Discrimination and trauma contributing to psychosis risk in Māori
Māori are greatly over-represented in people experiencing early psychosis in New Zealand, but little is known about why—until now.
A new study from Te Herenga Waka—Victoria University of Wellington, published this month in Schizophrenia Bulletin, looked at whether systemic stressors like trauma, discrimination, and financial adversity might explain the disparity, as well as how the experience may differ across cultures.
Dr Rebecca Grattan, a registered clinical psychologist and lecturer in Psychology at the University’s School of Psychology, led the study, supported by Dr Amanda Clifford, Clinical Psychologist and Lecturer at the University of Otago, and Aleesha Mehta, Te Herenga Waka Honours student. She says past work tended to only highlight the disparity, rather than trying to understand it.
“In order to best support people experiencing early psychosis, we need to understand the ‘why’ and aim preventative efforts at targeting that.
“This research suggests that systemic issues such as discrimination and trauma contribute, alongside cultural differences, to the way early psychosis symptoms are experienced by Māori.”
Her study surveyed 466 18- to 30-year olds in Aotearoa and compared the responses of Māori and non-Māori participants, measuring childhood trauma, discrimination, financial adversity, and psychotic-like experiences (PLEs). 18% of respondents self-identified as Māori, in line with the national average percentage of 16.7%.
“Māori reported experiencing more PLEs than non-Māori as expected, but when we controlled for systemic factors such as trauma, discrimination, and financial stress, this relationship was eliminated. This suggests that Māori are more likely to experience psychotic-like experiences as a direct result of these factors.
“This would mean that managing these systemic issues at a community level is likely to reduce psychosis and psychosis-related distress for Māori.”
She says the study showed that Māori were also more likely to report that the PLEs were a positive experience—a reminder, she says, that measurement of psychosis risk for Māori is highly nuanced.
“Māori cultural factors and traditions could likely reduce distress surrounding psychotic experiences, supporting the importance of culturally appropriate care that acknowledges and champions their cultural worldviews and values.
“Further research is needed to better understand how this resilience might impact ongoing risk and be promoted within therapeutic settings to improve outcomes for Māori.”
She aims to use this research as a starting point to develop a New Zealand-specific model of early intervention for psychosis.
“Australia, the UK, and the US all have country-specific models they follow, but here we tend to just adapt international models, which don’t account for our unique sociocultural issues and strengths.
“I’m currently working alongside the New Zealand Early Intervention in Psychosis Society to build this New Zealand model—my next step is to meet with communities impacted by psychosis and work together to develop the model.”