Keri Lawson-Te Aho discusses suicide prevention for Māori in the first of three online seminars. She shares a story from her own whānau, looks at how the issue is different for Māori including culturally-specific risk and protective factors, and suggests a paradigm shift is needed to respond to Māori suicide more effectively. For more information about this seminar series, see: http://www.spinz.org.nz/page/323-webinars

1. Preventing Māori suicide:
what can we do?
Keri Lawson-Te Aho
29 January 2013

2. Overview
Words of wisdom and encouragement
Tea-Kay’s story – heeding the lessons
The evidence - experiential/research based
Joining the dots
So what?

3. A paradigm shift is required to deal with the
issue of Māori suicide. That paradigm shift
must be based on the privileging of
Māori worldviews, Māori epistemology,
Māori values and processes (Irwin, 2012 )
thereby changing the way interventions are
currently conceptualised and strategies are
framed.

4. A Māori-centered approach to Māori
suicide prevention is critical and aligns
with indigenous thinking about the
prevention of suicide in indigenous
communities (Duran 2006; Elliot-Farrelly, 2004; Evans-Campbell,
2008; Durie, 2004; Duran, Firehammer & Gonzalez, 2008).

5. “young people need to be able to talk to
adults sometimes but often we can’t. No
disrespect mum, but sometimes adults don’t
know how to listen. It’s up to us to help each
other but sometimes we need help with that.
After dad died, the only people I could talk to
were my friends”
“I can’t imagine talking to a mental health
expert or a counsellor. They don’t know me
and it takes trust to open up. You know me”
Huriana Kopeke-Te Aho aged 17

6. “It’s not an easy thing to teach. I trusted
my mum and my dad, and my aunties and
uncles when I was young but as you grow
up, it sort of leaves you, bit by bit. Things
happen that sometimes strip that trust
away. How can we teach it and give it to
our kids so it becomes their āhua and
never let it be stripped away?” parent,
2012

7. "I can put my money on whānau. [...] to all
people that work with families is to be able to
help sort a problem. Go beyond that, and help
a whānau build capability, leadership [...]
unwittingly, we put the whānau into a passive,
dependant position and overlook the potential
they might have for strength and for leadership."
Professor Sir Mason Durie, 2012

8. “We admit that we are insular; we don’t want
people to know what’s going on in our
whānau and we don’t want to know what’s
going on over the back fence, let alone in the
hapū next door, and the iwi and the waka. We
have to, as Māori, rise above our own issues
to communicate with each other about the
mamae that we hold. How do we deal with
that? We have ideas that we can share and
implement and take practical steps. I am here
to listen to the kōrero.” (practitioner, 2012)

9. "No strategy should be dependent upon a
government contract that provides a
service to a community to fix up those
problems that is affecting those
communities. Once that contract is gone if
those communities are no better off any
more resilient or able to sustain those
strategies or approaches or responses that
have been injected into those communities,
those communities are going to end up where
they are.“ Pahia Turia, 2012

10. “The greatest resource is whānau. If you can
lift their sights, value them, give them dignity,
watch them go. We need to take stock of
ourselves. I’ve been in positions where I have
to fix families. What a waste of time. At the
end of the day, we were de-dignifying people.
Taking away their dignity and sense of their
future and responsibility. Are we trying to
assume responsibility for families or are we
getting there just to tell them how wonderful
they are.” Dame Iritana Tawhiwhirangi, 2012

11. Tea-Kay
1992-2012

12. Tea-Kay’s story
• Background of severe bullying (Klomek et al., 2008, 2009).
• Father took his own life when Tea-Kay was 4 (Brent & Melhem, 2008).
• Close knit whānau (Clarke et al, 2010; Kirmayer, 2007)
• Historical abuse (Joiner et al., 2007)
• Gang affiliations on father‟s side (Paikea, 2011; Ashby, 2011; Cuestas, 2013)
• Diagnosed with depression and anorexia/bulimia at 17 (Albizu-Garcia et
al., 2001) (Rohde, Seeley, Kaufman, Clarke, & Stice, 2006)
• Client of mental health services (Rohde et al, 2006; Te Rau Matatini, 2008)
• Sexuality (Coupe, 2005)
• Raised in Christian church (Garroute et al, 2008)
• Dreamed of being a fashion designer but no chance to realise
dreams/unemployment (Platt & Hawton, 2000)/heavy alcohol use (Baxter,
2008), self harming – seeing the cries for help and reading the signs

14. Tea-Kays strengths/protective factors
• Strong and loving whānau, connected to whānau (Clarke et
al, 2010; Wannan & Fombonne, 1998; Coggan et al., 1997)
• Dreams and goals/visions/moemoea/hope (Kruger et al,
2004)
• Close knit network of friends/gothic gay community/peer
support (Smalley, 2005;Lawson-Te Aho, 2012).
• Faith – raised in the Christian church (Garoutte, et al., 2003)
• Access to cultural identity and values (Durie, 2012;
Tahupārae)
• Giftings on his life/intelligent, creative, caring, courageous
• Loving and lovable/aroha

