<p>This thesis explores how rangatahi Māori and whānau define and experience self-injury in Aotearoa. The dominance of the current Western knowledge base that contributes to psychology in Aotearoa is questioned, specifically regarding the extent to which current knowledge adequately explains self-injury in rangatahi Māori. To do this, I use a mixed-methods approach that is informed by the principles of kaupapa Māori (G. H. Smith, 1997), Māori-centred (Cunningham, 2000) and interface research (Durie, 2005). Our current understanding of self-injury in rangatahi Māori is informed predominantly by international research and models grounded in worldviews that differ from the unique cultural context in Aotearoa. These definitions, such as that for “non-suicidal self-injury” (Zetterqvist, 2015), and models, such as the Experiential Avoidance Model (Chapman, Gratz, & Brown, 2006), are then applied to the assessment and treatment of rangatahi Māori. In this thesis I highlight why these Western definitions and models become problematic when they are incongruous with the behaviours that rangatahi Māori define as ‘self-injury’ and, as such, fail to consider the unique, complex and diverse experiences of rangatahi Māori who self- injure. The quantitative study involved cross-sectional survey data collected from 343 rangatahi who identified as Māori in the Youth Wellbeing Study. This survey data provided initial insight into the prevalence and correlates of self-injury in rangatahi Māori. In the second study, sequential focus groups were conducted with 25 rangatahi Māori and their whānau. The principles of Interpretative Phenomenological Analysis (J. Smith, 2004) informed the qualitative data analysis. Definitions of behaviours that rangatahi Māori and whānau considered to be self-injury were broad and varied, including harm to wairua (essence, spirit) of the rangatahi and their whānau. Reasons for self-injuring included experiencing intense emotional pain, for example, that which was caused by peers. The most common functions of self-injury endorsed by rangatahi Māori were to express emotional pain, to communicate distress, to maintain a sense of control over their lives, and to manage their suicidal thoughts. It is my intention to produce research that is directly relevant to rangatahi Māori, whānau, the broader community and the clinical profession. In the final chapter of this thesis I answer the question ‘how do we support rangatahi Māori who self-injure?’. I frame these answers by adapting whakataukī (proverb) ‘e kore au e ngaro, he kākano i ruia mai i Rangiātea’ (I will never be lost, for I am a seed sown in Rangiātea). I argue that, while we as Māori should never feel lost when we know who we are and where we come from, many rangatahi feel as though they are lost, and self-injury is one means of coping with this sense of struggle. For rangatahi Māori in this research, self-injury is differentiated from suicide by the concept of hope; suicide is a loss of hope whereas self-injury is a means of holding on to hope. By understanding it in this way, self-injury can form a target for early intervention and prevention of suicide.</p>
Public Health Workforce Burnout in the COVID-19 Response in the U.S.
