The Wharerātā Group is an international network of Indigenous leaders working in mental health & addictions, who share a vision of the near future in which Indigenous peoples sustain their optimal health and wellbeing, who contribute to that vision through the strategic use of our Indigenous leadership influence on mental health and addictions systems.
In 2010, we published our declaration – The Wharerata Declaration – the development of indigenous leaders in mental health. The Declaration is a proposed framework to improve indigenous mental health through state-supported development of indigenous mental health leaders, based on a new Indigenous leadership framework.
Our Group History:
Video: Indigenous leadership in mental health and suicide prevention’ match 2017
Video: Indigenous leadership in mental health and suicide prevention’ match 2017: long version
IIMHL in Australia 2017
Keynote speaker, Professor Helen Milroy – Childhood Trauma and Recovery: learning from Australia’s Royal Commission
IIMHL in Australia 2017 - Photo Highlights
IIMHL in Canada 2015
British Columbia Ministry of Health / First Nations Health Authority, Musqueam First Nation, Musqueam Cultural Education Resource Centre, 4000 Musqueam Avenue, Vancouver
1. Brief summary of the outcomes of your match:
Participants were appreciative of the opportunity to connect and share ideas and best practices with the goal of contributing to dialogue on how to advocate for shifting approaches to mental health from an illness to wellness perspective. They recognized that the adoption and implementation of wellness-focused models is still a work in progress, and requires partnership across diverse sectors before full scale change can occur. Collaboration should be led by Indigenous leaders who engage with their communities to determine what wellness means in a local context, because Indigenous knowledges are central to the work of describing wellness. Similarly, indicators to measure wellness constructs need to be defined by communities, and work needs to be done by health organizations to support communities in understanding the value that measurement can bring to improving health services and health outcomes. It was acknowledged that there is no one single indicator that can represent wellness, and that measuring varying concepts and dimensions of wellness can contribute to creating a ‘bigger picture’ of what health means to Indigenous communities. Finally, there was a consensus that Indigenous models of wellness hold value for the development of best practices in mental health across all cultures, and policy makers, practitioners, and advocates should be looking to Indigenous leadership for direction on these models.
2. Resources used in your match Mental health professionals gathered from organizations across the world, including Australia, New Zealand, England, and the US. The match was a low-tech conversation that used paper notepads, pens, and an easel with chart paper. Two facilitators from the host organizations posed questions to guide the conversation, although the discussion was free-flowing and required little direction. A note taker was present all day to capture themes, key ideas, and resources.
3. Brief description of how your match has accelerated change towards mental health, well-being and inclusion
Many participants described personal changes and new insights as a result of attending the match discussions. There was great value in learning more about the history of colonization both in Canada and abroad that empowered participants to feel better positioned to be a voice to advocate for change in clinical and systems approaches to mental health. The fact that the match was designed from an Indigenous perspective was acknowledged as an important change in and of itself. This perspective was enabled by the inclusion of Indigenous Elders sharing their knowledge; by healers engaging participants in cultural practices; and through presentations of Indigenous knowledge frameworks. Many felt that IIMHL could use Indigenous knowledge to inform its next matches so that it becomes a cross-cutting theme for all of the discussions, rather than a ‘sideshow’ on the margins.
4. Brief description of how your match has built leadership for the future
It was acknowledged that the match provided participants with opportunities for knowledge, learning, and exchange. One of the ways that ongoing learning will occur is through an online ‘portal’ hosted by the First Nations Health Authority that will contain the resources discussed during the match (the ‘Gathering Space’). The platform will also provide a space for continued virtual collaboration with the ability for partners to upload and share relevant documents related to their own or others’ research and practice. To support continuing professional development, a series of webinars was proposed over the next 18 months to gather and share information. In the interim, participants felt that they had “sowed the seeds of imagination” and felt that energy for change would bring them back to their respective organizations armed with new ideas, practices, and frameworks that could be built upon for future success in shifting the paradigm from mental illness to mental wellness.
IIMHL in Canada 2015 - Photo Highlights
IIMHL Ireland 2014
IIMHL in New Zealand 2013
International Initiative for Mental Health Leadership
March 1-12, 2013 in Auckland, New Zealand
Notes from Meetings
About 250 people from the IIMHL countries attended the IIMHL event in Auckland, New Zealand. Indigenous organizations hosted a few leadership exchanges in New Zealand, with a positive response from participants.
Moe Milne and Rose LeMay provided a joint keynote to the IIMHL on cultural competence. The IIMHL evaluation did not capture data on participant response to the keynote, however comments were positive.
Please see www.iimhl.com for all the workshop notes, some video, and presentations from keynotes.
The logo for the 2013 IIMHL is titled Hei whakamārama.
