Handover | Issue 42 - July 2018

Lois Boyd, National SPEC co-ordinator, Te Pou o te Whakaaro Nui shares an important korero with Dean Rangihuna, Te Kaihapai – Māori Consumer Advisor – Canterbury District Health Board (CDHB), specialist mental health services. 

Ko Horouta toku waka  

Ko Waiapu toku awa  

Ko Hikurangi toku maunga  

Ko Hinerupe toku marae  

Ko Te Aopare toku hapū  

Ko Ngati Porou toku iwi   

Ko Dean Rangihuna toku ingoa  

The focus of this article was to be about Dean’s involvement in, and support of, the national Safe Practice and Effective Communication (SPEC) training, but as anyone who knows Dean will appreciate, it also has to be about the essential roles of consumer advisors, cultural perspectives, and authentic influence and inclusiveness in mental health and addiction services.  

Working at CDHB since 2005, Dean spent the first nine years working as the Māori consumer advisor 0.5 FTE and a further 0.5 FTE as a Pukenga Atawhai (Māori mental health worker), at the Hereford Centre, a community mental health team. In 2014, CDHB consolidated the Māori consumer advisor role into a fulltime one with the title ‘Te Kaihapai’ gifted by the late Taua Ruahine Crofts.  

Acknowledging the important role that others have played in supporting and influencing his career and development over the years, is clearly important to Dean and contributes to his significant depth of practice. He doesn’t walk alone and regularly refers to the immense support and help he has received from the Divisional Leadership Team, Service Leadership Team and Consumer Advisory Team, and the many clinicians throughout CDHBs specialist mental health service, Te Korowai Atawhai.  

Dean brings an impressive kete of cultural, personal, professional and systemic knowledge, skill and experience to his role, but it’s clear that what drives him is his heart. He works hard to influence a service where people seeking assistance have positive, respectful and useful experiences that are driven by what they and their families require.  

In his Māori consumer advisory role, Dean remains true to providing advice from a cultural perspective as his point of difference and considers his Turangawaewae, standing place, is Te Korowai Atawhai the Māori mental health service. He follows their philosophy of Aroha ki te tangata, providing a cultural cloak of care across the CDHBs specialist mental health service and being culturally responsive to the needs of tāngata whai ora, whānau and clinicians.  

Key aspects of the role include liaising with key tāngata whai ora stakeholder groups, participating in job interview panels, being involved in key clinical quality improvement project work and future service planning and training for clinicians across CDHB specialist mental health services.  

In addition to the Māori consumer advisory role, Dean continues to work as a Pukenga Atawhai (Māori mental health worker), two days a month to support a 24-hour crisis resolution service that includes Pukenga Atawhai staff as key members of the team. This team engages with tangata whai ora and whānau in both community and inpatient services.  

Dean states that he was honoured as a Māori consumer advisor to be involved in the first train the trainer workshop in SPEC, alongside staff from Counties Manukau, Nelson Marlborough and Westcoast DHBs. He continues to be actively involved cofacilitating SPEC training.  

Requiring consumer-leaders as trainers ensures that the training remains person-centred, and training scenarios can be situated and discussed as effecting real people, every day. Opportunities for discussion from a consumer perspective, greatly enhance trainee’s learning. This is particularly relevant when training discussions are about working with people experiencing distress, overwhelming thoughts and feelings, preserving dignity and mana, as well as the importance of pain and prone free techniques.  

Māori leadership involvement, promoting a Māori perspective and cultural approaches in SPEC training is also crucial to the emphasis on a least restrictive practice direction.  

A short time after training, Dean was also asked to contribute his cultural expertise to the National SPEC Governance Board. Being involved in SPEC clearly aligns with his professional values, and the strategic direction and vision he has for future services. Components of SPEC discussed as particularly important include the involvement of consumers in the training of staff, the importance of cultural and trauma-informed approaches, and the change to pain free techniques and a prone free approach.  

When asked about the secret to managing the complexities of his role, Dean talks about situating himself and the role as “working alongside the system.” He is clearly an integral member of the CDHB team, however there are often times in the role when there is a need to manage the tension between working in the system, but not always being required to support or represent it. In taking this approach he is able to critically reflect on and positively support and influence how services are delivered.  

The discussion about the tensions of systems vs person focussed ways of working in services prompted these considerations:  

  • How much of our ways of being at work are driven by systems imperatives vs responding in person-centred ways?  
  • How do workers, individually and as teams, manage and reconcile this pull between systems and person?  
  • How do workers personally and professonally navigate this with integrity?  
  • While some ways of working are driven by the practicalities and legalities of working in a large system, how much of it is about our own approach to our work?  

Time spent with Dean was a privilege and a valuable professional development activity that I know I will continue to reflect on over time. Dean’s role and his interpretation of it, is a best practice example of why consumer leadership roles must be authentically included as an essential element in positively delivering effective and relevant services.  

Acknowledgements from Dean regarding support of his mahi:  

The late Taua Ruahine Crofts, Kaye Johnston and Dr Alfred De Lario, Te Korowai Atawhai/Nga Pukenga Atawhai/Te Kahui Pou, Canterbury DHBs specialist mental health service and Consumer Advisory team Te Rau Matatini/Te Huarahi o te Kete Pounamu, Lucy Bush, Te Pora Ehau, Vi Anderson, Henare Te Karu, Nga tāngata whai ora and their whānau.