Mata Taraiti – An Interview With Kirsty Maxwell-Crawford

Tuesday 3 May, 2022 | Blog

In this issue of Te Mahau, we spoke to Kirsty Maxwell-Crawford. Kirsty works as General Manager at the Poutiri Wellness Centre – an integrated and holistic health, employment and wellness-based based in Te Puke. We spoke to Kirsty about the organisation’s experiences serving the needs of whānau throughout the pandemic, and how kaupapa Māori Mental Health and Addictions providers can utilise our own indigenous expertise to serve the mental health needs of whānau today.

From your experience as an organisation, what would you say were the biggest needs of whānau Māori in relation to Covid-19?

There were two areas we found ourselves working in once Covid hit the Bay of Plenty.

The first was supporting whānau when Covid was still very new. We received a lot of calls and messages about feeling anxious about getting sick, and about what to expect once they tested positive. I suppose that part of the blessing of being an isolated country, is we’ve had plenty of time to prepare – but the downside is there have been two years for fear to build in our communities.

We needed to have our teams fully available to support the community. Fortunately, we had been on the frontline before things had even taken off – we had a mobile vaccination team, a medical centre, and existing community Mental Health and Addictions services. We had actually spent a lot of time prior supporting whānau in preparing for Covid, but the reality is it hits hard once it’s actually reached the community. Once it arrived here we quickly realised that we needed to be ready to respond to increased anxiety and fear amongst families. And that meant we needed to have more staff available – we went from supporting 20 households to 100s in one week.

The second thing that we focussed on was making sure tangata whaiora who were already feeling isolated didn’t feel that even more so in a time of mandated physical isolation. We have whānau who already bravely overcome extra challenges every day in terms of their recovery and wellbeing. We needed to stay connected – to find multiple ways of staying connected so that we could provide continuity for those we already had an ongoing service relationship with. We needed to ensure our dedicated Mental Health and Addictions teams could pivot and be available by phone, zoom or any other means, in order to stay as accessible as we could. We needed to expand quickly so we could provide additional wrap-around practical support when needed.

Many of our Māori Mental Health and Addictions providers have stressed that whilst we are in a pandemic, we must maintain servicing whānau needs that have existed before Covid. What are your thoughts?

Mental Health and Addictions services are needed even more so at a time when we have segregation in our community, rising living costs, isolation protocols, restrictions about where you can and can’t go… This time is a real pressure cooker for people who are caring for and focused on their mental health. So the focus for us is communicating that we can provide that access to well-being support when everything else around them has changed and become unstable.

There has definitely been a significant sector focus on Covid – we’ve felt that as an organisation. We’ve just been fortunate that we’ve successfully built four additional teams that support our Covid work, rather than stretching that across an already stretched workforce. That way our existing staff can continue to deliver our Mental Health and Addictions services.

I totally support that push that Covid is here, but we still have to respond to those associated mental health needs. Those needs can’t be ignored, shouldn’t be swept under the carpet, and shouldn’t be secondary. We’ve got to address both –  if we don’t keep providing proactive services we could see a growing number of Mental Health and Addiction needs occurring.

How do you feel the Hauora workforce has coped while responding to Covid?

It’s been full-on at the front line, but at the same time working in health is not for the faint-hearted. A lot in the Hauora workforce have come in to make a difference, to care for whānau – and times like these are when we need to be doing that even more so. I actually think this is where Hauora providers particularly shine. We’re used to having to pivot, used to not having huge resources and to meeting community needs.

It’s also been neat to work collaboratively with other providers, which we’ve seen more and more of over the last two to three years. There’s been a lot of sharing of the workload so that we can look after our teams and additional demands on our workforce.

We know that our knowledge systems and practices are instrumental to whānau wellbeing. How do your services use mātauranga Māori to serve whānau?

We currently have clinical services delivered by Māori practitioners, but we also are seeking to be more balanced in terms of recognising our own healing modalities and utilising rongoā, mirimiri, whakawhiti kōrero, pūrākau. A new part of our service is utilising the gifts of one of our staff, who was first a Whānau Ora navigator,  but has been able to utilise his passion for ta moko as a healing modality with whānau.

We have evidence of whānau sitting at the bottom of most health statistics, and as evidence-based practitioners, we need to recognise that what we have been doing since the 1960s hasn’t worked for us. There was a time when many Hauora providers felt they were no longer able to deliver as kaupapa Māori providers. It’s exciting to be in a space where the value of mātauranga Māori and our own modalities of healing are being recognised.

We’ve been blessed to have secured a kaupapa Māori primary mental health contract right across the western bay alongside Ngāti Ranginui. The Mataora service is the first time our contract has allowed us to be open about utilising our own health modalities, where we don’t have to squeeze it in amongst a predominantly clinical service. We can acknowledge that our own version of kōrero, te reo, narrative therapy and pūrākau are just as, and possibly even more, important to whānau. 

Providing kaupapa services is critical when we have growing generations of tamariki and rangatahi where reo has returned as their first language. They have an expectation that services will recognise their own ways of viewing the world. They shouldn’t have to chop themselves into pieces or compartmentalise to fit into a reductionist view of what mental health support looks like.