E rua ngā kōkiritanga kaupapa matua ka kitea i roto i tēnei whakaahuanga. Ko te Manu Tukutuku ka tahi, ko Tāwhirimātea ka rua. I te wā o ngā tūpuna ko tā te tamariki whakamahi i te Manu Tukutuku he ngahau noa iho engari he wā anō tōna ka riro mā te Manu Tukutuku te iwi hei arataki. Nā te āhua o te karawhiu a Tāwhirimātea, ngā aupiki me ngā auheke o te Manu nei, te haurangi haere, te wairangi haere, tōna rere me tōna topa tonu ka matakitea ngā pēneitanga me ngā pērātanga hei ārahi i te tohunga, hei whai ake mā te iwi.
Hei tohu tēnei Manu Tukutuku i te pakanga mutunga kore a ngā tuākana atua ki a Tāwhirimātea hei whakaū i te maunga–ā–rongo i waenga i a rātou. He pērā anō mō te ngākau tangata. Ahakoa ngā tukitukinga ka pā mai me rapu huarahi atu kia ekena te taumata whāinga e wawatatia nā.
Ka roa hoki te noho papa mai o tēnei momo Manu engari i roto i ēnei tau tata kua whai huruhuru anō ōna parirau i te kaha hokihoki o ngā iwi ki ngā mātauranga tūturu a ngā tūpuna Māori e noho taonga ai ōna rerekētanga me ōna painga mō te tangata, tōna katoa nei, te hapori, tae rawa atu ki te motu puta noa. Ko tā Tāwhirimātea i konei he kohikohi, he whakakotahi ake i ngā manuwhiri o ngā hau e whā o te ao, ā, hei whakaatu hoki i te ū o ngā pakitara o te Whare Tapawhā ki tōna kaupapa e pūmau ai tōna tū ahakoa te haka mai a Tāwhiri Nguha.
There are two central concepts depicted in this logo. That of the Manu Tukutuku or Māori kite and Tāwhirimātea the manifestation of weather, storms, wind and rain. In traditional times whilst the Māori kite was a popular toy enjoyed by children there were also times it was employed in revered ritual to predict possible future events by carefully observing its various motions when buffeted by the wind. Ascent, descent, eccentric or chaotic flight, all movements told of occurrences unfolding. In this way the Manu Tukutuku guided Māori ancestors.
It represents here the struggle to find stability and equilibrium while battered by the winds of ordeal, ultimately rising above tribulation and discovering positive direction. The renewed popularity of Māori kite flying especially to celebrate the Māori New Year is indicative of a desire to celebrate indigenity and acknowledge cultural values and diversity and their role in the betterment of the whole person, community and nation. Tāwhirimātea symbolizes a gathering of the four winds representing our international attendees while also acknowledging the aspiration of permanence for the four walls of the Whare Tapawhā that promotes good health and well being although constantly exposed to life’s tempests.
IIMHL Workshop on “Indigenous and other minorities”
Moe Milne and Carole Maraku facilitated this workshop in the IIMHL on Thursday. About 30 people attended, and shared their experience and knowledge. Some of the discussions were similar to those held previously, which likely highlights the need to increase our sharing of wise practices between countries.
What are the Issues facing Indigenous and other cultures in mental health/addictions?
• Access – availability of services; having to leave area and community to get services, and remoteness especially in around suicide and empowerment; and language barriers and understanding of the system. Entry criteria – from secondary services (NASC) – clinical, not holistic
• Ownership of services – ‘locally’ owned or imposed? Shift accountability to the community.
• Effectiveness – do services work? Indigenous knowledge honoured and included? Appropriateness of services. Do services reflect what “people” want or what funders/government wants?
• Holistic integration – social determinants break down silo thinking/doing.
• Political will and making influencing decisions from a cultural/clinical framework. Jurisdictions and “pass the buck”, but lack of political voice
• System based issues – relationships – personalities; effect of media; funding vs people dilemma “we don’t have the funding for that” as opposed to collaborative approaches to finding solutions
• Lack of understanding – i.e. peer pressure (importance of Powhiri)
• Whakapapa – “Keeping momentum going”
• Employment – Housing – Benefits – Attitudes – Discrimination
• Intergenerational impact – histories
• Cultural: health literacy; lack of resources, funding/contracts
• Output focussed, not outcomes
• $$ still sit in hospital services
• No Te Tiriti o Waitangi acknowledgment
• Workforce development: Ageing workforce; Reliant on kaupapa services rather than mainstream competencies; NASC – referrals – only decision-makers;
• NZ – Whanau Ora – Funding needs to transfer to community’s development – goal posts shift
• Shared interests
• Collaboration between agencies
• Learning across systems and countries
• Funding follows purpose
• Community development approach
• Leaning to tolerate learning
• Active participation
Wharerātā Group Meeting
Carole Maraku and Ray Watson graciously took notes for this meeting.
Rose provided an overview of the challenges and difficulties to sustain and maintain this international Group. It takes more time than one might expect, and it not sustainable without a structure or secretariat. There is a clear need for each country to have responsible members who ensure communication flows between members and with the Group internationally. The Wharerata website was maliciously hacked, and destroyed, and apology was given that the backup (which was allegedly rock-solid) was also destroyed, which was not expected at all.
The chair did offer resignation given that more time should have been spent on the Group’s business and website, and left the room to allow the participants to discuss.
