Go to National Library of New Zealand Te Puna Mātauranga o Aotearoa Go to Te Ao Hou homepage
No. 25 (December 1958)
– 57 –

This article, specially written for ‘Te Ao Hou’, brings to light many important new facts and opinions on the mental health of the Maori.

BOOKS
THE MENTAL HEALTH OF THE MAORI

Review of: Mental Health in New Zealand by Prof. E. Beaglehole

The problem of mental ill-health is one of great topical interest in New Zealand at present. Groups are being formed, newspapers are thundering, so it was with pleasant anticipation that one began this book, hoping it would state the issues foursquare and form a stimulating springboard for-discussion. It is excellently produced by a Wellington firm and the type is very clear. In the unchanged second edition, which appeared recently, Dr Beaglehole, Professor of Psychology at Victoria University, has put forward a number of good ideas for a regeneration of our Mental Health Services. He stresses the need for much more emphasis on clinics for the treatment of mentally disturbed children with which one can agree heartily. However, with some other aspects of the book one is forced to disagree just as heartily, first and foremost in the field in which the author has done a large amount of painstaking research, namely in the field of Maori illhealth.

For instance, on the first page he states that the incidence of mental disorder for Maoris is “… 64 per 100,000 as compared with the pakeha figure of 105 per 100,000 … [also] … a psychoneurotic percentage of 4 while the pakeha has 14; in the senile category the pakeha percentage is 16 while that of the Maori is 8.” These figures certainly seem to bear out his contention that the Maori is less afflicted with mental disease than the pakeha. They are taken from admission figures to Mental Hospitals. But let us see what that really means. He divides mental illness into five categories:

1.

Behaviour disorders, e.g., children who are difficult to control, are aggressive, unresponsive to thrashings, beatings, etc. “Teddy boys” in fact.

2.

Character disorders, e.g., sexual perversions, compulsive stealing, lying, drug addiction, alcoholism.

3.

Psychosomatic disorders, e.g., so-called bodily diseases in which disturbed emotions are of great importance: indigestion, peptic ulcer, asthma, rheumatism.

4.

Minor personality disorders: The psychoneuroses—“nerves” with excessive fear, guilt, depression, obsessional thoughts to a pathological degree.

5.

Major personality disorders: The psychoses, e.g., legal insanity, suicidal depression, “hearing voices”, wildly manic and illogical behaviour.

Picture icon

An important part of our mental health services is played by psychiatric nurses, and more and more Maori girls are taking up this profession. They are highly spoken of at the mental hospitals where they serve. Nurse P. N. Patate (above) comes from Masterton and had wide experience in ordinary and maternity nursing before she joined Porirua Hospital recently. (National Publicity photograph)

