Effective care for Māori with bipolar disorder: A qualitative study

Māori have high rates of bipolar disorder (BD) and mental health service use. Despite the high prevalence and the impact on functioning and whānau (family), there is limited research on treatment interventions for Māori with bipolar disorder and indeed on Māori and indigenous mental health generally. A qualitative study combining individual interviews and focus groups was conducted with the aim to explore mental health clinicians' and Māori mental health workers' perspectives of effective treatment for Māori with BD. Sixteen participants took part in either individual interviews, focus groups or both. The study found the importance of a Māori worldview; tikanga Māori (rituals); understanding the whānau context, whakawhanaugatanga (connection), the powhiri (introduction) process, and whakarongo (listening) were key to working effectively with Māori who had BD. Both the interviews and focus groups identified similar concepts. The concept of whakawhanaungatanga (connection) captures the themes from the individual interviews and focus groups. The participants in this study identified the person and their culture rather than the psychiatric diagnosis as crucial to providing effective care to Māori with BD. Without a foundation in whakawhanaungatanga, engagement, diagnosis, treatment adherence, and the process of recovery are unlikely to be as effective for Māori with BD. It was evident from the findings that it was the person not the diagnosis that was central to therapeutic engagement.