The pressure of maintaining the Group does require some kind of secretariat support, as well as more structure to maintain communications. Participants agreed that:
• Each country is requested to nominate two Group members to carry the kaupapa and be responsible for ensuring that all providers of mental health, addictions and disabilities are informed of national and International Indigenous messages. More information on this action will follow, as details are resolved.
• An organization will be asked to provide secretariat support to the Group and to the International Chair.
• Rose was nominated to carry on in the role of International Chair/Coordinator.
• Ray Watson will do some preliminary work on Group structure and secretariat support in the next few weeks/months.
Rose would like to share her sense of honour to continue to support the Group, and looks forward to building a structure to sustain the work for the next stage of development.
NOTE: Immediately following, the New Zealand organization Te Rau Matatini agreed to provide supports, yet to be negotiated. This organization is the Maori national organization on workforce development to enhance whānau ora (families/communities), and is well regarded in the country. Sir Mason Durie is the senior advisor, and Trish Davis is the Chief Executive. I’m very pleased to work with Trish, and if you are not familiar with this organization, I encourage you to get to know our newest partner at www.matatini.co.nz.
Sydney Dialogues, March 11-12, 2013
The Mental Health Commissions of Canada, New Zealand and Australia met in Sydney, Australia following the IIMHL in New Zealand in 2013. The intent was to share knowledge and collaborate on a limited number of topics that each Commission has responsibility. The agenda and participant list is included below.
The topics discussed included Indigenous mental health, and Rose LeMay attended on behalf of Wharerātā, also Pat Dudgeon from Australia attended. The level of support for Indigenous mental health and well-being was exemplary, and the chairs of the Commissions deserve commendations for their commitment to influencing systems change for Indigenous.
The following is the Indigenous well-being commitment excerpt of the Sydney Declaration, with signatures from all the participating organizations:
We recognize Indigenous peoples as the first or original peoples of our countries, who have a longstanding and enduring relationship to the land. We recognize that colonization negatively impacted on Indigenous cultures, communities and peoples, and that its legacy continues to affect their mental health and wellbeing today. We recognize and value the strength and resilience of Indigenous peoples and communities. Indigenous peoples share similar values regarding the importance of family and community as protective factors for social and emotional well-being. These values need to be inherent in mental health systems to help underpin holistic approaches to health, mental health and well-being for the benefit of all in our communities.
Together we commit to adopt the Wharerātā Declaration with its vision of Healthy Indigenous individuals, families and communities.
We commit to the principles of partnership with Indigenous peoples and mental health leaders to achieve the vision of culturally accessible and competent mainstream mental health services for Indigenous individuals, families and communities, and to the development of Indigenous leaders in mental health to influence future systems change.
We uphold the principle of genuine partnership with Indigenous peoples to develop mental health programs, interventions and policy together, to increase the effectiveness for Indigenous peoples and as Indigenous leaders request, “nothing for us, without us”.
We will advocate for cultural competence across all mental health professions as well as higher education curricula as a key quality improvement approach. In the development of cultural competence standards and future learning opportunities, it is crucial to ensure Indigenous peoples play significant leadership roles.
We recognize the vital role of Indigenous leaders to advocate for holistic, cultural and community-based approaches in mental health. We support the on-going development of Indigenous leaders in mental health so that they are able to influence change in systems which will benefit us all. As evidence of our commitment to Indigenous peoples mental health and well-being, we commit to:
1. Include and value Indigenous perspectives and practice in our respective programmes of work.
2. Advocate for and promote trauma-informed care approaches to strengthen mental health practice across all our communities.
3. Contribute to the on-going development of Indigenous leaders in mental health by supporting Indigenous peoples to collaborate and learn from each other domestically and internationally (for example with and through the International Initiative for Mental Health Leadership, IIMHL).
4. Impart knowledge from Indigenous communities on holistic approaches to health, mental health, social and emotional wellbeing.
