He Koha Aroha Ki Te Whanau: Deliberate Self Harm and Maori Whanau

Abstract

Deliberate self-harm (DSH) is a significant social problem facing young Māori (the indigenous people of New Zealand) today. Whānau, a concept meaning family and including extended family, is an essential factor in the well-being of Māori. Little is known about family members‟ reactions to a child‟s DSH or their needs following DSH, especially with Māori. Some research with non-Māori suggests that both the impact of DSH and consequent needs of family members may be considerable, yet often neglected. This study examined the impact of their children‟s DSH on Māori whānau, beliefs about the motives for the young person‟s DSH, and needs following the event. The whānau of ten young people, aged 10-18 years, presenting to a Child and Adolescent Mental Health Service following DSH were interviewed about the impact of the DSH, perceived motives for DSH and their needs. Five Māori clinicians were also interviewed about these topics. Interviews were recorded, transcribed, and subsequently analyzed using thematic analysis. Seven themes were identified from whānau ideas regarding motives for DSH: to communicate distress and seek help, to punish someone, to get relief from a distressing emotional state, due to the influence of others, as a response to feeling overwhelmed by difficult circumstances, to die, and the cultural influence of matakite. Clinicians presented similar motives; however, they did not mention matakite and included DSH being precipitated by social isolation. When discussing impacts of DSH, whānau reported that DSH had affected the entire whānau as well as having an effect on parents; including an emotional impact, an impact on parenting, and the concept of mental health was described as being difficult for parents to come to terms with. On the other hand, participants reported improvement in relationships within their whānau following DSH. Whānau also reported that DSH had resulted in practical difficulties. Themes derived from clinicians were similar; however, they did not discuss the effect of DSH on relationships. Whānau and clinicians both reported the need for greater levels of support and information. Implications are presented for the delivery of mental health services for young Māori and their families.