Indigenous psychiatry: how valuable is it?

July 5, 2022 • 12:30 pm

I’ve written a lot about how New Zealand is valorizing indigenous knowledge, and the educational system is on the path to teaching Mātauranga Māori (“MM”)—a mixture of myth, legend, practical knowledge acquired by trial and error, and spirituality—as “science”, coequal to science in science classes.  There is some science in MM, but as a whole it is certainly not the same thing as modern science, and many of its claims are either dubious or palpably false. To teach MM in science classes is to deprive the children of New Zealand of an understanding of science.

Many New Zealanders seems to regard everything about its indigenous people as not only valid, but admirable. A lot of it is, but many Kiwis are too cowed to stand up to some of the more  questionable claims of the Māori, including the claim that their Polynesian ancestors discovered Antarctica centuries ago. I know about this fear because Kiwis who do stand up against nonsense get persecuted, and I get emails from lots of them who agree with me but say that they dare not speak up because they’ll lose their jobs.

The latest effort to “indigenize” knowledge is the bestowing of a huge pot of money on Māori organizations to use “ancestral knowledge” to help cure mental health issues among the indigenous people. This is described in the Newshub article below, which you can click to read:

The article notes that “The new Māori Health Authority has a budget of half a billion dollars and CEO Riana Manuel has allocated $100 million of that to support centuries-old treatments.”

And there is a need for treatment, for the article also notes this:

Māori have the highest suicide rates of all ethnic groups in New Zealand. Mental distress among Māori is almost 50 percent higher than non-Māori and 30 percent are more likely to be left undiagnosed.

Now of course we can’t attribute this to problems that are unique to Māori, as I doubt there was a control for levels of income and other stressors that differ among ethnic groups. But there is a push to use Māori-centered therapy to cure mental illness in that ethnicgroup, and 100 million dollars for using “centuries-old treatments” is a lot of money.

What are these treatments? It’s not clear, but they’re based on lunar cycles and what can only be called psychoastrology. It’s confusing because the article is, as so often happens in Kiwi news, larded with Māori terms that even non-Māori can’t understand. See if you can suss it out:

Not so well known to non-Māori is their tradition of using the moon and stars to help treat mental health issues.

It’s called maramataka and will be incorporated into treatment by the new Māori Health Authority.

Rereata Makiha is on a mission to share ancestral knowledge with the next generation.

He’s an expert on maramataka Māori, or the Māori lunar calendar, and forecasting based on the moon cycles, star systems, tides, and the environment.

“The maramataka helps you, helps us to predict when things are going to happen, to tell us when the fish are going to run, when the eels are going to run – all those sorts of things,” he said.

“When you understand it a lot it’s a brilliant guide on when you should be doing certain things.”

Rikki Solomon teaches at-risk rangatahi and whānau how to use maramataka for improving mental health and knowing when to spend time doing certain activities in nature or around whanau.

“If we find that a whanau has had a low time or they may feel low, what we use is the maramataka to identify their cycles, their highs, and their lows,” Solomon said.

“What we observe in those low areas is what are some rituals at that time. And what I mean about rituals is what is the environment that they can connect to, because our environment is our biggest healer.”

That doesn’t really clear things up, but here’s more on the practice, with quotes from Riana Manuel, CEO of the Māori Health Authority:

“Connecting people back to those spaces and places that have been long forgotten is certainly something that will be investing in,” Manuel said.

Just like they do with Matariki, Māori use maramataka as a way of reading the cosmos to prepare for what’s coming.

“It’s a way of rebuilding the body, your wairua, and rebuilding your energy and getting prepared for the high energy days ahead,” Makiha said.

“So it goes in waves like that and if people understand it and go back to that rather than rush, rush, rush every day, I think that’s what drives a lot of the ill-health.”

If you can figure out what they’re doing from this, you’re a better person than I am.

Now there may indeed be a benefit to using Māori practitioners and ancient Māori practices to treat mental illness. After all, people often feel that therapists who have a background similar to their own are more desirable.  Women, for example, often feel that a woman therapist will treat their problems better, and the same goes for ethnic minorities.  So there may be something to shared experience and background that is therapeutic (there’s also, of course, a placebo effect).