Sydney Dialogue Participants
• Australian National Mental Health Commission: Chair, Professor Allan Fels. Commissioners: Peter Bicknell, Professor Pat Dudgeon, Sam Mostyn, Professor Ian Hickie, Professor Ian Webster, Jackie Crowe, Janet Meagher, Rob Knowles. Robyn Kruk Chief Executive Officer, Georgie Harman Deputy Chief Executive Officer, Catherine Lourey Director Report Card, Jane Moxon Director Policy, Strategy and Projects
• Mental Health Commission of Canada – Louise Bradley President and Chief Executive Officer, Sapna Mahajan, Director Prevention and Promotion Initiatives, Nicholas Watters, Director Knowledge and Innovation
• Mental Health Commission of Ireland – Martin Rogan, Commission Member and Dr Patrick Devitt, Inspector of Mental Health Services
• New Zealand Mental Health Commissioner – Dr Lynne Lane
• Australian Mental Health Commissions
o New South Wales Mental Health Commission – John Feneley Commissioner, Professor Alan Rosen Deputy Commissioner
o Mental Health Commission of Western Australia – Eddie Bartnik Commissioner, Barry MacKinnon Chair of the Mental Health Advisory Council
o Queensland (Mental Health Commission in development) – Liz Powell, Director Queensland Mental Health Commission Transition Unit
• Australian States and Territories
o Australian Capital Territory – Dr Peggy Brown, Director General, Health Department
o Northern Territory – Mike Melino, A/Executive Director, Health Services Division Department of Health, Bronwyn Hendry, Director Mental Health Services
o South Australia – David Davies, Executive Director, Mental Health and Substance Abuse
o Tasmania – Nick Goddard, CEO Mental Health Services, Department of Health
o Victoria – Paul Smith, Executive Director, Mental Health, Drugs and Regions, Department of Health
• Rose LeMay, International Chair, Wharerātā Group
• Geoff Huggins, Deputy Director of Health and Social Care Integration, Scottish Government, Edinburgh, Scotland, UK
• Professor Harold Pincus, Director of Quality and Outcomes Research, New York Presbyterian Hospital and Columbia University, New York, USA
• Dr Ken Thompson, Chief Medical Officer Recovery Innovations and Pennsylvania Psychiatric Leadership Council, Pittsburgh, USA
• Gregor Henderson, UK
• Australian Institute of Health and Welfare – David Kalisch, Director, Gary Hanson, Unit Head Mental Health Services and Palliative Care Unit
• Australian Bureau of Statistics – Dr Paul Jelfs, First Assistant Statistician, Social Health and Labour Division, Australian Bureau of Statistics
• Comcare – Paul O’Connor, Chief Executive Officer
IIMHL San Franciso 2011
Wharerātā and IIMHL in San Francisco 2011
Group Meeting on September 15, 2011 at the Fairmont San Francisco
Draft Meeting Notes
Sir Mason Durie, Massey University, NZ
Lady Arohia Durie, NZ
Linda Frizzel, Northwest Portland Area Indian Health Board, USA
Elaine Lavallee, White Raven, CAN
Gail Boehme, File Hills Qu’appelle Tribal Council, CAN
Bernard George, Nimkee Healing Centre, CAN
Vicki Ware, Nimkee Healing Centre, CAN
Dorothy LaPlante, Health Canada, CAN
Michelle DeGroot, First Nations Health Council, CAN
Charles Currie, Currie Group, USA
Patricia Wiebe, Health Canada, CAN
Jeff Bob, TsowTunLeLum, CAN
Helen Milroy, University of Western Australia, AU
Carol Maraku, Te Upoko Te Upoko O Nga Oranga O Te Rae, NZ
Kristin English, Cook Inlet Tribal Council, USA
Holly Echo-Hawk, Lummi Nation, USA
Rose LeMay (Sones)
Carol Hopkins, National Native Addictions Partnership Foundation
Austin Bear, National Native Addictions Partnership Foundation
Janet King, Native American Health Center, USA
Rose LeMay welcomed the group to a dinner meeting, and thanked the National Native Addictions Partnership Foundation for funding the meeting space and dinner. The September 15 evening meeting was held in conjunction with IIMHL 2011.
Rose provided a brief overview of the Wharerātā Group and Declaration, as there were a number of new members in attendance. Wharerātā hopes to influence change and transform people and systems to better serve Indigenous families and communities, build confidence to support investment in Indigenous mental health and leadership development, and generate a worldwide network to share knowledge and learning.
VisionKeeper Sir Mason Durie requested to speak about the Wharerātā plenary, which was to be held on the following day. Mason provided an overview of the key messages and process on the plenary, with some input from Carol Hopkins.
Debrief of IIMHL 2011
A debrief of the planning leading up to IIMHL 2011 was provided by Rose LeMay. Rose and Holly Echo-Hawk sat on the planning committee organized by the US Substance Abuse and Mental Health Administration. There were very few calls and opportunity to provide input to the Networking Meeting, and some challenges to ensure that Indigenous leaders had appropriate roles and visibility. However, Wharerātā greatly increased its presence and contribution at the 2011 event, based on the principle that Indigenous presence should contribute to all discussions (not limited to Indigenous issues only). Wharerātā supported the following contributions for IIMHL 2011:
1. Leadership Exchanges
Of the 40 total Leadership Exchanges, a number were hosted by Indigenous leaders and supported by Wharerātā.
Leadership and Culturally-based Governance in Mental Health & Addictions
This exchange was hosted in partnership by the Nimkee Nupigawagn Healing Centre and the National Native Addictions Partnership Foundation, in Ontario, Canada. This exchange focused on examples of highly successful culturally-based structures of governance in community-based mental health organizations.
Trauma and Mental Health in Indigenous Populations
Hosted by TsowTunLeLum Society in British Columbia, Canada, this exchange will focused on the Qul-aun Program and its successful practices addressing the special needs of people who have suffered, or who are experiencing trauma in their lives, including emotional, mental, physical and spiritual health issues that stem from: the effects of the residential school experience, past substance abuse, violence – domestic or physical, unresolved grief, and issues that are often passed from generation to generation unless the cycle is broken.
