11 results on '"Clark, Mau Te Rangimarie"'
Search Results
2. Reimagining eating disorder spaces: a qualitative study exploring Māori experiences of accessing treatment for eating disorders in Aotearoa New Zealand
- Author
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Clark, Mau Te Rangimarie, Manuel, Jenni, Lacey, Cameron, Pitama, Suzanne, Cunningham, Ruth, and Jordan, Jennifer
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- 2023
- Full Text
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3. Cancer diagnosis after emergency presentations in people with mental health and substance use conditions: a national cohort study
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Cunningham, Ruth, Stanley, James, Imlach, Fiona, Haitana, Tracy, Lockett, Helen, Every-Palmer, Susanna, Clark, Mau Te Rangimarie, Lacey, Cameron, Telfer, Kendra, and Peterson, Debbie
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- 2024
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- View/download PDF
4. Experiences of physical healthcare services in Māori and non-Māori with mental health and substance use conditions.
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Cunningham, Ruth, Imlach, Fiona, Haitana, Tracy, Clark, Mau Te Rangimarie, Every-Palmer, Susanna, Lockett, Helen, and Peterson, Debbie
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SUBSTANCE abuse treatment ,MENTAL illness treatment ,HEALTH services accessibility ,CROSS-sectional method ,PHARMACOLOGY ,BIPOLAR disorder ,POST-traumatic stress disorder ,PHOBIAS ,MEDICAL quality control ,FAMILY medicine ,RESPECT ,COMPULSIVE behavior ,MENTAL health services ,RESEARCH funding ,QUESTIONNAIRES ,AGORAPHOBIA ,STATISTICAL sampling ,NEW Zealanders ,HOSPITAL emergency services ,HOSPITALS ,ANXIETY ,SCHIZOPHRENIA ,PERSONALITY disorders ,JUDGMENT sampling ,DESCRIPTIVE statistics ,CHI-squared test ,EXPERIENCE ,PATIENT-professional relations ,PANIC disorders ,DISCRIMINATION (Sociology) ,PATIENTS' attitudes ,MENTAL depression ,GENERALIZED anxiety disorder ,SOCIAL anxiety - Abstract
Objectives: Inequities in physical health outcomes exist for people with mental health and substance use conditions and for Indigenous populations (Māori in Aotearoa New Zealand). These inequities may be partly explained by poorer quality of physical healthcare services, including discrimination at systemic and individual levels. This study investigated the experiences of people with mental health and substance use conditions accessing physical healthcare and differences in service quality for non-Māori relative to Māori. Methods: A cross-sectional online survey of people with mental health and substance use conditions in New Zealand asked about four aspects of service quality in four healthcare settings: general practice, emergency department, hospital and pharmacy. The quality domains were: treated with respect; listened to; treated unfairly due to mental health and substance use conditions; mental health and substance use condition diagnoses distracting clinicians from physical healthcare (diagnostic and treatment overshadowing). Results: Across the four health services, pharmacy was rated highest for all quality measures and emergency department lowest. Participants rated general practice services highly for being treated with respect and listened to but reported relatively high levels of overshadowing in general practice, emergency department and hospital services. Experiences of unfair treatment were more common in emergency department and hospital than general practice and pharmacy. Compared to Māori, non-Māori reported higher levels of being treated with respect and listened to in most services and were more likely to report 'never' experiencing unfair treatment and overshadowing for all health services. Conclusion: Interventions to address discrimination and poor-quality health services to people with mental health and substance use conditions should be tailored to the physical healthcare setting. More needs to be done to address institutional racism in systems that privilege non-Māori. [ABSTRACT FROM AUTHOR]
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- 2024
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5. The Right to Equal Health: Best Practice Priorities for Māori with Bipolar Disorder from Staff Focus Groups.
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Haitana, Tracy, Clark, Mau Te Rangimarie, Crowe, Marie, Cunningham, Ruth, Porter, Richard, Pitama, Suzanne, Mulder, Roger, and Lacey, Cameron
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HEALTH services accessibility ,BIPOLAR disorder ,MENTAL health services ,FOCUS groups ,RESEARCH funding ,MAORI (New Zealand people) ,HEALTH care reform ,RIGHT to health ,PSYCHOSOCIAL factors ,POVERTY - Abstract
Bipolar disorder (BD) is a serious mental health condition that is clinically complex to monitor and manage. While best practice guidelines exist, they vary internationally lacking consensus. Indigenous peoples, including Māori in New Zealand, experience higher community rates of BD. While New Zealand practice guidelines recommend providing culturally responsive care to Māori, studies show that Māori do not receive best practice. This qualitative study aimed to share the evidence about patterns of health service use and Māori patient experiences with focus group participants involved in the design and delivery of BD services, to discuss and develop guidelines for best practice for Māori with BD and address areas of unmet need. Three focus groups were conducted with 22 participants involved in the delivery of services to Māori with BD across three sites. Willing participants were sent background information and three focus group questions framed to elicit priority solutions to improve clinical, structural and organisational features of mental health service delivery for Māori patients with BD and their whānau (family). The nominal group technique was used to synthesise responses, and then develop a prioritised list of proposed solutions. Results identified system-level changes required at the clinical, structural and organisational levels of healthcare. Findings further evidence the need for healthcare reform in New Zealand, to be responsive to Māori with BD. [ABSTRACT FROM AUTHOR]
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- 2024
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6. Racism, early psychosis and institutional contact: a qualitative study of Indigenous experiences.