My criticism here is simply that these practices are being adopted in the absence of clinical trials, and so there is only a “traditional” basis for the therapy. Might Māori be helped more with other practices, like cognitive behavioral therapy, practices that have been tested and shown to be efficacious? Or even medication, which has a significant effect on things like depression. (A combination of talk and drug therapy seems to be the most curative).

As a colleague wrote me, this absence of scientific testing of a method that will absorb $100 million is the same issue raised with MM: what is claimed (or assumed) to be “scientific” has not been vetted using the scientific method. To quote the colleague:

This is exactly the problem that led me to raise concerns about MM versus science in the first place. We now have two alternate sets of “facts.” One is based on scientific evidence, and the other may be supported by some evidence but has never been tested in a way that would be considered acceptable for medical science.

Mental health is a form of health, and this is like treating diseases using astrology and “traditional methods” that have never been subject to genuine scientific tests. Doesn’t it seem wise, before investing $100 million in mental-health treatment, that the government of New Zealand be sure that those treatments actually work? 

Sadly, that’s not the way the New Zealand government rolls.

18 thoughts on “Indigenous psychiatry: how valuable is it?

  1. Sounds fishy as hell.

    It’s common for religious counseling or therapy with a spiritual approach to reframe well-tested secular therapies into mythological frameworks. “God wants you to be strong” or “The Cosmos seeks to harmonize habits with our goals” or something else which is NOT faith healing. Using Bible verses as illustrations for Cognitive Behavioral Therapy? No problem. Substituting CBT with Casting OutDemons? Problem.

  2. So, astrology. It seems that there is a mass psychosis affecting a large part of the NZ population, who are increasingly unable to distinguish fantasy from reality, and are now accepting the delusion that the position of celestial objects controls their mental state. They are indeed in need of mental health counseling.

  3. I’d be willing, were I a New Zealander, to be part of a clinical trial, if they did a legitimate one, of whatever this therapy is…I’ve suffered from dysthymia and intermittent full depression since I was a teenager, and I’ve been on most of the pertinent meds and had many versions of CBT and other therapy, and I’ve had mixed results at best. But I would not want myself or anyone with similar issues–which are frequently life-threatening–to be subjected to “treatments” that are without any empirical basis, and in preference over more reliable approaches. Lives are at stake; I could be wrong, but I would predict that people will die from depression under this “regimen” who might have been saved by what one might ironically consider more “traditional” treatment.

  4. Thanks for bringing this to my attention – I follow this larger disaster closely having lived in NZ. I can’t even….. I mean… where do I start? What can I say without looking racist? Or angry? Because I AM angry about it – really. This valorization of Things That Don’t Work…… (ugh)

  5. When it doesn’t work at least Maori won’t be able to blame colonisation and ‘colonial’ treatments.

  6. As with the indigenous science centre at Otago University, this is about carving out a reliable, year-on-year funding stream from the national budget so that prominent and well-connected Maori can get their snouts permanently in the trough. Even more than with the science centre, the inability of anyone to empirically measure the efficacy of the results will make the whole thing conveniently opaque to outside scrutiny.

  7. Would a responsible health care practitioner be comfortable implementing a treatment that has not undergone clinical trial ? Imagine the angst this is going to cause to responsible mental health professionals ? The healthcare system should NOT be a battleground for ideology 😢

  8. For those interested in how Maori treat their mental health issues this 30 minute program produced in NZ is an excellent guide. Spoken in Maori with good subtitles it features two Kaumatua (elders) talking about their concept of the spirit (wairua) world and how it can be used to cure folk, especially men, of their demons. I imagine that indigenous cultures throughout the world would what have similar beliefs. This is the knowledge that is being promoted by the Maori health authorities; it is very seductive, but how we apply the scientific method to it is problematic since it is so built into the cultural world of the Maori. (Huia is an extinct native bird whose tail feathers were treasured by Maori)

  9. More than 30 years ago, a number of Maoris with little or no apparent expertise muscled their way into treating psychiatric patients, on the basis that Maori patients needed Maori treatment. Here is one of the outcomes for their leader, Titewhai Harawira, quoted from her Wiki entry: “In 1989 she was jailed for nine months for assaulting a patient at a mental health unit she ran.”