Hosted by the White Raven Healing Centre in All Nations Healing Hospital in Saskatchewan, Canada, this exchange focussed on a mental wellness team approach to integrating culture, mental health and primary care. The use of natural medicines and traditional knowledge keepers are key components in White Raven. The potential for culture as healing is greatly increased with such connections to land, prayer, healers and ceremonies.
Peer Networking for Consumers
Hosted by the Cook Inlet Tribal Council, this exchange focussed on the consumer voice supported by and based in Indigenous programming, and issues related to remoteness.
Historic and Contemporary Trauma and Healing in Indigenous Populations
A special Leadership Exchange hosted in partnership by the Friendship House in San Francisco, California, and the Wharerātā Group, the objectives were: Share successes from the host site and participants on the theme(s) of historic and current trauma and healing, Indigenous populations, and wise practices in combining cultural/Indigenous ways of healing with mainstream/clinical interventions; and Build knowledge about Indigenous mental health healing practices, and successes in partnering with mainstream services and practices, as described in the Wharerātā Declaration. About 50 participated in this special exchange, from both Indigenous organizations and non-Indigenous organizations. IIMHL Director Fran Silvestri and Chair Kathy Langlois attended, and the exchange was also honoured to have the Children and Youth Leadership Exchange participants join in for a day. The highlight of the exchange was the sharing from Dr. Helen Milroy on dreaming our own future of Indigenous well-being. The final report and most presentations are available on the Wharerātā website.
ACTION: Leadership Exchange hosts are requested to send a short report on their exchange to Rose for posting on the website.
2. Indigenous Leaders at Other Exchanges
For 2011, the Group agreed to spread out across other exchanges to build networks with partners and allies.
3. Indigenous Contributions in the Networking Meeting
The California Traditional Pomo Dancers performed on the welcoming evening. Drum Keeper Michael Bellanger opened and closed the event in song. The most positive comments about Indigenous presence was shared from participants in response to the closing round dance that Janet King organized along with Michael Bellanger at the end of the event.
In the opening speech, IIMHL Chair Kathy Langlois touched on Indigenous issues, healing and culture.
Rose Sones and Janet King participated on a panel to speak on the San Francisco special exchange on trauma in Indigenous communities, led by Larke Huange from the US.
Wharerātā provided a plenary panel led by Sir Mason Durie, along with Carol Hopkins and Helen Milroy. SAMSHA named Coloradas Mangas from the US to the panel.
3. Increased Numbers of Indigenous Participants
The number of Indigenous participants at IIMHL doubled, to 26!
Wharerātā Activities Report
Rose provided a written update on activities completed in the past year, which can be found on the website. Highlights include:
• Story about the Group and its Declaration in the May 2011 newsletter of the LIME Network for Indigenous medicine education.
• With support from the National Native Addictions Partnership Foundation in Canada, a new brochure describing the Group and the Declaration was completed in the summer of 2011, and translated to French and Spanish. The brochure is available for download off the website, and a limited number are available in print.
• Presentations on the Wharerātā Declaration were made at conferences and workshops.
• The website continues to grow in content, and receives about a 1000 visitors a month.
Healing Our Spirit Worldwide
Rod Jeffries was requested to give an update on HOSW, but was unable to attend. No confirmation was available, but the next HOSW is expected in 2013 at Alice Springs, Australia.
(Note: as of May 2012, no information is available online but there is rumour that the next HOSW will be in 2014 in New Zealand).
Terms of Reference
Members continued the discussion on a Wharerātā terms of reference. There was discussion on the question of Indigenous and non-Indigenous participation, whether membership is individual and/or organizational, terms and/or expectations for participation, how to become a member. The discussion ranged widely over a number of points and questions. A new member recommended that the Terms of Reference should be completed by members who have participated in the first meetings, as they have the history to accurately input and build a strong Terms of Reference.
The group was reminded that the original intent and vision of the Wharerātā Group was set by the participants hosted by Sir Mason Durie at the Indigenous Leaders Exchange in New Zealand, 2009. Wharerātā membership is individual, but with the understanding that organizations see value in their employee’s participation. Wharerātā is an Indigenous leaders’ group, meaning that it exists to develop Indigenous leaders in mental health. This understanding must always be shared in balance with the Wharerātā principle of partnership with allies and non-Indigenous leaders and partners, as we cannot achieve our vision of Indigenous well-being in isolation. Wharerātā creates a unique space for Indigenous participation and leadership development, a space that rarely is respected or created in non-Indigenous circles.
A discussion was also held on the letter received from the Assembly of First Nations on the previous draft of the terms of reference, and consensus was reached that membership is by individuals, and a country’s discussion on representation is that country’s decision.
Members agreed that the next draft of the terms of reference should be shared by email in Track-Changes for input and/or approval, to complete as soon as possible. Unfortunately, the meeting ended at this point as it was quite late in the evening.
Members who were in attendance at the first 2009 meeting quickly reviewed the terms of reference content and process, and strongly recommended that the next draft be reviewed by founding/original members, and then circulated to all Wharerātā members. The issue is that membership continues to increase, and new members may not have the experience of working with the Declaration which underwrites the Terms of Reference. There is a need for a backgrounder or orientation for new members.
