Experiences of physical healthcare services in Māori and non-Māori with mental health and substance use conditions.

Journal: The Australian and New Zealand journal of psychiatry

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Affiliated Institutions:  Department of Public Health, University of Otago, Wellington, Wellington, New Zealand. Māori/Indigenous Health Institute (MIHI), University of Otago, Christchurch, Christchurch, New Zealand. Department of Psychological Medicine, University of Otago, Wellington, Wellington, New Zealand.

Abstract summary 

Inequities in physical health outcomes exist for people with mental health and substance use conditions and for Indigenous populations (Māori in Aotearoa New Zealand). These inequities may be partly explained by poorer quality of physical healthcare services, including discrimination at systemic and individual levels. This study investigated the experiences of people with mental health and substance use conditions accessing physical healthcare and differences in service quality for non-Māori relative to Māori.A cross-sectional online survey of people with mental health and substance use conditions in New Zealand asked about four aspects of service quality in four healthcare settings: general practice, emergency department, hospital and pharmacy. The quality domains were: treated with respect; listened to; treated unfairly due to mental health and substance use conditions; mental health and substance use condition diagnoses distracting clinicians from physical healthcare (diagnostic and treatment overshadowing).Across the four health services, pharmacy was rated highest for all quality measures and emergency department lowest. Participants rated general practice services highly for being treated with respect and listened to but reported relatively high levels of overshadowing in general practice, emergency department and hospital services. Experiences of unfair treatment were more common in emergency department and hospital than general practice and pharmacy. Compared to Māori, non-Māori reported higher levels of being treated with respect and listened to in most services and were more likely to report 'never' experiencing unfair treatment and overshadowing for all health services.Interventions to address discrimination and poor-quality health services to people with mental health and substance use conditions should be tailored to the physical healthcare setting. More needs to be done to address institutional racism in systems that privilege non-Māori.

Authors & Co-authors:  Cunningham Imlach Haitana Clark Every-Palmer Lockett Peterson

Study Outcome 

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Statistics
Citations : 
Authors :  7
Identifiers
Doi : 10.1177/00048674241238958
SSN : 1440-1614
Study Population
Male,Female
Mesh Terms
Other Terms
Mental and substance use disorders;discrimination;health services;patient experience;physical health
Study Design
Study Approach
Country of Study
Publication Country
England