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Manuel, Jenni, Pitama, Suzanne, Clark, Mau Te Rangimarie, Crowe, Marie, Crengle, Sue, Cunningham, Ruth, Gibb, Sheree, Petrović-van der Deen, Frederieke S., Porter, Richard J., and Lacey, Cameron
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RACISM ,MINORITIES ,PSYCHOSES ,INTERVIEWING ,EXPERIENCE ,QUALITATIVE research ,RESEARCH funding ,THEMATIC analysis ,CONTROL (Psychology) ,CORPORATE culture - Abstract
There is evidence of Indigenous and ethnic minority inequities in the incidence and outcomes of early psychosis. racism has an important role. This study aimed to use Indigenous experiences to develop a more detailed understanding of how racism operates to impact early psychosis. Critical Race Theory informed the methods used. Twenty-three Indigenous participants participated in 4 family focus group interviews and 13 individual interviews, comprising of 9 youth, 10 family members and 4 mental health professionals. An analysis of the data was undertaken using deductive structural coding to identify descriptions of racism, followed by inductive descriptive and pattern coding. Participant experiences revealed how racism operates as a socio-cultural phenomenon that interacts with institutional policy and culture across systems. This is described across three themes: (1) selective responses based on racial stereotypes, (2) race related risk assessment bias and (3) institutional racism in the mental health workforce. The impacts of racism were reported as inaction in the face of social need, increased coercion and an under resourced Indigenous workforce. These findings indicate that organizational cultures may differentially impact Indigenous and minority people and that social responsiveness, risk discourse and the distribution of workforce expenditure are important targets for anti-racism efforts. [ABSTRACT FROM AUTHOR]
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- 2023
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7. "If we can just dream..." Māori talk about healthcare for bipolar disorder in New Zealand: A qualitative study privileging Indigenous voices on organisational transformation for health equity.
- Author
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Haitana, Tracy, Pitama, Suzanne, Cormack, Donna, Clark, Mau Te Rangimarie, and Lacey, Cameron
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- 2022
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8. Culturally competent, safe and equitable clinical care for Ma¯ori with bipolar disorder in New Zealand: The expert critique of Ma¯ori patients and Wha¯nau.
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Haitana, Tracy, Pitama, Suzanne, Cormack, Donna, Clark, Mau Te Rangimarie, and Lacey, Cameron
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CULTURAL identity ,HEALTH services accessibility ,RESEARCH methodology ,TRANSCULTURAL medical care ,INTERVIEWING ,QUALITATIVE research ,CULTURAL competence ,PSYCHOSOCIAL factors ,MAORI (New Zealand people) ,FAMILY relations ,BIPOLAR disorder - Abstract
Objective: Research designed to increase knowledge about Māori with bipolar disorder is required to understand how health services support wellbeing and respond to identified levels of community need. This paper synthesises the expert critique of Māori patients with bipolar disorder and their whānau regarding the nuances of cultural competence and safety in clinical encounters with the health system. Methods: A qualitative Kaupapa Māori Research methodology was used. A total of 24 semi-structured interviews were completed with Māori patients with bipolar disorder and members of their whānau. Structural, descriptive and pattern coding was completed using an adapted cultural competence framework to organise and analyse the data. Results: Three themes were evident from participants' critique of clinical components of the health system. Theme 1 established that the efficacy of clinical care for bipolar disorder was dependent on Māori patients and whānau having clear pathways through care, and being able to access timely, consistent care from clinically and culturally competent staff. Theme 2 identified the influence of clinical culture in bipolar disorder services, embedded into care settings, expressed by staff, affecting the safety of clinical care for Māori. Theme 3 focused on the need for bipolar disorder services to prioritise clinical work with whānau, equip staff with skills to facilitate engagement and tailor care with resources to enhance whānau as well as patient wellbeing. Conclusion: The standard of clinical care for Māori with bipolar disorder in New Zealand does not align with practice guidelines, Māori models of health or clinical frameworks designed to inform treatment and address systemic barriers to equity. Research also needs to explore the role of structural and organisational features of the health system on Māori patient and whānau experiences of care. [ABSTRACT FROM AUTHOR]
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- 2022
- Full Text
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9. Eating disorders in New Zealand: Implications for Māori and health service delivery.