HOSW Hawaii 2010
Wharerātā in Hawai’i September 2010
Meeting Notes and Next Steps
September 13, 2010
Wharerātā members are requested to email documented successful practices or examples to Rose to include on the website. The Online Library is a major draw for visits to the site. To continue its growth, and to uphold our principle to share successes, please email at least 2 documents to Rose by October 15 (ie. Intake procedures that include cultural factors, suicide prevention protocols that include cultural factors).
Wharerātā Meeting Notes
Participants: Mike Degagne, Aboriginal Healing Foundation, Canada
Yvonne Rigsby-Jones, TsowTunLeLum, Canada
Carol Hopkins, National Native Addictions Partnership Foundation, Canada
Elder Anne Bob, Canada
Joan Breland, Prince Albert Grand Council, Canada
Brenda Restoule, Native Mental Health Association, Canada
Leilani Bell, Te Upoko O Nga Oranga O Te Rae, New Zealand
Carole Maraku, Te Upoko O Nga Oranga O Te Rae, New Zealand
Tesa Ingley, New Zealand
Elder Jim Dumont, Canada
Sonia Isaac-Mann, Assembly of First Nations, Canada
Elder Moe Milne, New Zealand
Rose Lemay (Sones), First Nations and Inuit Health Branch, Health Canada
Rod Jeffries, Healing our Spirit Worldwide
Wharerātā members in Hawai’i for HOSW took the opportunity to meet on the afternoon of September 7. Thank you to Rod Jeffries for negotiating a free meeting room.
Updates on activities since the last meeting in Toronto in May 2010 were given:
• IIMHL in Ireland – Helen Milroy, Carol Hopkins and Rose LeMay presented the Wharerātā in a workshop format. It was successful in building support, and equally successful in presenting indigenous holistic health and leadership as a model benefitting non-indigenous. Kathy Langlois, new chair of IIMHL, attended the workshop, along with Charles Currie who used to be Administrator of SAMHSA.
We met with Pam Hyde, Administrator of Substance Abuse and Mental Health Services Administration (SAMHSA), USA, confirmed that Wharerātā will be part of the planning process for San Francisco 2011, and she also announced during the closing IIMHL plenary that “we will learn from indigenous knowledge” at the 2011 event.
Ken Thompson and Charlie Currie, both with connections to SAMHSA, communicated their interest in the Declaration, and offered to support a strong indigenous component or theme at the San Francisco 2011 event.
• International Union for Health Promotion and Education – Carol Hopkins attended the IUHPE 20th world conference in July 2010 in Geneva. During the indigenous stream meetings, discussions about indigenous space were held, and Carol took the opportunity to share an overview of Wharerātā. Indigenous participants were supportive of the basics of the Declaration, and asked if Wharerātā can include health leaders as well as mental health leaders.
• Indian Health Service-Behavioral Health Conference, Sacramento July 2010 – Rose LeMay attended this meeting to provide a workshop on the Declaration, and meet with US indigenous behavioral health leaders. The workshop was successful, and more discussions will be held with Rose Weahkee, Director of IHS-Behavioral Health, and Holly Echo-Hawk, Group member based in Washington State, to work together to plan indigenous content in the IIMHL San Francisco 2011 meeting. Communication was started with a local indigenous mental health leader in San Francisco to ensure protocols are met in planning for the 2011 event.
• Declaration published – International Journal of Leadership in Public Services, Vol6(1), February 2010. The article is available for purchase here.
• Website Development – Additional resources have been added to the website, with emphasis on indigenous authored articles in the Online Library. Wharerātā members are requested to email documented successful practices or examples to Rose to include on the website.
A longer discussion on the current assumed mandate, future potential influence, membership and structure of Wharerātā was held. A number of points were made:
• There is a difference between mainstream organizations “giving space” to indigenous, compared to indigenous peoples “taking space”. We do not request legitimacy by mainstream organizations, as we have our own indigenous protocols and ways of community and leadership that requires no external authority. However, in saying that, we also uphold the Wharerātā principle of collaboration and partnership with non-indigenous. Wharerātā will be indigenous-only at its core, and we also will work to maintain and strengthen our relationship with the IIMHL Steering Committee as this benefits both the IIMHL and Wharerātā. Indigenous peoples discuss issues and make decisions based on culture and indigenous intelligence. We need to protect indigenous space, and this space is used to make decisions based on indigenous intelligence and culture.
• There is great potential in the Wharerātā Declaration and use of influence by the Wharerātā Group, but we also must retain the work from the community or roots up, as we have done to this point. Measured growth is better than moving too quickly. We will prove our contribution and leadership at San Francisco 2011, and then consider options for growth including ways to increase influence in IIMHL.
