28 April 2022
He Toka Tūmoana; A Standing Rock in the Sea.
Writer Maraea Rihari talks with social researcher Dr Dianne Wepa, about her contribution to mental health in Aotearoa, and globally.
He toka tūmoana he ākinga nā ngā tai.
A standing rock in the sea, lashed by the tides (Kawharu, 2008).
“It’s almost like a calling, anything to do with kaupapa Māori,” says community researcher Dr Dianne Wepa. “You make a deliberate choice to ride out the rough seas, when you work in Māori Health. The disparity is so huge that you can’t not be involved, especially when it’s your whānau that has been affected by this; you have this inner drive, as Māori, to keep persevering.”
Dianne affiliates to Ngāti Pahaurewa, Ngāti Hinepare and Ngāti Hawea from the East Coast; and she was whāngai (adopted/fostered) from the Hawkins whānau to the Wepa whānau. “My birth mother’s whakapapa is Hawkins, and her father was a Nētane, from Ngāpuhi, and as you did back in the day, the name got changed to “Nathan” and he married a wahine from Mohaka, a Hawkins, the whakapapa goes through back to the whaler/sealer whanau from England. They settled in Haumoana just between Hastings and Napier, a seaside village, and my mother whangai me out to my grandaunt, Moana Wepa.”
Education was a focus in Dianne’s upbringing. “Nan was an educationalist, so she put the boys through Te Aute College, and in those days, you could stay a couple of years and then leave and go shearing, so I was the only one who finished high school and got my School Certificate and carried on and got my degree. I think Nan thought I’d become a teacher or a policewoman! Back in those days, you didn’t get student loans – you paid maybe a couple of hundred dollars a year, not like today – I think maybe we’re the last generation, Gen X, who did that. I’d just finished my Bachelor of Social Work, a four-year degree, and I couldn’t work it out – I just thought: ‘why can’t we just keep doing what we’re doing?’ So, I was very aware that I was privileged to basically have a free education.”
Dianne’s mahi has seen her work intensively, and deeply, in mental health, amongst other vital aspects of life. This mahi saw her work with suicide and technology in the United Kingdom, and in Australia. In Australia, Dr Wepa worked with Aboriginal whānau, particularly parents and their partners reviving skin-to-skin bonding with Kangaroo Care – a practice that began in 1978 in Bogota, Columbia, as a way to cope with neonatal wards under pressure because of high mortality rates and limited incubators.
Dr Wepa has also edited two books: Cultural Safety in Aotearoa and New Zealand, and Clinical Supervision in Australia and New Zealand, a Health perspective.
Dianne’s moemoea (dream) is to establish her own research centre: “I wanted to do that when I was in Hawkes Bay when I first started teaching and nursing, and that’s still a dream of mine. So Tapua O Te Waiora Maori Research Centre is at AUT, Professor Wilson and others that she runs, and I am a member of that as well. And I would like to establish a Maori Mental Health Research Centre, because I think there’s a lot of work.”
Read Dianne’s full story below.
Contact Dianne here.
View Dianne’s research here.
Thank you to writer Maraea Rihari for her mahi, and to Dianne for sharing her story.
He Toka Tūmoana; A Standing Rock in the Sea.
An interview with Dr Dianne Wepa for Community Research to celebrate community researchers
By Maraea Rihari
He toka tūmoana he ākinga nā ngā tai.
A standing rock in the sea, lashed by the tides (Kawharu, 2008).
Dr Dianne Wepa is humble when I open our interview with this whakataukī, attributed to her by Professor Denise Wilson, her then doctoral supervisor: “It’s almost like a calling, anything to do with kaupapa Māori. It’s easy to opt out; to choose other areas to work in. But you make a deliberate choice, to ride out the rough seas when you work in Māori Health…the disparity is so huge that you can’t not be involved, especially when it’s your whānau that has been affected by this; you have this inner drive, as Māori, to keep persevering.”
The tohu of tides is also inherent in her whānau ingoa: ““Taihaere is my middle name on my whāngai side. I called my son that name as his first name, and I’ve had it described to me – it’s about the tide coming and going, a beautiful name.”
