Anita Gibbs

An exploration of kaupapa Maori research, its principles, processes and applications

Kaupapa Maori research developed as part of a broader movement by Maori to question westernized notions of knowledge, culture, and research. Kaupapa Maori research has been used as both a form of resistance and a methodological strategy, wherein research is conceived, developed, and carried out by Maori, and the end outcome is to benefit Maori. This piece reviews the development and main principles of kaupapa Maori research, and it also describes and critiques the main processes of kaupapa Maori research. Three exemplars of research carried out by Maori researchers are provided to illustrate these principles and processes. We conclude that kaupapa Maori research is a relevant approach for research involving Maori and that it can enhance the self‐determination of Maori people. Kaupapa Maori research also has implications for research with indigenous people more generally.

How patients in New Zealand view community treatment orders

Background: New Zealand operates a well-embedded community treatment order scheme for patients with serious mental disorders. A similar scheme may be enacted for England and Wales. Aim: To explore the views of patients with recent experience of community treatment orders. Method: All patients in one region under an order in the last 2 years, not readmitted to hospital for at least 6 months, were included, subject to their capacity and consent. Forty-two patients out of 84 potential participants were interviewed. Results: The majority of patients were generally supportive of the community treatment order, especially if the alternative was hospital. Many valued the access to services and sense of security obtained, and attributed improvements in their health to treatment under the order. They also experienced reduced choice about medication and restrictions on residence and travel. For a minority this meant they were strongly opposed to the order, but for most the restrictions did not unduly hinder them. The majority of patients viewed the order as a helpful step towards community stability. Conclusions: The usefulness of community treatment orders is accepted by most patients under them in NZ, as well as by most psychiatrists. Critical factors include the quality of therapeutic relationships and the structure provided for community mental health care.

Ambivalence about community treatment orders

The trend to endorse the use of outpatient commitment, or community treatment orders (CommTOs) (the terms are equivalent), seems to be gathering momentum. There is now some empirical evidence and a significant body of clinical opinion to suggest that CommTOs can affect clinical outcomes when properly established, resourced, and sustained. Their range has been extending in North America to cover New York and Ontario, for instance. Their introduction is actively under consideration in England and Wales (Department of Health, 2000). They are used extensively in Australia and New Zealand (Dawson, 1991; Dawson & Romans, 2001; Power, 1999; Vaughan, McConaghy, Wolf, Myhr, & Black, 2000). It seems CommTOs are now politically acceptable in many places. The general question we wish to pose about CommTOs is why, despite this gathering momentum, there remains such widespread ambivalence about their use. In addition, what are the reasons for this ambivalence? Does it flow only from the inadequate and conflicting nature of the evidence concerning their efficacy, or is the problem more fundamental and less easily resolved?

Maori Experience of Community Treatment Orders in Otago, New Zealand

Objective: To consider the impact of community treatment orders (CommTOs) on Maori patients and their whanau (extended family) and the associated views of mental health professionals. Method: As a distinct aspect of a larger study of CommTOs, eight Maori patients under compulsory community care were interviewed and, where possible, members of their whanau. Associated interviews were held with their psychiatrists, key workers and other carers: 39 interviews in total. Results: Both benefits and drawbacks of CommTOs for Maori were identified by patients and whanau. CommTOs were considered helpful in increasing patient safety and whanau security and in promoting access to services. They were favoured over hospital care, forensic care and homelessness. The drawbacks included the sense of external control imposed on both Maori patients and staff, particularly concerning medication and restrictions on choices. Conclusions: This was a small study of a limited number of Maori patients under CommTOs. Their views may not be fully representative. There was a general consensus among those interviewed that the timely use of CommTOs can enhance the mental wellbeing and social relationships of Maori patients. Continuing efforts are needed by health professionals to communicate effectively with whanau and to understand the conflicts experienced by Maori in reconciling their traditional beliefs with the medical model of mental illness.

Family perspective on community treatment orders: a New Zealand study.