• Wharerātā may be able to benefit from strategic partnerships to define roles and collaboration: HOSW, National Native Addictions Partnership Foundation, Native Mental Health Association, United Nations Permanent Forum on Indigenous Issues, International Network of Indigenous Knowledge and Development, IIMHL, World Health Organization. The concept of a “coalition” of international indigenous organizations was raised, as one way to increase influence. Partnerships are not likely until Wharerātā has a ratified Terms of Reference. Once a Terms of Reference is complete, NNAPF and NMHA are interested in developing partnerships with Wharerātā.
• We need a Terms of Reference that documents our vision and activities, to ensure that we are describing the Group and Declaration consistently.
• A discussion was held on the risks of accountability of indigenous researchers and use of indigenous knowledge. HOSW is requested to consider how its venue might be used to address accountability – in the future, could Wharerātā and other presenters use this forum to provide updates on activities, and so be transparent and accountable to as many indigenous participants as possible?
A short discussion was held on the IIMHL San Francisco 2011 event, and Pam Hyde’s request and commitment to involve Wharerātā in the planning and contribution to the event. Time was running short by this time, so input will be completed on this topic by email. This discussion is time-sensitive, and members are requested to provide input as quickly as possible. The following decisions made by the meeting participants in consensus:
1. A pivotal right of indigenous peoples is the right to self-determination (i.e by indigenous people for indigenous people). This right or principle is reflected in the workings of the Wharerātā group by:
a. Ensuring the primacy of Indigenous People only discussion
b. Ensuring determinations or decision making is by Indigenous People
2. The principle of ‘partnership with non indigenous people to achieve indigenous self-determination aspirations’ is reflected in the workings of the Wharerātā group by: a. Ensuring partnership opportunities are explored
b. Inviting non indigenous participation in certain discussions
c. Inviting non indigenous participation in certain initiatives.
d. Valuing and sustaining our relationship with IIMHL.
3. Wharerātā will start negotiating a partnership with HOSW, given that we likely are in agreement on the HOSW Covenant already. a. We request to introduce Wharerātā during an HOSW plenary now. DONE.
4. A Terms of Reference will be developed that defines vision, membership and structure, decision-making, and key activities. Rose will circulate a draft for email input as soon as possible, with ratification by email. a. The concept of a “leadership” or “council” of 2 members per country to address time-sensitive decisions was generally accepted, and will be further defined in the Terms of Reference.
b. Participants confirmed Rose LeMay as the “international chair” of Wharerātā, with the title to be confirmed through the Terms of Reference.
c. Carole Maraku will share the previous Alaska version of the terms of reference of the group which met through IIMHL.
5. A promotional item will be developed immediately on the key points of the Declaration.
6. Discussion and input on the IIMHL San Francisco 2011 event will be completed by email. This discussion is time-sensitive, and members are requested to provide input as quickly as possible. Rose will send a separate email to solicit your input.
Healing our Spirit Worldwide (HOSW)
About twenty Wharerātā members attended HOSW on September 4-9 in Honolulu, and altogether presented more than 30 workshops and posters. Carol Hopkins and Rose LeMay presented the workshop on the Wharerātā Declaration to about 30 participants, which was a larger attendance than most workshops on the second-last day of HOSW. Discussion from participants was positive. Finally, Rose introduced Wharerātā on the last day of HOSW in plenary to the approximately 2,600 participants. While sharing the message of the benefits of supporting each other as indigenous leaders, the website address was highlighted. Thank you to Sonia Isaac-Mann for negotiating this opportunity.
NACE/SAMHSA Meeting Notes
Upon the invitation of Steve Onken, a few Wharerātā Group members participated in this US meeting on September 1-2, 2010. Steve is from the Myron B Thompson School of Social Work, at the University of Hawai’i. The Native American Center for Excellence (NACE, http://nace.samhsa.gov) is a national resource center for up-to-date information on American Indian and Alaska Native substance abuse prevention programs, practices, and policies. An initiative of the Substance Abuse and Mental Health Services Administration (SAMHSA), NACE also provides training and technical assistance support for urban and rural prevention programs serving indigenous populations.
The meeting agenda was focused on research and evaluation ethics in indigenous communities, and a number of non-indigenous researchers along with indigenous community representatives were present. This meeting built on discussions held at a 2009 meeting on the same topic. There is ongoing discussions in the US on the concept of evidence-based interventions in mental health and addictions, as it relates to American Indian/Alaskan Native communities. A draft document authored by NACE was circulated titled “Steps for conducting research and evaluation in native communities”.
Carol Hopkins, Kristin English and Rose LeMay participated, and Rose gave a keynote on Wharerātā on September 1. The key messages of Wharerātā (community-based, building leadership in community) were very well received. Overall, participants welcomed the message that sharing between countries can be beneficial.
