Abstract
To the Editor
We read with interest the paper by Sanders and colleagues (Sanders et al., 2011) investigating the perceptions of schizophrenia among Māori and non-Māori. It is pleasing to see research that attempts to give voice to the experience and views of tangata whaiora regarding their illnesses and future. However, the presentation and interpretation of the findings in this study raise some concerns. The authors introduce historical Māori views of mental illness such as described by Te Rangi Hiroa (Sir Peter Henry Buck) in the early 20th century and appear to intimate the renaissance of Māori culture may mean a return to these beliefs about mental illness and may subsequently contribute to reduced medication compliance. This assumption pervades the title, discussion and conclusions despite their results demonstrating the general lack of difference between Māori and non Māori views.
While the potential selection bias is acknowledged this warrants highlighting. The sample consisted of 68 Māori who were all high users of mental health services, with unknown duration of illness, interviewed by mental health consumers with a response rate as low as 55% to the causal beliefs question. Furthermore the causal beliefs section is described as open-ended and would have been better presented using a qualitative research method. Concluding that ‘differences between Māori and New Zealand European patients’ beliefs about mental illness may be related to Māori traditional beliefs about mental illness’ seems an exaggeration of the generalizability of this study given these concerns, along with the results failing to demonstrate this difference.
If this study had been presented as ‘Māori and non-Māori shared attitudes to medication’ and the positive attitudes to medication emphasized, this may have aided combating some psychiatrists’ views such as ‘Māori just don’t take medication’ as previously identified in research in this journal (Johnstone and Read, 2000).