The inquiry into abuse in care has been told that a lack of cultural recognition in the treatment of mental health patients is a form of abuse.
Leota Dr Lisi Petaia says it is important to strike a balance between cultural and clinical approaches to the care of Pacific patients.
The Royal Commission of Inquiry into Abuse in Care is holding its Pacific hearing in South Auckland.
Leota Dr Petaia, who is the only Pacific forensic psychiatrist in the world, said to increase the understanding of Pacific people's behaviour, clinicians must learn about Pacific people's history of migration to New Zealand, their values, belief systems, the impact of the dawn raids and why they are over represented in mental health services.
''The need to have multi-disciplinary professionals who are well trained clinically and culturally, so it's a true integration of these concepts in terms of managing people. It is a broad understanding of people, rather than just a medical, western kind of mono-cultural system.''
She said mandatory cultural training for doctors and nurses working in mental health is important.
''I have been clinically trained well so I am sure people should be engaged in good cultural training and the medical profession, not just medicine, but doctors, nurses, social workers and cultural workers as well. We don't want Pacific people in mental health services just because they are Pacific and can speak the language. They need technical, good knowledge of what they are dealing with.''
Petaia said, even when they actively seek care, Pacific people often don't receive the high quality and timely services they need.
She said the mental health services should adopt a Fonofale model, which places emphasis on involving a patients family in their care and reflects Pacific cultural values.
''These are values that are not really emphasised in the main stream western medical paradigm that is predominant in New Zealand.''
She was closely questioned by the chair of the Royal Commission, Judge Coral Shaw, who asked her bluntly, did she think the failure to provide any form of cultural recognition, appropriate treatment, appropriate engagement with Pacific people is a form of abuse.
''Absolutely, yes,'' was her reply.
Petaia said 24 percent of the Pacific population in this country experienced mental distress compared to 19 percent of the general population, but only 25 percent receive treatment, compared with 58 percent of non Pacific people.
Alternatives not considered
Rachael Umaga had 11 admissions to psychiatric care over a 21-year period, starting at the age of 22.
She said she was always over medicated and that doctors were unwilling to consider alternative treatments.
Umaga said, over the years, she was diagnosed with many things and believes they were just labels to justify her admissions.
''To me I felt that I was labelled with particular medical conditions that gave medical professionals a licence to pump me with more drugs. I believe they were just experimenting with their drugs on me.''
She is calling for the establishment of an independent advocacy service for inpatients of mental health units.
''I believe there needs to be a focus on addressing the workforce in developing care practices and policies that address the needs of patients. Not only the medical model, but alternative ones as well.''
Umaga said changes to the future of mental health care are needed and the best place to start is with consulting survivors.