide ideation will give them confidence to listen to their clients challenges and difficulties. Hair4Life involves suicide prevention workshops being delivered in hair salons and barber shops to establish a suicide prevention capability. These workshops will provide hairdressers with suicide prevention tools and resources to initiate a greater community awareness, while creating leaders to assist the building of resilience among customers and reduce the risk of suicide through simple information. Hairdressers and barbers will also be given the opportunity to receive suicide prevention training through programmes like ASSIST and SafeTalk. Ensuring sustainability beyond the workshops and provides a support network within the community. 44 Te Rau Matatini Annual Report

47 WHAKAWHANAKE - ORGANISATIONAL DEVELOPMENT Whakaahua 23 Te Rau Matatini staff at NZQA assessment conclusion Organisational growth is imperative for development. Te Rau Matatini understands this and places emphasis on ensuring that all employees are provided with opportunities for professional development. As capability and capacity among employees and the organisation are enhanced, it allows higher performance and quality programmes to be established, with knowledgeable staff to assist in community implementation. The ODP seeks to include alignment, execution and renewal initiatives which will see the organisation grow in leadership position and impact. Te Rau Matatini acknowledge that future successes rest on the ability to be more collaborative, but at the same time the organisation must find innovative ways of being effective. Te Rau Matatini understand the need to express what it means to be a high performing organisation. Noting that individual staff members are exemplars of high The organisational development plan (ODP) is designed to support the organisation s long term strategic intent and performers, the aim is to have all staff at the same level of cultural and specialist skills. priorities. This is achieved by building capability in areas which will directly impact on success. The strategic focus is addressed through the challenge of developing a high engagement/high performance culture within a Māori workforce context. International Standardisation Organisation Accreditation Completion of stage 1 of audit for International Standardisation Organisation (ISO) 9001:2008 recertification was concluded prior to the one-site audit dates of January, The Te Rau Matatini have taken care to ensure that the ODP is aligned to the organisation mission and vision; to be the leading organisation in building a strong Māori workforce, for the advancement of Māori health and wellness. This ultimately aligns with the long term goal to be Centre of Global Indigenous Excellence. audit was carried out by two auditors from Health Audit New Zealand issuing six Corrective Action Requests as a result from the audit. All corrective actions were remedied through proposed corrective actions and approved by the Lead Auditor so that the organisation may be recommended for Certification. Recertification was received in July 2015, valid for a period of three years matatini 45

48 Moving forward, Health Audit New Zealand has scheduled Audit Surveillance for January These audits are used to evaluate the ongoing maintenance of the organisations management system and to close out any Corrective Action All staff currently employed by Te Rau Matatini now have a minimum Level 5 qualification. Further opportunities will be presented for all those with Level 5 qualifications to continue to a Bachelor s Degree. Requests raised at a previous audit. New Zealand Qualification Authority review In 2011 Te Rau Matatini was granted approval by New Zealand Qualifications Authority (NZQA), under section 251 of Staff have attended all nine workshops and completed assignments relating to developing a project charter, compiling a project plan and producing a body of evidence for all interactions and decisions. the Education Act 1989, to provide training schemes to the wider public. For Te Rau Matatini to maintain Private Training Establishment registration, the Kaitiaki Ahurea programme was registered on the Framework as a Level 2 Training Scheme. The programme has provided staff members with a foundational knowledge of project management best practice which Te Rau Matatini will continue to develop. Engagement in periodic external evaluation and review is one of NZQA s policies. Each external evaluation and review provides an independent judgement of the educational performance and capability in self-assessment of all nonuniversity tertiary education organisations. Nōna Te Ao In 2014 Te Rau Matatini undertook a process to identify Mental Health and Addiction service performance improvement through the provision and support for e-learning resources. E-learning was defined as Learning that is enabled or supported by the use of digital tools and content. During May an NZQA External Evaluation and Review (EER) assessment was completed. The external review resulted in a rating as Highly Confident in educational performance, and Highly Confident in the organisation s capability in selfassessment. This is the highest rating possible under this As a result, a consistent approach to the use of e-learning technology when delivering learning opportunities to staff in mental health and addiction was proposed according to these imperatives: system. Develop accessible, effective and culturally appropriate Educational performance is the extent to which the educational outcomes achieved by the TEO represent quality and value for learners and the wider community. e-learning across the sector as a whole; Support the sector in responding to technological change; and Ensure that E-learning capability develops efficiently. Capability in self-assessment indicates the effectiveness of an organisation to use self-assessment information and understand performance and how to bring about improvement. New Zealand Institute of Management training The New Zealand Institute of Management provided the Level 5 National Diploma in Project Management for staff. Te Rau Matatini provided this opportunity for staff members through Te Rau Matatini has approached Catalyst to commission the implementation of an e-learning platform to address imperative three for and within Te Rau Matatini. The name of this initiative is Nōna Te Ao. The name is inspired by the whakataukī. Ko te manu e kai ana i te miro, nōna te ngahere. Ko te manu e kai ana i te mātauranga, nōna te ao, - The bird that partakes of the miro berry reigns in the forest. The bird that partakes of the power of knowledge has access to the world. funding from the Māori Performance Development Scheme (MPDS). 46 Te Rau Matatini Annual Report