Dianne affiliates to Ngāti Pahaurewa, Ngāti Hinepare and Ngāti Hawea from the East Coast; and she was whāngai (adopted/fostered) from the Hawkins whānau to the Wepa whānau. “My birth mother’s whakapapa is Hawkins, and her father was a Nētane, from Ngāpuhi, and as you did back in the day, the name got changed to “Nathan” and he married a wahine from Mohaka, a Hawkins, the whakapapa goes through back to the whaler/sealer whanau from England. They settled in Haumoana just between Hastings and Napier, a seaside village, and my mother whāngai me out to my grandaunt, Moana Wepa.”
“As you know, whāngai adoptions are very open, so I always knew my mother lived around the corner, it wasn’t like a secret… but I never thought about it, because I called my grand-nan ‘mum.’ One day, I went to get my driver’s licence, of course, you had to have your birth certificate, and I went: ‘Oh yes, I’m Dianne Wepa,’ and they looked it up and they said: ‘There’s no Dianne Wepa,’ So I said my mother’s maiden name – Nathan – and they were like: ‘Oh yes, here you are.’ And it was like that scene you see from the movies, where the room grows smaller, so I learned at sixteen years of age, the kaupapa Pākehā way, that the Pākehā way of adoption wasn’t the same as the Māori one.”
Dianne had older brothers and sisters who had grown up and left home, and her nieces and nephews were her age. “It was very much that whānau way of growing up, and it gave me an appreciation for going to the sea…all my whānau were great fishermen and women, and learning at the sea. You weren’t there to go swim and make lots of noise, you were there to do the mahi; collect kaimoana. I was very fortunate, I was immersed in the tikanga from that side, and I learned the reo from my Nan; she was from Ngāti Porou and she was a fluent speaker. I could’ve easily been brought up in the State system, in Social Welfare, so I feel fortunate that I didn’t get caught up in the system.”
Dianne had an aptitude for te reo Māori which she took right up to University level. “Back in those days, if you took te reo Māori, it always clashed with another paper, so I failed a paper for my degree because I was taking te reo Māori, and I had to pick that up later. I’m very good at writing the reo, but I’m not a natural speaker.”
Dianne grew up in a home that focused on education. “Nan was an educationalist, so she put the boys through Te Aute College, and in those days you could stay a couple of years and then leave and go shearing, so I was the only one who finished high school and got my School Certificate and carried on and got my degree. I think Nan thought I’d become a teacher or a policewoman! Back in those days, you didn’t get student loans – you paid maybe a couple of hundred dollars a year, not like today – I think maybe we’re the last generation, Gen X, who did that. I’d just finished my Bachelor of Social Work, a four year degree, and I couldn’t work it out – I just thought: ‘why can’t we just keep doing what we’re doing?’ So, I was very aware that I was privileged to basically have a free education.”
Dianne experienced the impacts of undiagnosed mental health trauma in her own whānau: “Growing up, I was exposed as an adult to my own whanaunga dying by suicide, and that was a cousin of mine. He had undiagnosed depression. He was 27 in the end and he had a son, and that was a trigger, I guess, to say: ‘That’s not right!’ My first job out of Massey University was in mental health. Back in those days, the government had sold off Telecom, and so the money from that sale was to set up community services for mental health, and they were closing down the big hospitals like Lake Alice and so they had to do something for these people who were being discharged, My mahi back then was to work with the whānau to be able to receive their loved ones, and it was like overnight; this was their home in these big hospitals, and now they’re back with their whānau, and what were we going to do about it?”
Whānau Māori became the first Māori Health Providers: “They formed trusts and they set up halfway houses, and that was the beginning in the early Nineties of Māori Health Providers. And that was triggered by the Government bringing in a system called “devolution” where they devolved services, so a lot of whānau became providers overnight and purchased ex-state housing rentals and they had their loved ones in supervised accommodation. These were men with chronic mental health conditions.”
