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In 1984 Mason Durie documented a framework for understanding Maori health, Te Whare Tapa Wha, which has subsequently become embedded in Maori health policy. In addition, the adoption of this framework is now widespread among Maori and Iwi health and disability service providers and clinicians. Within psychological practice Te Whare Tapa Wha forms the foundation of a number of practice frameworks. This article presents a specific assessment framework, the Meihana Model, which encompasses the four original cornerstones and inserts two additional elements. These form a practice model (alongside Maori beliefs, values and experiences) to guide clinical assessment and intervention with Maori clients and whanau accessing mental health services. This paper outlines the rationale for and background of the Meihana Model and then describes each dimension: whanau, wairua, tinana, hinengaro, taiao and iwi katoa. The model provides a basis for a more comprehensive assessment of clients/whanau that then underpins appropriate treatment decisions.
When I (SP) was growing up in rural Hawkes Bay there was one question I was constantly asked each year when I returned to school after the summer break: "Did your whanau have a hangi for Christmas dinner?" I always had to answer, "No". This would invariably be met with looks, if not exclamations, of surprise. It was as if I'd broken some unwritten rule about what it meant to be a whanau at Christmas.
Just asking me one question did not reveal the whole story behind my hangi experience. It merely resulted in an absence of knowing about die other things that influenced my response; for example, people also needed to know whether or not my whanau:
* actually got together for Christmas,
* had the knowledge to build a hangi,
* wanted to engage in building a hangi over the hot Christmas period,
* all liked to eat hangi,
* had space and resources available to build a hangi, and
* had an understanding of current council laws about building a hangi during a usual summer fire ban.
Mental health assessment is not that far removed from asking someone about whether their whanau had a hangi at Christmas. Invariably, asking a larger set of questions will lead to a greater knowing about a whanau and their circumstances (Huriwai, Robertson, Armstrong,...