Background: People with serious mental disorders typically live with family members. Despite increasing interest in compulsory community treatment for such patients, the experience and views of their family members have been little studied. Material: Qualitative interviews with 27 family members, whose relatives have been subject to compulsory community treatment. Discussion and conclusions: Family members are generally in favour of the use of compulsory community treatment orders. They perceive a positive influence on their relative, on themselves, on family relationships, and on relations with the clinical team. Family members are aware of the ethical and other dilemmas that attend the use of compulsory community care.

The Electronic Ball and Chain? The Operation and Impact of Home Detention with Electronic Monitoring in New Zealand:

Abstract In New Zealand, Amendment No. 9 (1999) of the Criminal Justice Act 1985 introduced Home Detention Orders as an early release from prison option, implemented on the 1st October 1999. The orders, with electronic monitoring,were available to convicted offenders who had not committed serious offences and who were sentenced to, or serving, varying lengths of imprisonment.The purpose of the new scheme was to ease the transition of prison inmates back into the community. It was also hoped that home detention would result in a reduction in overall time spent in prison, as well as addressing offending behaviour through the intensive supervision and programs accompanying the home confinement. After reviewing the literature on home detention, and outlining the development and operation of home detention in New Zealand, we will discuss research undertaken by the authors during 2001. The research aimed to ascertain the impact of home detention on offenders, and their families, and to explore the views of other stakeholders, for example, probation officers and prison board members.We interviewed 21 offenders, 21 sponsors, 6 probation officers, 2 security staff and observed over 20 members of district prison boards. Eleven key findings were identified: including factors of suitability, impacts on behaviour and relationships, gender issues and the effectiveness of home detention.We conclude with a brief discussion of the implications of the research: the need to support families and sponsors, ongoing ethical and legal issues, and the acceptance of surveillance as the norm in New Zealand.

Social work and empowerment-based research: Possibilities, process and questions

Abstract Social work research, emphasising the use of rigorous, scientific and evidence-based approaches, has a tendency to exclude the subjects or participants of research, from either acting in co-researcher capacity, or from significantly influencing the course that research involving them will take. This article highlights the need for an inclusive approach with an aim to empower participants, through their greater participation in and decision-making control over research. Three specific research strategies are discussed to illustrate empowerment-based research in social work: action research, collaborative enquiry, and kaupapa Maori research (where Maori self-determination and constructions of knowledge are the starting points for research), The article will discuss the possibilities and process of empowerment-based research in social work and highlight the emerging issues for researchers using this approach.

Reflections on Designing and Teaching a Social Work Research Course for Distance and On-Campus Students

Social work educators are increasingly challenged to train future social workers who can both value research and believe in themselves as capable researchers. One way to achieve this is the teaching of a specific social work research course at a basic qualification level. At Otago University, such a course was introduced in late 2005, and early 2006, for both on-campus and distance (off-campus) students. This Ideas in Action piece reveals the thinking behind and strategies used to help future social workers overcome their reluctance about social work research and enable them to take practice-related research skills into their future work.

Is Home Detention in New Zealand Disadvantaging Women and Children

This article reviews the use of home detention with electronic monitoring in New Zealand, drawing on research undertaken in 2001. The discussion considers the impact of home detention on women who are subject to this disposal, as well as the impact on the women and children who support those on home detention. The research found that most women were positive about this option but increased tensions in the home and deprivation of liberty for some families are disadvantages of the scheme.

Coping with Compulsion: Women's Views of Being on a Community Treatment Order

Abstract An interview-based study of 42 people with serious mental illness was undertaken in New Zealand during the early 2000s. Of the 42 people, 10 were women. The women were either currently on a Community Treatment Order or had been recently discharged from a long period of being on a Community Treatment Order. Analysis of the original interview data revealed how these women experienced both benefits and limitations under conditions of compulsory community treatment. The womens key workers, clinicians, and nominated family members were also interviewed. The findings indicate that women considered the overall advantages of Community Treatment Orders to outweigh the disadvantages. Advantages included: greater access to treatment and respite care in hospital; and an increased sense of safety and reassurance for women and their families. Disadvantages included: some restrictions, such as where women resided; feelings of stigma; and having to comply with treatment with the threat of being returned to hospital if they did not. Overall, Community Treatment Orders made a significant impact on the lives of the 10 women but they also allowed the women to remain out of hospital long enough to rebuild their lives and maintain their close relationships.