New Zealand's taxpayer-funded research industry has once again discovered the answer to a problem that nobody was asking.
This week's breakthrough revelation? Eating disorders apparently require a "Kaupapa Māori-led" response.
Not better access to treatment.
Not more specialist clinicians.
Not faster referrals.
Not increased psychiatric capacity.
Not more specialist clinicians.
Not faster referrals.
Not increased psychiatric capacity.
No, according to the latest academic wānanga (discussion workshop), what anorexia, bulimia and binge-eating disorders have really been missing all these years is another layer of cultural bureaucracy, another set of ethnicity-specific programmes, and another round of calls for "sustained investment".
The study itself contains some observations that are entirely sensible.
- Poverty can contribute to unhealthy eating patterns.
- Trauma can contribute to mental health problems.
- People with complex needs often struggle to navigate fragmented services.
- Specialist services can have workforce shortages.
In fact, none of it is uniquely Māori either.
A struggling solo mother in Invercargill, a family in South Auckland living week-to-week, or a teenager dealing with trauma in Christchurch face many of the same challenges regardless of ancestry.
Yet somehow every road leads back to the same destination: more race-based funding.
The article highlights "DPB eating", where families experiencing periods of financial hardship may binge when money becomes available. That sounds less like a cultural issue and more like a poverty issue. The solution would seem to be helping people escape hardship, improving access to treatment, and ensuring adequate mental health support.
But in modern New Zealand academia, ordinary social problems are rarely allowed to remain ordinary social problems.
Everything must be filtered through a cultural lens.
Everything must become a Treaty issue.
Everything must require a uniquely Māori framework.
The study also complains that mainstream services focus too heavily on weight-loss interventions while overlooking emotional wellbeing and trauma.
If that's true, then improve the treatment model for everyone.
A patient suffering from an eating disorder does not suddenly require a different standard of medical care because their great-grandparents belonged to a different tribe.
Mental health professionals should already be considering trauma, family circumstances, co-existing conditions and personal history. That's simply good clinical practice.
What is perhaps most remarkable is the growing tendency to treat cultural branding as a substitute for evidence.
Terms such as "whānau-centred", "culturally grounded", "Māori-centred assessment tools" and "kaupapa Māori knowledge" sound impressive, but the article provides little evidence that ethnicity-based approaches produce superior outcomes compared with well-resourced, accessible treatment available to all New Zealanders.
The assumption increasingly appears to be that if a programme contains enough Māori terminology, questioning its effectiveness becomes almost taboo.
Meanwhile the real issue receives far less attention.
New Zealand already struggles to provide adequate mental health services across the board. Waiting lists exist. Specialist staff are in short supply. Resources are stretched.
Those problems affect patients of every ethnicity.
Perhaps before creating separate frameworks, separate assessment tools, separate commissioning pathways and separate funding streams, we should focus on ensuring that every New Zealander suffering from an eating disorder can access timely, evidence-based treatment.
Because eating disorders do not check whakapapa before causing harm.
Anorexia does not discriminate by iwi.
Bulimia does not consult Te Tiriti.
And binge eating is not cured by replacing clinical language with cultural terminology.
The tragedy of eating disorders is that they are serious illnesses deserving serious treatment.
The tragedy of modern health policy is that increasingly every challenge must first pass through the race-relations department before anyone is allowed to discuss practical solutions.
Once again, New Zealand is being asked to believe that the path to better healthcare lies not through more doctors, more specialists and better services, but through ever more cultural frameworks, advisory groups and taxpayer-funded studies explaining why everything needs to be viewed through an ethnic lens.
Apparently even eating disorders have now been colonised.
Geoff Parker is a passionate advocate for equal rights and a colour blind society.
4 comments:
Indoctrination.
Health care people, please push back .
I don't believe that poverty contributes to unhealthy eating patterns. You can't be extremely poor and be fat, because food is expensive.
It is more likely that both obesity and poverty are caused by a lesser developed rational faculty - the language-based thinking thing you call 'I' and which distinguishes humans from other animals.
A weak rational faculty results in a lack of self-control with respect of eating.
The question then becomes, is rational faculty strength due to nature or nurture?
Having maoori manage courses in eating disorder is as irrational as maori running courses on contraceptin and famiy planning, albeit with less potential political gain with manipulation of food allergies. Whenever I walk through the local shopping centre food court I sit and observe the crowd. There is a very direct relationship between the mountain on the plate and the mountain consuming. It helps me understand how I have acumulated savings.
Barrie Davis raises a very interesting question: what exactly is the relationship between poverty and unhealthy eating habits?
When A and B occur together, it may be that A causes B, or B causes A, or both are cause by a third variable, C. Barrie seems to prefer the third option. Personally, I think all three apply. Healthy eating does cost compared with cramming oneself with nutritionally deprived kilojoules, so there is a case to be made for poverty causing bad eating where cheap kilojoules are involved. At the same time, spending money on 'fancy' highly processed foods can be even more expensive, so we have bad eating causing poverty. An outside factor influencing both is a lack of effective education about food, money and health. Such education would include removing unhealthy options from school canteens - preaching about healthy eating and having a canteen that sells kids fatty pies and bags of salty crisps and sugary buns laced with artificial cream comes down to "Do as we say, not as we do". Pupils must, of course, be able to process the information they are given, which brings in their ability to think rationally.
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