Dianne had not long graduated: “I was a young 20-year-old wahine working with the men; but the actual mahi was more with the whānau. And there were occasions of suicide back in NZ then, and there was a real spike in youth suicide, so the focus was mostly on youth. I moved to Australia, where I was providing counselling services for the N.D.I.S (National Disability Insurance Scheme) and Medicare where you can be set up as a counsellor and you’re directly paid by the government to see people, so I would see families and children and some of that was school-based counselling too.”
Dianne was shocked to hear accounts of children threatening suicide: “A high majority of my caseload were parents saying that ‘my 7 or 8 or 9-year-old is saying they want to kill themselves,’ and I was like: ‘What?’ And so, it was in the Australian context that if you scratch the surface, it’s there, so I thought: ‘We’ve got to do something about this,’ and that got me trying to work with the whānau in Australia, to help their children navigate through that.”
“You’ve got to take it seriously, no.1. You just can’t say: ‘They’re just being naughty,’ and you’ve got to triage like you would with any condition to say: ‘What’s going on here?’ And believe them! You start to weed out the ones where they’re saying that because they need attention, compared to the ones who are truly in that dark space and so I’d work with the whānau for strategies around that.”
Dianne moved to the United Kingdom, where she researched digital technology and suicide prevention: “I saw that it’s mostly the ones under ten who don’t have the tools to help them have a voice, if nothing else. ‘Suicide prevention’ – it’s like a bit of a sexy thing, it grabs peoples’ attention, whereas if you say you want to look at technology for depression or anxiety, no-one cares but really, that’s at the heart of it. The suicide attempts is what grabs the headlines and sadly, that’s what grabs the funding. At the heart of the children saying: ‘I want to kill myself’ you’ll find there’s some sort of hurt, or loss of hope, maybe underlying depression or anxiety, so that’s really the kaupapa that I want to look at. I do think there’s a discomfort around the world – no one wants to hear that their child is saying that. It’s a matter of people being open to the fact that suicide is an issue, rather than having their blinkers on going, ‘No, that’s not my child, not like that.’”
Dianne shares that technology can be one of the tools to work through that initial resistance and confusion; but not the only tool: “I worked with a Masters student in Australia who did a scan of all of the digital technologies for suicide prevention. And what she found, which was really interesting, is at the end of the day, someone wants to talk to someone real. So the apps are good to navigate and the tech can give you sign posts to resources and to maybe watch videos, but you really still need that human to human contact, even if it’s on the phone. And that was really interesting finding that out, because we adults think youth can do that easily; but because they’re still at that age and stage of their development, they still need someone to talk to, to walk them through what’s happening. Even though we think they’re really good at accessing information online, the comprehension part still needs an adult or a peer support person to walk them through the strategies.”
In Australia, Dr Wepa worked with Aboriginal whānau, particularly parents and their partners reviving skin-to-skin bonding with Kangaroo Care – a practice that began in 1978 in Bogota, Columbia, as a way to cope with neonatal wards under pressure because of high mortality rates and limited incubators. Research has determined that Kangaroo care can have a positive impact on babies with lower mortality rates and healthier outcomes for mother and child: “…because that’s what Māori used to do…you would do the skin-to-skin and that would be all part of it with the baby. And that study was to do with newborns and neonatal care, so quite vulnerable babies. In my book called Cultural Safety in Aotearoa, New Zealand, I worked with Jean Tehuia, who’s a very well-known Māori Midwife and C.E O, and in her chapter, she talked about the role of men in birthing and how the woman would have two men next to them and they would hold her around because they had that strength, and they’d hold her under her armpits so she could bear down and give birth. So from there, men have been involved from that birthing process right through. And I think colonisation and the worldview of the role of women and men, that’s tainted that, and a lot of that history has been forgotten, and people that held that knowledge may have passed on, but I think there will be a return to the dual roles of child rearing and birthing.”
Mainstream health services and delivery has not inspired trust amongst Māori communities, and there’s a big shift coming with the establishment of a Māori Health Authority. What does this signal for Māori? “In his book, Whaiora, Tā Mason Durie talked about the Māori Health Authority, which I think is going to change the landscape for Māori forever in this country…he said it’s not a new concept because in the 1920s, the leaders of the Māori Council, they came together back then and said: ‘We need a Maori Health Authority’ and it’s always been on the agenda for Maori leaders to have something like that. Now he’s been brought in to implement the Māori Health Authority to address a lot of those concerns.”