– 58 –

MENTAL DISEASE PREVALENT AMONG THE MAORI

Now it is dangerous and unjustifiable to assume that admissions to Mental Hospitals will give an adequate picture of Maori ill-health if we use the above classification. Dr Beaglehole has little or no contact with the patients in these institutions or he would realise that Maoris are very reluctant to enter them, so that the only Maoris seen there are those who are so floridly and severely psychotic that even their loving and tolerant families can no longer cope with them, i.e., the wildly manic, the acutely hallucinated, the acutely suicidal. Yet these form only a small percentage of his group 5. He himself says “psychosis is relatively insignificant in the whole picture of mental health.” The other four categories are hardly ever seen in Mental Hospitals except for the severe cases in Groups 1 and 2 referred from goal or borstal. A Maori voluntary boarder is a rarity, and these are the ones who will be suffering from any of his first four categories, not because these cases are rare in the Maori, but because they stay with their tolerant family and tribal groups rather than enter a Mental Hospital. Staying with their families, they manage to get along somehow, seen only perhaps by the tohunga who, it must be regretfully admitted, is liable to give them a vastly better type of supportive psychotherapy than a pakeha therapist can provide. So his figures are really meaningless. He would explain them by a subtle re-statement of the myth of the noble savage, happy and relaxed with his beer, cigarettes and making love in the sunshine, untroubled by the tensions which beset the superior pakeha. And of course, it is a myth which could be exploded by general practitioners working in such places as Rotorua and Auckland. The asthmatic “wheezy” chest is so prevalent among Maori children in Rotorua as to be considered almost “normal” according to one doctor who works there. Unfortunately there are no published figures, or at least not enough to draw firm conclusions from, but at least they point in the direction opposite to that in which the author would lead us to think. One would like to see some figures for the incidence of his first four categories of illness when the Maori competes on “equal terms” with the pakeha (i.e. unequal terms because based on pakeha values). At any rate, when he does not compete he falls back defeated into the psycho-neurotic retreat from life typified by the pakeha stereotype of the Maori—“lazy, carefree, happy-go-lucky, unambitious, thoughtless of the future.” Surely this is a mental health problem, and surely the Maori mental health problem is much graver than the professor would have us believe. Our prisons are full of his first four categories, if only they were diagnosed. As things are, they just don't get diagnosed.Now it is dangerous and unjustifiable to assume that admissions to Mental Hospitals will give an adequate picture of Maori ill-health if we use the above classification. Dr Beaglehole has little or no contact with the patients in these institutions or he would realise that Maoris are very reluctant to enter them, so that the only Maoris seen there are those who are so floridly and severely psychotic that even their loving and tolerant families can no longer cope with them, i.e., the wildly manic, the acutely hallucinated, the acutely suicidal. Yet these form only a small percentage of his group 5. He himself says “psychosis is relatively insignificant in the whole picture of mental health.” The other four categories are hardly ever seen in Mental Hospitals except for the severe cases in Groups 1 and 2 referred from goal or borstal. A Maori voluntary boarder is a rarity, and these are the ones who will be suffering from any of his first four categories, not because these cases are rare in the Maori, but because they stay with their tolerant family and tribal groups rather than enter a Mental Hospital. Staying with their families, they manage to get along somehow, seen only perhaps by the tohunga who, it must be regretfully admitted, is liable to give them a vastly better type of supportive psychotherapy than a pakeha therapist can provide. So his figures are really meaningless. He would explain them by a subtle re-statement of the myth of the noble savage, happy and relaxed with his beer, cigarettes and making love in the sunshine, untroubled by the tensions which beset the superior pakeha. And of course, it is a myth which could be exploded by general practitioners working in such places as Rotorua and Auckland. The asthmatic “wheezy” chest is so prevalent among Maori children in Rotorua as to be considered almost “normal” according to one doctor who works there. Unfortunately there are no published figures, or at least not enough to draw firm conclusions from, but at least they point in the direction opposite to that in which the author would lead us to think. One would like to see some figures for the incidence of his first four categories of illness when the Maori competes on “equal terms” with the pakeha (i.e. unequal terms because based on pakeha values). At any rate, when he does not compete he falls back defeated into the psycho-neurotic retreat from life typified by the pakeha stereotype of the Maori—“lazy, carefree, happy-go-lucky, unambitious, thoughtless of the future.” Surely this is a mental health problem, and surely the Maori mental health problem is much graver than the professor would have us believe. Our prisons are full of his first four categories, if only they were diagnosed. As things are, they just don't get diagnosed.

The whole problem needs to be re-assessed and by Maoris, preferably Maori psychiatrists and