16. Tea-Kay’s risk factors
• Father‟s suicide (Brent & Melhem, 2008).
• History of violence, gang membership/abuse in father‟s side
(Dube et al., 2005; Brodsky et al., 2008; Lawson-Te Aho,
1997)
• His sexuality was invisible
• Low self esteem/bulimia/anorexia (Lawson-Te Aho, 2012)
• Alcohol abuse
• Bullying/physical threats to his safety (Klomek et al., 2008,
2009)
• Unfulfilled dreams
• Confusion about his cultural identity
• Accumulation of stressors – sexual identity; history of abuse;
death of dad; lack of continuity between services and
community

17. What did we do?
• Supported him into training as a fashion
designer
• Mum opened home to his friends
• Youth looked out for him
• Friends supported him via Facebook
• Church supported him and involved him in
leading church youth events
• Searched for help for self harming

18. After his suicide - what did we do?
• Took him onto his marae, had a tangi for him, friends spoke at
service/performed haka/Toia mai
• Drew his friends together and kept an eye on them/opened
homes/Provided a safety net for his friends
• Sought grief counselling (not easy to find help)
• Talked about his suicide (as whānau but not openly with
friends/friends talked about his suicide amongst themselves)
• Used Facebook as a form of social support
• Tried to rally the community
• Information and training (assessing need)
• Networked amongst suicide prevention networks/social
support/counselling networks/professional responses
• Identified „at risk‟ youth in his networks (safety)
• Sought understanding/started telling his story

19. What could we have done
differently?
• Supported him to be who he was/out of school (Durie, 1997)
• Counselling and support to deal with loss of father (Lawson-Te Aho, 2012)
• Address bullying/protection and safety (Lawson-Te Aho, 2012)
• Address historical trauma and abuse (Duran, 2006; Walters et al, 2012) –
long term agenda (Chandler and Lalonde, 2008)
• Supported his whānau/mum raising children as a widow
• Tried behavioural activation as suicide prevention (Bennett, 2010)
• Attended to wairua issues more closely (Valentine, 2010)
• Cultural development? Strategies for self determination?
• Sustained activism (Durie, 2005)
• Strengthened the whānau/capacity building of the whānau (Turia, 2012)
• Specific interventions – problem solving/improving flow between psychiatric
care and home (Coupe, 2012)
• Kept him in the community/treated him in his own community instead of
sending him away into psychiatric care
• Got down off our professional high horses/overcoming fear

20. Looking at the big picture
–
Indigenous suicide
prevention what we know

21. whakapapa
hHistorical traum creates
a
determinants blockages in the life flow
risk factors
whānau as a
protective factor/solution
cClinical services/external
agencies
cCom unity support
m
cCultural options

22. The depiction of the whānau as the waka/vehicle for suicide
prevention recognises at the most pragmatic levels, that it is
the whānau who buries their loved one after suicide. It is the
whānau who supports their loved one after a significant
suicide attempt. It is the whānau who breaks the news to the
wider whānau when a loved one has ended their life. It is the
whānau who dresses their loved one after suicide. It is the
whānau that carries the burden of guilt and shame after
suicide. The whānau is the primary point of responsibility,
the socialisation site (Tomlins-Jahnke & Durie, 2008) and
the potential guarantor of Māori cultural continuity. It is the
whānau that is the engine room of iwi development (Kruger,
2010). It is the whānau that is committed for life (by
whakapapa) to vulnerable and suffering whānau members.
To reiterate, whānau offer the most untapped potential
for Māori suicide prevention (Turia, 2012; Lawson-Te Aho,
2012).

23. What is historical trauma?
mamae
• Trauma, cumulative, occurred over a
lifespan and generations, from
cataclysmic events in history
• HT creates prolonged stress and distress
• Trauma events produce outcomes HTR
• Pathways by which trauma transfers
through generations
• HT factors (unresolved grief) interact with
current experiences (proximal stressors)
create a vulnerability to stress and
disease (Walters et al, 2012)

24. Historical Context
Aboriginal/indigenous/Māori suicide is
different – additional risk and protective
factors (Durie, 2005; Lawson-Te Aho, 2012)
Historical and contextual issues and inter-
generational transfer; unresolved grief
poverty through land alienation
cultural loss through sustained colonisation
(Duran, 2006; Wesley et al, 2008; Walters
et al, 2012; Lawson-Te Aho & Liu, 2010)

25. Common Themes in Indigenous
Suicide Prevention
• Requires a paradigm shift – power within not power
without/impacts of history
• Cultural development (Te Pataka Uara)
• Gaining consciousness of who we are and where we come
from (whakapapa consciousness)
• Self determination enables privileging of indigenous/Māori
responses (mana motuhake/Rangatiratanga)
• Cultural continuity a hedge against suicide
• Long term healing not short term treatment (wairua healing)

