Jerry Coyne: Indigenous psychiatry - how valuable is it?

I’ve written a lot about how New Zealand is valorizing indigenous knowledge, and the educational system is on the path to teaching Mātauranga Māori (“MM”)—a mixture of myth, legend, practical knowledge acquired by trial and error, and spirituality—as “science”, coequal to science in science classes. There is some science in MM, but as a whole it is certainly not the same thing as modern science, and many of its claims are either dubious or palpably false. To teach MM in science classes is to deprive the children of New Zealand of an understanding of science.

Many New Zealanders seems to regard everything about its indigenous people as not only valid, but admirable. A lot of it is, but many Kiwis are too cowed to stand up to some of the more questionable claims of the Māori, including the claim that their Polynesian ancestors discovered Antarctica centuries ago. I know about this fear because Kiwis who do stand up against nonsense get persecuted, and I get emails from lots of them who agree with me but say that they dare not speak up because they’ll lose their jobs.

The latest effort to “indigenize” knowledge is the bestowing of a huge pot of money on Māori organizations to use “ancestral knowledge” to help cure mental health issues among the indigenous people. This is described in the Newshub article below, which you can click to read:

The article notes that “The new Māori Health Authority has a budget of half a billion dollars and CEO Riana Manuel has allocated $100 million of that to support centuries-old treatments.”

And there is a need for treatment, for the article also notes this:

Māori have the highest suicide rates of all ethnic groups in New Zealand. Mental distress among Māori is almost 50 percent higher than non-Māori and 30 percent are more likely to be left undiagnosed.

Now of course we can’t attribute this to problems that are unique to Māori, as I doubt there was a control for levels of income and other stressors that differ among ethnic groups. But there is a push to use Māori-centered therapy to cure mental illness in that ethnicgroup, and 100 million dollars for using “centuries-old treatments” is a lot of money.

What are these treatments? It’s not clear, but they’re based on lunar cycles and what can only be called psychoastrology. It’s confusing because the article is, as so often happens in Kiwi news, larded with Māori terms that even non-Māori can’t understand. See if you can suss it out:

Not so well known to non-Māori is their tradition of using the moon and stars to help treat mental health issues.

It’s called maramataka and will be incorporated into treatment by the new Māori Health Authority.

Rereata Makiha is on a mission to share ancestral knowledge with the next generation.

He’s an expert on maramataka Māori, or the Māori lunar calendar, and forecasting based on the moon cycles, star systems, tides, and the environment.

“The maramataka helps you, helps us to predict when things are going to happen, to tell us when the fish are going to run, when the eels are going to run – all those sorts of things,” he said.

“When you understand it a lot it’s a brilliant guide on when you should be doing certain things.”

Rikki Solomon teaches at-risk rangatahi and whānau how to use maramataka for improving mental health and knowing when to spend time doing certain activities in nature or around whanau.

“If we find that a whanau has had a low time or they may feel low, what we use is the maramataka to identify their cycles, their highs, and their lows,” Solomon said.

“What we observe in those low areas is what are some rituals at that time. And what I mean about rituals is what is the environment that they can connect to, because our environment is our biggest healer.”

That doesn’t really clear things up, but here’s more on the practice, with quotes from Riana Manuel, CEO of the Māori Health Authority:

“Connecting people back to those spaces and places that have been long forgotten is certainly something that will be investing in,” Manuel said.

Just like they do with Matariki, Māori use maramataka as a way of reading the cosmos to prepare for what’s coming.

“It’s a way of rebuilding the body, your wairua, and rebuilding your energy and getting prepared for the high energy days ahead,” Makiha said.

“So it goes in waves like that and if people understand it and go back to that rather than rush, rush, rush every day, I think that’s what drives a lot of the ill-health.”

If you can figure out what they’re doing from this, you’re a better person than I am.

Now there may indeed be a benefit to using Māori practitioners and ancient Māori practices to treat mental illness. After all, people often feel that therapists who have a background similar to their own are more desirable. Women, for example, often feel that a woman therapist will treat their problems better, and the same goes for ethnic minorities. So there may be something to shared experience and background that is therapeutic (there’s also, of course, a placebo effect).

My criticism here is simply that these practices are being adopted in the absence of clinical trials, and so there is only a “traditional” basis for the therapy. Might Māori be helped more with other practices, like cognitive behavioral therapy, practices that have been tested and shown to be efficacious? Or even medication, which has a significant effect on things like depression. (A combination of talk and drug therapy seems to be the most curative).

As a colleague wrote me, this absence of scientific testing of a method that will absorb $100 million is the same issue raised with MM: what is claimed (or assumed) to be “scientific” has not been vetted using the scientific method. To quote the colleague:

This is exactly the problem that led me to raise concerns about MM versus science in the first place. We now have two alternate sets of “facts.” One is based on scientific evidence, and the other may be supported by some evidence but has never been tested in a way that would be considered acceptable for medical science.

Mental health is a form of health, and this is like treating diseases using astrology and “traditional methods” that have never been subject to genuine scientific tests. Doesn’t it seem wise, before investing $100 million in mental-health treatment, that the government of New Zealand be sure that those treatments actually work?

Sadly, that’s not the way the New Zealand government rolls.

Jerry Coyne is an American biologist known for his work on speciation and his commentary on intelligent design, a prolific scientist and author. This article was first published HERE