The Wharerātā Declaration published in 2010
The Wharerata Declaration – the development of indigenous leaders in mental health
Indigenous populations and communities around the world confront historical, cultural, socioeconomic and forced geographic limitations that have profound impacts on mental wellness. The impacts of colonialism and, for some indigenous populations, forced residential schooling and the resulting loss of culture and family ties, have contributed to higher risks of mental illness in these groups. In addition, there are barriers to healing and mental wellness, including inconsistent cultural competence of mainstream mental health professionals, coupled with the limited numbers of indigenous mental health professionals. The Wharerata Declaration is a proposed framework to improve indigenous mental health through state-supported development of indigenous mental health leaders, based on a new indigenous leadership framework. Developed by the Wharerata Group (original membership noted in the acknowledgments section at the end of this article), the framework will be presented for support to the member countries of the International Initiative for Mental Health Leadership (IIMHL) in 2010.
Follow this link to read the full Declaration.
IIMHL in New Zealand and Australia 2009
IMHL 2009 in Brisbane – Indigenous Leadership Workshop
Kathy Langlois, Director General of First Nations and Inuit Health Branch, Health Canada
Rose Lemay (Sones), Assistant Director of Strategic Health, Assembly of First Nations, Canada
Ray Watson, Commissioner, Mental Health Commission, New Zealand
Carol Hopkins, First Nations Youth Solvent Abuse Committee, Canada
Helen Milroy, National Mental Health Committee, University of Western Australia
Kimini Anderson, Queensland Health, Australia
Spero Manson, Cook Inlet Tribal Council Inc., United States
About 35 people attended the workshop on Indigenous Leadership on March 4, 2009. Participants included: Pacific Islands, Tonga, Inuit and First Nations in Canada, New Zealand, Scotland, Australia, India; as well as consumer advocacy groups, mental health provider organizations, and policy makers.
Helen and Kimini
Dr. Manson provided an overview of The Wharerata Declaration, a product of the IIMHL Indigenous Leadership Exchange in Palmerston North. Wharerata is a Maori word, with multiple meanings including “house of wisdom and understanding”, and “house of shelter and protection”.
The Wharerata Declaration is intended to draft a starting point to address mental wellness and inclusion of indigenous peoples in mental wellness systems and countries. There are five themes:
1. Indigeneity: distinctive societies with worldviews that are strongly connected to the land, as well as to family and community.
2. Best Practice: clinical and indigenous/cultural are equally valued
3. Best Evidence: multiple sources of information and outcomes provides a wholistic picture
4. Leadership: indigenous leaders are recognized by their community, and can build bridges across different groups a. Informed – by conventional as well as innovative knowledge, comfortable with ambiguity, and ability to translate between worlds/able to switch codes
b. Credible – within indigenous as well as health sector, personal credibility
c. Strategic – visionary, creative, facilitative and empowering, skilled in negotiation
d. Connected – to own community, sector, professional, and leadership network
e. Sustainable – ongoing training, personal balance
5. Influence: Leaders advocate and influence the wider population, including in political spheres.
Table discussions were held, with the following points:
• Could be strengthened with explicit language to recognize traditional healers and allied health professionals as the first responders, as opposed to assuming health professionals only play a leadership role
• Emphasize the richness of traditional knowledges
• Similarity of the experience of disenfranchised with mental health consumers, and the role of indigenous leaders who communicate a message that may also benefit other minorities, and what is the role of indigenous leaders to bring others along with us
• Indigenous leaders are already leading in mental health
• Framework has meaning across cultures, beyond indigenous cultures
• The space in-between as a sacred space for relationship and connection
• Need to shift attitudes and assumptions, and question
• Further refine clarity between Best Practice and Best Evidence, they are similar
• Leadership is essential to changing the mental health system
• Relationship is so important with funders and policy makers, and indigenous peoples demand funders have more cultural competency but we also hold that knowledge
• Importance of human-ness and values as a leader, and that health training might not support this development
• The theme of influence may not capture the construct and intent, could be re-named the levels of influence from community through to politics
• Influence is both lobbying as well as leveraging partners
• The Framework is a paradigm shift away from a financial quest to one of abundance in people and culture
In summary the group supported the paper, and appreciated the humanity and values-based approach. There is an overall theme about the need to balance the voices in mental health, and how to best accomplish this.
The Framework is about building indigenous health leaders, as this is the gap that is holding back distributed action within countries and internationally. The Framework is a recipe leading to the five goals:
1. Pathways to health
2. Cultural integrity
3. Value for money
4. Facilitation of change
5. Contribution to leadership development
Ultimately, success is based on indigenous ownership and action.
[Cut model from endorsement and insert]
The model is a call for indigenous groups to endorse, for countries to acknowledge and support the framework, for partnerships including indigenous communities and governments to undertake activities
There is also an overall theme about the personal and professional aspect of indigenous health. Discussions on indigenous health invariably lead to cultural competence, and the issues are issues of the heart – it is a very different discussion from others in health.
The Framework could influence the world, as the Qualities, Networks and Goals could apply to all cultures.
“Nothing for us, without us.”
The next steps will be (not necessarily in order):
• Revise the Framework based on this workshop’s input
• Endorsement and support from indigenous groups for the revised Framework
• Article(s) in the next Journal on the Framework
• Further discussion at the December IIHML meeting
• Influence IIMHL countries to officially support the Framework
• Build the network internationally for indigenous health leaders
• Build indigenous leaders in health