- Author
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Lacey, Cameron, Cunningham, Ruth, Rijnberg, Vivienne, Manuel, Jenni, Clark, Mau Te Rangimarie, Keelan, Karen, Pitama, Suzanne, Huria, Tania, Lawson, Rachel, and Jordan, Jennifer
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BULIMIA diagnosis ,DIAGNOSIS of eating disorders ,TREATMENT of eating disorders ,ANOREXIA nervosa ,HEALTH services accessibility ,HEALTH status indicators ,LONGITUDINAL method ,MEDICAL care ,MENTAL health ,HEALTH of indigenous peoples ,DESCRIPTIVE statistics - Abstract
Objective: Lifetime prevalence rates in Te Rau Hinengaro (The New Zealand Mental Health Survey) suggest eating disorders are at least as common in the Māori population as the non‐Māori population, yet little is known at a population level about those accessing specialist mental health treatment for eating disorders in New Zealand. The aim of this study was to describe the population undergoing specialist mental health treatment for eating disorders and compare Māori and non‐Māori clinical characteristics and service use. Method: This study uses the Programme for the Integration of Mental Health Data data set, managed by the New Zealand Ministry of Health to describe the characteristics of people with eating disorders and their use of specialist mental health services from 2009 to 2016. Results: There were 3,835 individuals with a diagnosed eating disorder who had contact with specialist mental health services in this time period, 7% of whom were Māori. Within the cohort, Māori had a higher prevalence for a bulimia nervosa diagnosis, fewer diagnosed with anorexia nervosa, and a higher prevalence of other psychiatric comorbidity than non‐Māori. Discussion: There is discrepancy between the proportion of service users accessing specialist mental health services who are Māori and the assessed crude prevalence of eating disorders for Māori in national estimates. Once Māori are in specialist services; however, their use of services is comparable to non‐Māori. Further research is needed to highlight the experiences of those Māori with eating disorders and address barriers to accessing services for Māori with eating disorders. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
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10. Do patients with mental health and substance use conditions experience discrimination and diagnostic overshadowing in primary care in Aotearoa New Zealand? Results from a national online survey.
- Author
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Cunningham R, Imlach F, Lockett H, Lacey C, Haitana T, Every-Palmer S, Clark MTR, and Peterson D
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- Adult, Humans, Maori People, New Zealand, Primary Health Care, Mental Health, Substance-Related Disorders diagnosis, Social Discrimination
- Abstract
Introduction Quality of health care contributes to poor physical health outcomes for people with mental health and substance use conditions (MHSUC). AIM This study investigated experiences of people with MHSUC who sought help for a physical health condition in primary healthcare services, examining quality of care attributes. Methods An online survey of adults currently or recently accessing services for MHSUC was fielded in 2022. Respondents were recruited nationally through mental health, addiction and lived experience networks and social media. The attributes of service quality assessed were relationships (respect and being listened to), discrimination due to MHSUC, and diagnostic overshadowing (MHSUC diagnosis distracted from physical health care). Results Respondents who had used primary care services were included (n = 335). The majority of respondents reported both being treated with respect (81%) and being listened to (79%) always or most of the time. A minority of respondents reported diagnostic overshadowing (20%) or discrimination due to MHSUC (10%). People with four or more diagnoses or a diagnosis of bipolar disorder or schizophrenia had significantly worse experiences across all quality measures. Those with a diagnosis of substance use disorders had worse experiences for diagnostic overshadowing. Māori had worse experiences for respect and diagnostic overshadowing. Conclusions Although many respondents reported good experiences in primary care, this was not the case for everyone. Quality of care was affected by type and number of diagnoses and the person's ethnicity. Interventions to reduce stigma and diagnostic overshadowing for people with MHSUC are needed in primary care services in New Zealand.
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- 2023
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11. Gender and mental health service use in bipolar disorder: national cohort study.
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Cunningham R, Crowe M, Stanley J, Haitana T, Pitama S, Porter R, Baxter J, Huria T, Mulder R, Clark MTR, and Lacey C
- Abstract
Background: Despite evidence of gender differences in bipolar disorder characteristics and comorbidity, there is little research on the differences in treatment and service use between men and women with bipolar disorder., Aims: To use routine data to describe specialist mental health service contact for bipolar disorder, including in-patient, community and support service contacts; to compare clinical characteristics and mental health service use between men and women in contact with secondary services for bipolar disorder., Method: Cross-sectional analysis of mental health patients with bipolar disorder in New Zealand, based on complete national routine health data., Results: A total of 3639 individuals were in contact with specialist mental health services with a current diagnosis of bipolar disorder in 2015. Of these 58% were women and 46% were aged 45 and over. The 1-year prevalence rate of bipolar disorder leading to contact with specialist mental health services was 1.56 (95% CI 1.50-1.63) per 100 000 women and 1.20 (95% CI 1.14-1.26) per 100 000 men. Rates of bipolar disorder leading to service contact were 30% higher in women than men (rate ratio 1.30, 95% CI 1.22-1.39). The majority (68%) had a diagnosis of bipolar I disorder. Women were more likely to receive only out-patient treatment and have comorbid anxiety whereas more men had substance use disorder, were convicted for crimes when unwell, received compulsory treatment orders and received in-patient treatment., Conclusions: Although the prevalence of bipolar disorder is equal between men and women in the population, women were more likely to have contact with specialist services for bipolar disorder but had a lower intensity of service interaction.
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- 2020
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