Maori cultural adaptation of a brief mental health intervention in primary care

Abstract

INTRODUCTION: There are no brief psychological mental health interventions designed specifically for Maori in a primary care setting. AIM: To adapt an existing cognitive behavioural therapy–based, guided self-management intervention for near-threshold mental health syndromes in primary care, for Maori, and to examine its acceptability and effectiveness. METHODS: Semi-structured interviews with primary care clinicians and Maori patients were conducted to inform adaptations to the intervention. Clinicians were then trained in intervention delivery. Patients were recruited if they self-identified as Maori, were aged 18–65 years, were experiencing stress or distress and scored =35 on the Kessler-10 (K10) measure of global psychological distress. Patient and clinician satisfaction was measured through a questionnaire and semi-structured interviews. Post-intervention, patients’ mental health status was measured at two weeks, six weeks and three months. RESULTS: Maori adaptations included increased emphasis on forming a relationship; spirituality; increased use of Maori language and changes to imagery in the self-management booklets. Nine of the 16 patients recruited into the study completed the intervention. Patients and clinicians rated the intervention favourably and provided positive feedback. Improvement was seen in patients’ K10 scores using intention-to-treat rated global psychological distress following intervention. DISCUSSION: This study found that it was not difficult to adapt an existing approach and resources, and they were well received by both providers and Maori patients. Further research is required with a larger sample utilising a randomised controlled trial, to establish whether this approach is effective. KEYWORDS: Primary health care; Maori mental health; patient satisfaction; brief intervention