Developing Citizens: Missed Opportunities in Health and Social Service Provision? A View From Aotearoa New Zealand

Abstract

This article is a reflection on an evaluation of multisystemic therapy services in Aotearoa New Zealand, established to treat young people aged 12–16, for alcohol and drug misuse and to decrease unwanted or “antisocial” behaviors. The therapy engaged parents/caregivers in a systems approach and did not require the young person to be directly engaged. This raised three issues. First, because the young people were not active participants, the services missed the opportunity to help the young people develop skills of self management. Second, this lack of engagement created a missed opportunity to engage the young person to re-establish or reconnect relationships that had been harmed. Finally, we reflect on the cultural fit of the service with Māori values. These issues raise a number of questions about the aims of service provision with young people and the assumptions that underpin particular types of service.

KEYWORDS:

• alcohol
• citizenship
• drugs
• ethnicity
• exclusion

ACKNOWLEDGMENTS

Thanks to the families and whānau, the service providers, and the stakeholders who participated in the evaluation, as well as the other members of the evaluation team: Barry Murray, Jaimee Thompson, Ann Flintoft, Jess Senior, Josh Palmer, and James Tait. The evaluation was funded by Hutt Valley District Health Board. Thanks also to Marian Barnes and the anonymous reviewers for helpful comments on an earlier version of this manuscript.

Notes

Māori are the indigenous people of Aotearoa New Zealand and comprise some 14% of the total population. However, Māori youth/rangatahi—those younger than 24 years of age—comprise 53.2% of the total Māori population (Ministry of Health, 2013).

Māori terms are used throughout this article with a translation. We would like our readers to know that while we have provided some western definitions of Māori concepts, we recognise their inadequacy as it is not possible to capture the entirely different philosophical underpinning of Māori knowledge and ideas. Our translations are taken from Mead (2003).

Meeting area of a village or settlement, including its buildings and courtyards.

Mainstream services are those which deal with Māori as merely part of the larger population of New Zealand. Mainstream services are expected to be “responsive to” Māori and reflect Māori perspectives both in their policy and in their practice (Cunningham & Durie, 1999).

The sixteen interviews undertaken in the comparison site do not feature as part of this analysis, as the site did not offer a MST service and the young people self referred and participated in the service.

In this instance, for a number of years the young person had been attending an alternative education center at the marae, rather than attending mainstream school, and had been receiving alcohol and drug counseling, traditional arts skills, and mentoring, and continued to work toward mainstream education qualifications. The young man referred to the marae as his “second home”.

Kaumatua refers to a tribal elder.