Wihak, C. (2004). Psychologists In Nunavit: A Comparison of the Principles Underlying Inuit Qaujimanituqangit and The Canadian Psycological Association.
Abstract: The Nunavut territorial government is the first public government in
Canada (and possibly the world) to be shaped fundamentally by an Aboriginal
world view. When the Nunavut government revises legislation governing the
profession to reflect Inuit Qaujimanituqangit (IQ), Inuit traditional knowledge,
Nunavut psychologists will need to question very deeply whether the
ethics of the profession are compatible with Inuit ethical values. As one of
the small number of psychologists registered in Nunavut and a researcher on
health-related issues in the territory, this is a very personal ethical dilemma.
But it is one that I share with any member of a regulated health profession
who is involved in research or practice in Nunavut and who strives to follow
the code of ethics established by his/her professional body.
In this paper, I begin an exploration of the compatibility of Inuit values
and those of professional psychologists by comparing IQ principles (Arnakak
2002, Department of Health and Social Services 1999) with the Code of Ethics
of the Canadian Psychological Association (CPA 2000). This exercise was helpful
to me personally in understanding what I learned during many years
spent in Nunavut and in suggesting directions for further investigation of
ethical questions and value conflicts. I hope it may prove of assistance to
psychologists and other health professionals doing health-related research
in Nunavut or in other Indigenous communities with world views similar to
that of the Inuit.
Mental Health Commission. (1998). Clinical Accountability within the Mental Health Sector. 57, .
Abstract: Accountability within mental health services has been thrust to the forefront as an issue for the
mental health sector over recent years, largely within the context of the move from institutional
to community based care for people with serious mental illness. Very little information has
been available regarding the range of issues seen as needing attention within the sector. This
review of clinical accountability within mental health services has occurred as part of a wider
process of information gathering undertaken by the Mental Health Commission to facilitate
accurate strategic planning for the national development of mental health services.
A project team representative of the major stakeholder groups within mainstream mental health
services was commissioned and given the brief to undertake a “snapshot” review of practice
regarding clinical accountability, identify key issues which are highlighted during the review
and make recommendations regarding developments which might be necessary to improve
accountability of mental health services. In approaching it’s task, the project team soon
realised that clinical accountability is an elusive concept, and that there is a lack of shared
definition and of a framework for understanding both clinical accountability and the wider
accountabilities within the health sector. A review of the literature regarding accountability in
health services was thus undertaken. To canvas opinion within the range of stakeholder
groups, two complementary questionnaires were developed – one for providers of services, and
one for people receiving services (consumers and family members). These questionnaires were
designed to be used in a semi-structured interview format, and sought respondents’ views
regarding a range of issues and aspects of clinical accountability. Visits were then made to one
urban and one rural health area in each region of New Zealand, and interviews conducted with
the range of stakeholder groups of mental health services.
The literature review revealed that the lack of shared definitions and frameworks for
understanding accountability in the health sector is a universal phenomenon, and a number of
suggested frameworks and models were found in the literature. An excellent review of
accountability in health care (1) outlined three components of accountability (Who – the locus
of accountability, What – the domains of accountability, and How – the procedures of
accountability), which interact to create a matrix of accountability. The three dominant models
of accountability which prevail are then outlined – the professional model (which equates to
clinical accountability), the economic model (the accountability of the market place), and the
political model (the accountability of the political sphere). The fact that these models cannot
readily be integrated and in fact may be in conflict with one another is highlighted. The three
components of accountability suggested helped to frame the analysis of data, and have been
used in reporting the findings and outlining the conclusions of the project.
The findings of the project affirmed the elusiveness of the concept of accountability, and the
need for development of shared definitions and frameworks for understanding and debate within
the sector. While there was a notable diversity of viewpoints and opinions expressed, a number
of important trends were evident. It was apparent that while all services visited had some
structures and processes to support accountable practice, there was significant variation in the
extent to which these were developed, and how helpful and effective they were found to be by
those working in and those using services. Overall it was clear that whilst all of the services
visited had some systems in place to address issues of clinical accountability, there is a great
need for development in this area, and for resolution of a number of important areas of
differing opinion which are likely to compromise accountability of practice.
Mental Health Commission. (1997). Early Intervention and Prevention in New Zealand.
Abstract: Early intervention is multi faceted and should take account of people who are accessing the service for the first time, those who have relapsed since first contact with the mental health service and those who are living in smaller and sometimes isolated communities. Furthermore early intervention must consider not only the changing needs of the population but also the changing needs of the workforce who are assigned the task of meeting those needs. For the purpose of this workshop there was a clear distinction made between people presenting for
the first time with a mental illness and people who have presented previously with a mental illness and have subsequently relapsed. The issues and ongoing treatment of these presentations are quite different. However there is a demand for early intervention services and strategies to deal with both types of presentation. To keep this distinction intact the group decided that the term Early Intervention and Prevention Programme (EIPP) would address both concepts and so this term is used throughout this report
Mental Health Commission. (2004). Journeys Towards Equality.
Abstract: Journeys Towards Equality describes and analyses all the major work in New Zealand to counter discrimination against people with experience of mental illness. As the size of this report suggests, there is a lot of it going on in many agencies and sectors. Yet most of this work has only started in the last decade.
An initial major development was the amendment of the Human Rights Act in 1994 to include protections for people with disabilities. In the same year the Office of the Health and Disability Commissioner opened. The Mental Health Commission, with its mandate to reduce discrimination, started operating in 1996 and published the Blueprint in 1998. In the same year the Like Minds, Like Mine project began. The Ministry of Health’s 1997 mental health strategy, Moving Forward, included an anti-discrimination objective, although no targets were set. Also in 1997 the national Mental Health Sector Standards created a standard for promoting community acceptance of people with mental illness. And in 2001 the government published the New Zealand Disability Strategy, before setting up the Office for Disability Issues in 2002.
Wikaere, E., & Ratima, M. (2011). Maori Participation in The Physiotherapy Workforce. Pimatisiwin: A Journal of Aboriginal and Indigenous Community Health, 9(2).
Abstract: Aims: This research aims to identify barriers and facilitators for Māori participation and retention in the physiotherapy workforce to inform evidencebased policy and intervention to strengthen the Māori physiotherapy workforce. Methods: A kaupapa Māori research approach was taken. Ten stakeholders participated in in-depth key informant interviews using a structured questionnaire. Thematic analysis was carried out within a kaupapa Māori approach. Results: Māori face significant barriers to participation in the physiotherapy workforce at the systems, organizational, and individual levels. Some interventions have been established to address disparities and facilitate Māori success in physiotherapy education, recruitment, and retention in the physiotherapy workforce. However, existing interventions are not comprehensive and are limited in scope. Conclusion: A comprehensive approach to Māori physiotherapy workforce development is required that draws on learnings from the experiences of other disciplines and fields, such as medicine and mental health. Account must be taken of the broader determinants of Māori physiotherapy workforce participation, for example, social, economic, political, and cultural factors, and should address individual, organizational, and structural level barriers.
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