title: Strategies to reduce the use of seclusion with tāngata whai i te ora (Māori mental health service users).
abstract: Māori, the indigenous people of New Zealand, have the highest crude population-based rate of seclusion events reported internationally (McLeod et al. ). This qualitative study explored Māori clinical, cultural and consumer perspectives on potential strategies and initiatives considered likely to facilitate prevention of, and reduction in, the use of seclusion, with tāngata whai i te ora (Māori mental health service users) in mental health inpatient services. A hui (gathering) over 2 days was held with 16 Māori participants with high levels of clinical, cultural and consumer expertise. The gathering was taped and the tapes transcribed. A thematic analysis of the hui data generated three key categories: Te Ao Māori (access to a Māori worldview); Te Ao Hurihuri (transforming practice); and Rangatiratanga (leadership, power, and control). The findings of this study align with the "six core strategies" for best practice to reduce the use of seclusion (Huckshorn ). A comprehensive approach to the reduction of the use of seclusion with tāngata whai i te ora is required, which is clearly based on a Māori model of care and a vision for transformation of practice in mental health inpatient services, which involves Māori leadership.
authors.affiliation: University of Auckland, Auckland, New Zealand.
authors.forename: Julie PhD
authors.initials: JP
authors.lastname: Wharewera-Mika
authors.affiliation: University of Auckland, Auckland, New Zealand.
authors.forename: Erana PhD
authors.initials: EP
authors.lastname: Cooper
authors.affiliation: Auckland Regional Forensic Psychiatry Services, Auckland, New Zealand.
authors.forename: Nick Rn
authors.initials: NR
authors.lastname: Wiki
authors.affiliation: Auckland Regional Forensic Psychiatry Services, Auckland, New Zealand.
authors.forename: Trudie Rn
authors.initials: TR
authors.lastname: Field
authors.affiliation: Auckland Regional Forensic Psychiatry Services, Auckland, New Zealand.
authors.forename: Jason
authors.initials: J
authors.lastname: Haitana
authors.affiliation: Auckland Regional Forensic Psychiatry Services, Auckland, New Zealand.
authors.forename: Mike
authors.initials: M
authors.lastname: Toko
authors.affiliation: Auckland Regional Forensic Psychiatry Services, Auckland, New Zealand.
authors.forename: Erika
authors.initials: E
authors.lastname: Edwards
authors.affiliation: Auckland Regional Forensic Psychiatry Services, Auckland, New Zealand.|School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand.
authors.forename: Brian Rn Ba MHSc PhD
authors.initials: BR
authors.lastname: McKenna
mesh_terms: D003469:Culture; D005260:Female; D006303:Health Services, Indigenous; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000208:ethnology / Q000628:therapy; D008605:Mental Health Services; D009520:New Zealand; D010356:Patient Isolation / Q000379:methods / Q000523:psychology
keywords: Māori; inpatient mental health services; mental health nursing; seclusion