Abstract
Objective: The aims were to review progress in Indigenous mental health over the past 25 years and to identify possible directions for the next 25 years.
Method: Māori involvement in health and health care was used to illustrate key Indigenous developments since 1984. Challenges in the decades ahead were discussed in the context of demographic transitions, life course epidemiology, global trends, technological innovations and health leadership.
Results: Progress was measured by a range of indicators including Māori-referenced life expectancy, Māori agendas for health, strengthened cultural identity, the dissemination of health knowledge, and Māori participation in the health sector. In contrast to being ready to respond to change (future takers), active planning for the future (future makers) was seen as a better way of achieving Indigenous aspirations. One option for health advancement currently being developed in New Zealand involved an integrated approach premised on intersectoral delivery and a focus on families.
Conclusions: Indigenous health will be advanced by dedicated approaches to family wellbeing that avoid fragmentation, focus on positive strengths, and lead to positive outcomes for family members and the family as a whole.