“And then he forecast that eventually there will be a Māori Education Authority, a Māori Housing Authority, and so on and so on. And then he says there will be like a taumata over that which will connect with all these authorities. He was very hopeful for the next generation coming through to continue with that vision. And so I think that’s using the model of kōhanga reo, how Māori opted out of the mainstream system of early education – drawing on our own cultural resources and the way we do things always works for us. So if we’re saying the Pākehā system is not serving us, we’ve tried and tried; it’s still not working, so we’re opting out. Well actually; we’re going to do it this way. And in the RNZ radio interview the other day, I think it was Julian Willcox, and he goes: ‘Will there be a dual parliamentary system?’ And then Mason, how good he is, he goes: ‘It’s got nothing to do with the parliamentary system, it’ll just be its own thing. So it’ll just do what it does!’ So that’s where I’m hopeful for our future because we’ve tried so much to work within the system and it doesn’t matter what we do, it just seems to still not be working.”
“But in the meantime, I mean there is still work to be done because he did say Māori are the users of the health system, not only in Māori services, but in the general system. And so it’s where you can capture the funding where Māori are and pull it back. But it’s hard to work within a system that’s self-serving. It relies on Māori to have the disparity because that brings in the income to try and solve the Māori problem. So what he’s saying is very visionary but it was from our old people, from generations ago. They could see that. So now I think the timing is right with the government. We have our own in government now that can make those changes. In the meantime, there’s still work to be done like capacity and capability of Māori. So we still need capable Māori being educated through the system but we still need our Pākehā colleagues that are enablers and you can’t not do work with them at the moment.”
Māori communities have been struggling with whānau members and friends who have embraced alternative sources of information; who are challenging traditional leadership structures and cultural norms which culminated with tense standoffs at Pipitea and Wainuiomata marae, and a full-blown riot at Parliament grounds in March. Some would say that it’s the result of over one hundred and fifty years of frustrations at colonialist systems and a legacy of dispossession as well as the insidious impacts of imported far-right conspiracy theories that finally reached a tipping point. How can we reconnect with our loved ones and bring them home? “Our people, our culture, has always been dynamic, and our culture has always evolved. Otherwise, we wouldn’t have survived as long as we have with all of the things that have impacted on us. And I think this is an event in time where we will adapt and evolve again. So Māori, they’re very much a dynamic culture, very resilient. And I think when we draw on our tikanga and what makes us Māori, we do well. And so I think that sense of reconnecting is in our DNA. You always know when you meet a Māori person, they always want to make a connection; that’s just in the DNA. So it’s not just an etiquette, polite thing; it’s a truly embedded thing in us that we want to get to know a person. I think we will work out a way to do that if we, I guess, draw back on what makes us – us! I think we lose our way somewhat when we’re working to some other culture’s agenda or the government, things like that. So I do think we will weather the storm.”
“I think there’s some good practices internationally that we can draw on because Māori are very adaptable like that. So I think there will be some change. But I think being true to who we are with our culture will be steadfast…and the leadership, the true leadership around us as a people is what’s needed. I guess to say this is how we are. It’s temporary and we will be able to regather our strengths and come back even stronger as a people…That’s the other thing people admire about Aotearoa is that you can have a disagreement but you can have a conversation about it. You’re not going to go to war, so people still can have a debate about these issues.”
On the fundamental practice of manaakitanga: “And over here you look at Poland that is trying to manaaki the Ukraine people. And Poland has gone through that terrible history in the past. And so I think all cultures at one stage had that sense of wanting to connect. But I think the more urbanised and industrialised, or Individualised. So I think we are fortunate here. I guess the leadership is required here in Aotearoa to keep reminding us, putting us back on track because I think we can slide a little bit to other people because we do manaaki too much. Sometimes we do walk to the beat of another drum and then I think our true leadership can put us back.”