26. Whanganui kaumātua, Rangitihi Tahupārae
said:
“Let us return to our origins. Since the time
we as Māori were immersed in the
knowledge streams of Tauiwi we have
become like a branch grafted to a foreign
tree, producing fruit of a different quality
and somewhat unpalatable. It is time that
we returned to the rootstock of our
ancestors”

27. Ancestral rootstock
1.Kotahitanga – whānau are collective and concerted in their
approach
2.Ūpōkaitanga – whānau are well connected to their home,
land and people
3.Whanaungatanga - whānau live with reciprocal obligations
to each other consistent with being part of and affirming the
values of the wider collective
4.Wairuatanga – whānau are experiencing the fulfillment of
life; wairuatanga connects all of the principles and is central to
the interconnectedness of all of the principles of whānau ora
5.Manaakitanga – through the expression of aroha, hospitality,
generosity and mutual respect as whānau practice
6.Kaitakitanga – whānau are working in empowering and
enabling ways that foster and encourage self determination
7.Te Reo – is strong and vibrant in the everyday lives of
whānau

28. Te Whānau e tū kaha ana
Te Taiao
- A secure identity
- Taiohi, a voice, participation
- Leadership, succession, generations coming together, whānau engagement
- Whānau connectedness
- Absence of abuse
- Kaimahi development
- Ahi kaa
Whanaungatanga Manaakitanga
Rangatiratanga/Mana Wairuatanga
Whakapapa

29. “The revolution begins at home. So often
we look outside ourselves for the answers
and they are there staring us in the face
but we don’t always have the confidence
or the courage to see what is there in front
of us and so we look for answers where
there aren’t any”
Keri Lawson-Te Aho, 2012

30. Hapu Transformation

31. Gaining consciousness
Understanding our history and its outcomes
today has to be part of a healing process –
painful. The rongoa is in the mamae
“In one sense all we have to offer to future
generations is the past containing as it does the
hopes, the spirit, the determination of the
people, their constant example of both virtue and
of error. But what a treasure chest that really is.
That is brightness enough to light the way”
Professor Robert Te Kotahi Mahuta (2001)

32. Whakapapa analysis
Whakapapa consciousness
• The homies/te ahi kaaroa
• The lost generations/diaspora
• Repatriation and reconnection
• Internalised oppression

33. Healing processes
The pathways back to ourselves:
Whakapapa reconnection and
healing
Kōrero
Manaakitanga
We have some choices

34. Whakawaatea
Grief rituals
Spiritual healing
Faith in our own traditions, our own
cultural values and practices

35. Cultural development
Restoration of cultural values foundational for
the promotion of positive health for Māori
• Whanaungatanga
• Manaakitanga

36. Leadership
Giving voice to the kaupapa
Passion, drive, commitment, longevity
No one owns this kaupapa
The summary from the first hui with
Hon Tariana Turia on 16 December
2012

37. Kaimahi of „Whānau Ora‟ services
need to facilitate whānau telling their
own stories. It may be that the people
best placed to support the
transformation of whānau are already
placed within the whānau, or broader
network of the whānau. It is important
that whānau are able to identify the
resources for support they have within
themselves, their histories, and their
networks.

38. The role of kōrero in suicide prevention,
intervention, and postvention is important.
Trust is essential. Peer support groups, as
well as inter-generational support
mechanisms, have proven effective
amongst hui participants.
Rather than „fixing‟ whānau, support
services must help to equip whānau with
the tools to navigate their own wellness.
Whakapapa is a tool which can be used in
understanding social responsibilities for the
purpose of suicide prevention, intervention,
and postvention.

39. There is a wealth of untapped potential in
our traditional knowledge bases, including
lessons to be drawn from characters such
as Hine-nui-te-pō, which needs to be
drawn on in the approach to Māori suicide
prevention. Authoritative research on
traditional methods for dealing with mamae
is called for, as is a more thorough
understanding of the positive implications
of political activism on an individual.
Te Taha Wairua is a critical component
which must be addressed in Māori suicide
prevention strategies e.g. karakia, and a
fuller understanding of the application of
mātauranga Māori.
Māori suicide prevention must not solely
rely on an individual‟s ability to access, or
connect with, their taha Māori.

40. Whānau must be engaged at every level of
prevention, intervention, and postvention;
from governance to delivery of care. Whānau
must also be willing and able to receive care.
Whanaungatanga is a tool which can be used
to celebrate the positive, and connect
individuals with a wide fabric of people.
‘Whānau ora’ will mean different things to
different whānau. It is important that whānau
have the mana to determine their own
wellness. There is a distinction to be made
between whānau-ā-whakapapa and whānau-ā-
kaupapa.
For whānau to be well, in every sense, an
unbundling and accounting of the histories and
trauma they have suffered across generations
needs to occur.

41. So what? That is for you to
determine
Whakapapa preservation and
protection to ensure continuity
Healing is our kaupapa
Those of us who can should impact and
influence what we can when we can
Many hands make light work

42. the revolution begins at home
Me kotahitanga tatou!