Picture icon

Nurses W. and K. Beattie are among the growing number of Maori women to take up psychiatric nursing. The two sisters who come from Wairoa are working at Porirua Hospital. (National Publicity Studios photograph)

psychologists. It is difficult enough for a pakeha to diagnose other pakehas, let alone to plunge into the unfamiliar territory of Maori values, myths and symbols which are of much greater importance to Maori psychic life than the corresponding religious symbols are to pakehas. Anyhow, the pakeha is just not trusted, “he wouldn't under-stand,” and this is unfortunately true. There are perhaps some gulfs which just cannot be bridged by kindness and the desire to help. Even if the Maori patient does talk, the most a pakeha can do is give mild supportive therapy even if he has “made a study of the Maori.” Worse still, most pakeha psychiatrists and psychologists follow the principles laid down by Sigmund Freud (which are not, and, with our present scientific method, cannot be “proved scientifically” as Dr Beaglehole states). Now these are brilliant and fecund “hunches” by a genius, a genius who was a middle-class, nineteenth century German, materialistic and mechanistic, but they are a handicap in under-standing the spiritual and religious experiences which are of such vital moment to Maori psychic life. No treatment can be successful unless the therapist is prepared to accept the reality of these experiences and this is just the sort of thing that many Europeans cannot and will not swallow. A true follower of Freud must despise these aspects

– 59 –

of the Maori and strive to eradicate them, to make him “fully integrated”, to remove his “illusion”. The concepts put forward by Jung are far more potent, more flexible in their approach to myth and religion. There is a great need (and the possibility) to pursue the problems of Maori mental ill-health from different premises, premises more suited to the realities of Maori psychic life.

ONLY A DOCTOR CAN TELL

In other ways the book is unsatisfactory and misleading. For instance he says that “doctors are not necessarily the best” for the treatment of psychosomatic disorders, i.e. those bodily diseases in which disturbed emotions play a large part. He would suggest lay therapists, i.e. those without any medical training. Surely a medical training is absolutely essential in this of all psychiatric fields dealing with such diseases as (in his own words) “peptic ulcer, cardio-vascular troubles, diabetes, asthma, hay-fever, eczema, various skin disorders, rheumatism, eye, ear and throat cases”! ! He says that once the lay therapist has excluded an “organic basis” he can go ahead and cure with psychotherapy. Just how does the lay therapist exclude the organic basis, how does he tell the difference between an anxiety state and a toxic goitre which can present with the same symptoms, and what if it's a bit of both as it usually is? How does a layman diagnose a person who is weak, tired, depressed, fed up and bitter because he has undiagnosed early T.B. or cancer, or having peculiar personality disorders because of a brain tumor. Non-medical psychologists are extremely useful, like tohungas, in their place, but there is a limit to their powers, even in our credulous generation. Both think they can cure psychosomatic diseases, but neither can, and for very similar reasons. The whole idea of directing diseases rigidly into those “of mind” or “of the body” is rubbish. It's always a bit of both and a medical and psychiatric training is required to weigh the various factors at all stages.

THE SUPERNATURAL FORCES IN HEALING

Apart from being misleading in several important respects, this book suffers from the heavyhanded dullness which permeates so many psychological treatises like an anaesthetic these days. The author makes obeisance to all the modern shibboleths—the need of children for natural feeding, for proper toilet training, for affection, for security, for tolerance of their habits, etc., etc., but these just don't mean anything any more. They will make the children “integrated and harmonious”, “mature and adult”. One must “steer a middle course” … one yawns, the head nods—we know all those things, those things which sidestep the vital question of upbringing. What children really need for bounding mental health is to have parents who will make them intelligent, passionate, handsome, rich and proud. Excusably enough this book discreetly gives no directions for attaining such a goal.

But what makes this book unacceptable to a Maori (or a pakeha) as a blueprint for New Zealand's mental health is its totally secular nature. The author puts forward a picture of mental health which allows no room for religious sentiments or supernatural belief, no room for the driving force of myth and symbol which alone give life its radiance. His picture is one of rather out-dated gross and absolute materialism.

If Maori mental health is to improve it cannot be by the means he advocates. Rather it will have to come from the Maoris themselves, who have access to the treasures of their ancestors, treasures buried in their mythology and religion which need to be re-interpreted, infused with new energy to meet the demands of their descendants here in the world. There must be Maori psychiatrists and psychologists, more and more of them. (As far as I know there are only two in New Zealand at present.) They are the ones who will unlock the secret places, and who knows, might make a richer world for mankind.