Dr. Wepa has a long list of credentials and interesting projects that she has been involved in, including being the Associate Professor for Mental Health at the University of Bradford, as well as co-designing and leading major research projects like Social Impacts of Dementia. Dianne is a registered social worker who has worked for many years in Māori mental health, as associate lecturer in Māori health at AUT; a Māori Workforce Coordinator, Family Therapist and she contributed towards mandatory social work registration as member of the Social Worker’s Registration Board. In her thesis, Dianne also established a new grounded theory: Struggling to be Involved, (2020) which has been described as a beacon for health care providers in how to engage with whānau Māori to improve their engagement with health services. “I interviewed 30 whānau Māori, so they weren’t just individuals, they were whānau from Hawkes Bay. I talked to them about their health experience. And basically what I found in this theory is that it’s always a struggle. So say, if Nanny had to go and have a hip operation, she got the hip operation, despite the service not being culturally safe or culturally responsive. It was always a struggle. So the patient journey, if you like, which I ended up saying, well, it’s a whānau journey as well, because there’s always whānau wrapped around our loved ones. They never go through these journeys on their own. There’s always someone there having eyes on it. And that’s what I wanted to capture. And so what kept coming through the kōrero was it was a struggle. So having the appointments that suited whānau that maybe were remote and couldn’t be there at 08:00 in the morning for the consultant’s appointment was a struggle. Having to keep asking questions about what was going to happen was a struggle. So that was always the theme. So that’s what basically came through – Māori got a service despite the journey – but it was always a struggle.
And what can we do to change that? “So the concept “we-dentity”, I really love, I think I came across it through an African-American series, but I can’t quite find who it is. I’ve captured it and am trying to keep that concept alive. Instead of identity, we talk about, ‘I do this and I do that’. I found in my interviews, as soon as I say ‘Tell me about what happened to you.’ They straight away go to ‘we’. It’s unique to Indigenous cultures; they speak in the collective. It’s very rare you will find an Indigenous person that starts their kōrero with ‘I’ because it’s not in the DNA, it’s not in the narrative, just to separate oneself from the collective. So I talked about our collective consciousness and I’m going to do a presentation in Adelaide with my Aboriginal colleagues on this concept in September, and I presented on it before where I found that the Māori language is very much focused on verbs, action, doing things, whereas Western languages focus on nouns. And there’s a real interesting tension and difference in that. So if you are an Indigenous person trying to talk about your health situation with a person that’s not from that same culture, you will find there’s a talking past with each other happening.”
“I had one doctor who was in a Māori provider setting. He was lovely. So what he did, he knew Māori loved to connect, but of course, you only have 15 minute appointments. What he did is he had on the wall significant memorabilia about who he was. He was a musician. So he had something on there and he had photos of his children and he would refer to that and say, ‘Kia ora, I am Dr X, and these are my whanau. I’m interested in my music.” And straight away you felt connected to him and then you got on with the consultation. So simple things like that just make the journey so much easier; that interaction. I really loved that, the way he made that effort to connect, and it would work for him. Like we say, what’s good for Māori is good for all, I reckon.”.
Dr Wepa edited two books: Cultural Safety in Aotearoa and New Zealand, and Clinical Supervision in Australia and New Zealand, a Health perspective. The question begs to be asked: is she seeing a warmer reception to cultural understandings? “Absolutely, I think so. We’re still trying to navigate our way through that. I think some people still don’t understand cultural safety. They say, ‘cultural sensitivity’, and I say, no, that’s not what it is. That’s the starting point. And then you have cultural awareness; the starting point to be aware. Not everyone is the same as me, because if you grow up in a dominant Western culture, you don’t have to know about other cultures. So the starting point is knowing I have a culture, it’s everything I take for granted. The way I brush my teeth, the way I go to weddings, funerals, that’s my culture. Rather than always thinking that someone else or they have a culture because they can sing and dance and have a different language. It’s really reorienting that to celebrate what I have as a culture that’s awareness and then sensitivity is being aware, like not sitting on tables, the do’s and don’ts of different cultural interactions. And then safety is ultimately the person that I’m providing care to. They define if I have met their cultural needs. So it depends on each and every individual event. A bit like ethical safety.”