49 Staff Well-being - Te Whaioranga Te Rau Matatini implemented two workplace programmes for staff members to improve staff wellbeing. The first was a physical health check conducted by registered nurses from Ora Toa Health Services. Height, weight, glucose and cholesterol measurements were all taken, providing a baseline for each of the participating staff members. Information sessions were also conducted throughout the day with medical professionals discussing heart disease, cancer prevention and testing, as well as highlighting the risks caused By working together, the two organisations will gain better outcomes and business synergies, resulting ultimately in better heal outcomes for Māori. Information and Communication Technology Strategy The Te Rau Matatini Strategic Information and Communication Technology (ICT) plan was completed in August This keystone document provides a three-year roadmap of strategic initiatives in order to align the ICT environment, its people, processes and technology with Te Rau Matatini and its current and future business needs. by lifestyle choices. The second programme is a whānau fit physical health workout. This programme continues on from the health checks and provides Te Rau Matatini staff with the opportunity to set nutrition and health goals. Fitness sessions will be held with qualified staff from the SWET gymnasium to ensure that all staff are empowered to lead a healthy lifestyle. Te Rau Matatini has led the Māori health sector recently with the development of Māori Health and well-being websites and apps, the implementation of leading edge Voice over Internet Protocol (VoIP) communications systems, enabling remote staff with 24/7 collaborative access and mobile workspaces, and the exponential growth of social media profiles, sites, reach Hamilton Office Opening and distribution. Te Rau Matatini has expanded into a second office which is located within the Te Rūnanga o Kirikiriroa Office at 59 Higgins Street, Dinsdale, Hamilton. The office space was opened with a soft launch on Monday 29 September The overall themes identified in the plan will be used to develop interrelated projects and effective action plans which will be implemented over the next three years. Te Rau Matatini will initially focus on continually enhancing communications Te Rūnanga o Kirikiriroa hosts four staff within their Higgins Street facility. This facility is a fully open plan office. The and document management, throughout the organisation using technology. office uses smart technology for internal and external communications. Te Rau Matatini Hamilton Office Level 2, 59 Higgin Street, Hamiltion Whakaahua 24 Hamilton Office matatini 47

50 TE RAU DESIGN Te Rau Design is the in-house design team at Te Rau Matatini committed to creating unique and innovative contemporary Māori design that illuminates our publications and resources. All of the artwork used in the publications and this booklet is Te Rau Design believe that experience and passion for both design and the Māori culture has the power to make a positive difference. Further information is available via matatini.co.nz by Te Rau Design. Te Rau Design is available to all external customers as a specialist Māori contemporary graphic and web design company, specialising in managing the design life cycle of brand development for both individuals and companies. This includes design and development of graphic requirements for websites, digital displays, tablet and mobile sites, and stylised clothing. It also includes traditional printed materials such as reports, documents, brochures, flyers, posters and promotional information. 48 Te Rau Matatini Annual Report

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