    I expect those pushing for renewed by-Maori-for-Maori policies are sincere in their astrological delusions, but as for independent, scientific evaluation, ha ha. 50 years on, Watergate advice is as relevant as ever – follow the money.

  10. None of this comes as a surprise. Maori have been pushing for this for years, consecutive governments have ignored any approach in any meaningful way and it has given rise to frustrations on the part of Maori. It could have been handled better, something similar to Restorative Justice, a system made up and implemented with input from Maori and to help serve their unique needs.
    The difference with this health initiative is they are getting considerable sums to apply traditional systems in a modern environment. You may even see it as a 100 million dollar experiment.
    We have seen worse, the great Russian experiment that was Trofim Lysenko and his FAITH in Lamarckism. On that note though, NZ can’t afford millions of lives there would be no one left!
    So if gains are made overall some of the money may be well spent, lets hope they are utilized, worked in with proven modern mental health programs, the science and the failures promptly dropped.
    I could add I hope the last sentence applies to all blending of cultural differences, practices all backed up by the scientific method where needs be.

    1. When I advocate for all the other cultures in NZ to be at least recognised, I get told more often than not “this is New Zealand “ . As if we are not ‘real’ New Zealanders because we are not Māori or ‘white pakeha’ 😢

  11. ”larded with Māori terms that even non-Māori can’t understand”

    Should that be “ larded with Māori terms that even Māori can’t understand”?

    Or “larded with Māori terms that non-Māori can’t understand?

  12. Smudge pots and sweat lodges are cheaper than novel antipsychotics. What would the rich white residents of our finest suburbs say if we offered them charms and incantations instead of chemotherapy?
    Let me be blunt, we are using our ‘sensitivity’ to primitive cultural traditions to fob off certain sections of our population with either unproven or proven-to-be-useless medicine, incorrect education (‘decolonised’ math, anyone?), corrupt self-government at taxpayers’ expense and little or no attempt to police crime in those communities. Is this really sensitivity, or a failure on our part to honestly address the issues?

  13. Generally I ignore the delusions going on in NZ. But I just noticed this :

    including the claim that their Polynesian ancestors discovered Antarctica centuries ago.

    As someone else said with regard to the NZ version of psychobabble, “follow the money”. But there’s a slight difference here to the normal guff.
    If the NZ government support and accept this claim to Maori discovery of Antarctica, they’re in a strong position to support a claim to ownership of at least a substantial part of the Antarctic continent (and continental shelf. They’d have a claim at least as strong, arguably stronger, as the claims of Argentina, Chile, Australia and South Africa. And completely knocking the claims of Britain, France, Norway into a cocked hat. (Are there others? Denmark?) Now the claims of northern hemisphere nations deserve to be in a cocked hat, but a claim like this is certainly grounds for arguing for a larger slice of the pie compared to, say, South Africa. Or the neighbours.
    At the moment the dollars and cents value of such claims is pretty negligible. But a some point the Antarctic Treaty is going to go into the cocked hat too, and someone is going to start pricing up the mineral resources. There are certainly coal deposits (and we know how convinced the Australians are about the relative values of greenhouse gas reduction against coal export. Looking at the mineralogy of the Andes and projecting down the West Antarctic peninsula and across the continent, through the putative NZ claim, I’d say “porphry copper” and lead-zinc-silver plays were real prospects too.
    Suivez la monnaie!
    I’ll grant that the Maori claim isn’t utterly impossible. Damned difficult voyage, though. An Antarctic archaeological site equivalent to L’Anse aux Meadows would be a career-making discovery for any archaeologist, Maori or Chilean. But somehow, I won’t be holding my breath in anticipation.

  14. NZ is a boat drifting in the dark, with no charts or compass, and the crew are all on magic mushrooms.

Leave a Comment

Your email address will not be published. Required fields are marked *