“I can’t say I’m ethically safe all the time because nothing’s happened yet. I’ve got to wait for that situation to occur. And so that’s the closest I can explain it to people. And so it’s always embedded in the person receiving the care, the powers with them to define if I’ve met their cultural needs or not. So I think there’s a movement in it beyond nursing.”
“I say to people: ‘We need to push back when people that are funding services or even in a conversation keep lumping Māori with Pacific people, the statistics keep saying Māori and Pacific. I said, ‘No, we need to stop that. We need to have Māori on their own because of the Treaty of Waitangi.’ And you speak to our Pacific cousins and they say the same, they go, ‘Yeah, we don’t want to be lumped with Māori either!’ And so there needs to be a reframing of how information is also counted in statistics because then we’re competing for cultural space in our country and we’re relegated to just another minority.”
“And where else can Māori go to have their culture celebrated? We got nowhere else to go to be ourselves. So that’s the place that it should be where Pacific people can always connect back to their origins.”
Dianne’s moemoea (dream) is to establish her own research centre: “I wanted to do that when I was in Hawkes Bay when I first started teaching and nursing, and that’s still a dream of mine. So Tapua O Te Waiora Māori Research Centre is at AUT, Professor Wilson and others that she runs, and I am a member of that as well. And I would like to establish a Māori Mental Health Research Centre, because I think there’s a lot of work.”
“Here in Bradford, they have, like, dementia is huge and cancer is huge (in research). It’s where the funding goes. And then Australia, where I’m still connected to their research centre – that’s called the Mental Health Education and Suicide Prevention Research Centre. I do enjoy the work there, but I think I’m now, at that stage, I need to be able to develop my own, have my own kaupapa around that. So that’s the goal.”
Does Dr Wepa have any parting advice for rangatahi wanting to enter the research and health professions? “I coordinated Tūruki, which is the Māori word for development strategy at the Hawkes Bay District Health Board. And I worked a lot with the national initiative called Kia Ora Hauora, and I would encourage rangatahi to look that up online. It’s an initiative that’s run from the Ministry of Health to all the District Health Boards around New Zealand, and they do a lot of work in the kura and the high schools where they’re encouraging Māori to study in health. And one takeaway message from that, if rangatahi can keep the Sciences; that opens many doorways into mahi and science related subjects. And Māori, I find, tend to like biology. We relate really well. We like biology because it’s about us. So I found when I was in that role, Māori would just do biology and do really well at it as a subject. And so what I’ve encouraged people is to also take chemistry, because chemistry is a type of biology and people might go, oh, chemistry, that’s too hard. But if you think of it, biology is connected to chemistry. Biology is a form of chemistry. Yeah. So if they’re able to choose those subjects earlier, in their high school because once you do it too late, you’ve missed the boat sometimes for University study, definitely the Sciences is key, I think for our rangatahi to enter the careers in health because then you can do a lot more. You have more options at your plate to enter into those careers. But if not, just stay at school, go right through 13 and things like that. But definitely if they are able to at least look at that website, it’s amazing. The Kia Ora Hauora connects with mentors, peer people. So again, it’s Māori working outside the system, working with their own. Even though they work with the schools, they would rather target rangatahi directly because schools have too much bureaucracy to work with them. And so that’s what I found too. If you can target a whānau with young ones at school directly, then we’ve captured them to support them on a journey to achieve well with their studies. And they have hui, student hui. Well, now they’ll have them again, so that’s definitely the place. I think they will find lots of information to support them.”
References:
Wepa, Dianne & Wilson, Denise. (2020). Struggling to be involved: An interprofessional approach to examine Māori Whānau engagement with healthcare services. Journal of Nursing Research and Practice. 3. 1-5. 10.37532/jnrp.2019.3(3).1-5.
Wepa, D. (Ed.). (2015). Cultural Safety in Aotearoa New Zealand (2nd ed.). Cambridge: Cambridge University Press. doi:10.1017/CBO9781316151136
Wepa, D. (2007). Clinical supervision in Aotearoa/New Zealand : a health perspective. Auckland, N.Z : Pearson Education New Zealand
Durie, M. (1998). Whaiora, Maori Health Development (2nd ed.). Oxford University Press.