MENTAL ILL-HEALTH

Te Ao Hou, December 1960, Page 8

MENTAL ILL-HEALTH This is an aspect which has held very little interest until recently and is often not recognised for what it is. We find that every country in the world has the same problems, in different forms, as we have here. (1) Intelligence Quotient level. When we think of mental ill-health, we must think of the child in the beginning, and among the Maori people, you have a tremendous proportion with depressed I.Q.'s. People with normal intelligence quotients are said to have an I.Q. of 100. Very frequently, when Maoris, especially from rural districts are tested, they are found to have an I.Q. level much below what is normal. This is partly a cultural difference in that it shows, I feel, that the Maori is not able to perform in the different European culture as well as he might if he were left in his own Maori background. Not only has the Maori difficulties in contending with different cultural background, but he also suffers from the difficulty of being bi-lingual. It is not easy for him to answer questions which rely on language skills. When a person is bi-lingual, although he has advantages in social intercourse with the two races, he usually learns a much smaller vocabulary. This vocabulary tends to be much larger in a mono-lingual person. It has also been found that even where two races are brought up with fairly similar cultural backgrounds, there will be an I.Q. that is not de-

veloped when the standard of home conditions is depressed in one section of the community. This has been argued out many times, and by many people it has been felt that these are inherited racial differences. But most evidence points to the fact that a child's I.Q. will not dvelop normally if it has not been properly fed and given a reasonable physical environment, even in the first twelve months of its life. Southern Negroes in rural districts for instance, have an I.Q. level of only 50 whereas in a city like Los Angeles, where Negroes are tolerated fairly well and have better standards of home conditions and opportunity of education, then their I.Q. level is about 102. 2. High Accident Rate. Liability to accident is usually classed with mental ill-health because it is associated with lack of co-ordination and lack of awareness of one's environment. We find also that the Maori clings to life a good deal less than the European does. I think that most Maoris have a firm belief in an after-life. They enjoy this life in a happy-go-lucky carefree way, but they are fairly certain in their own minds that life will continue in the same way among their ancestors. This certainty of the hereafter is not quite so marked in the European who tends to cling to the life he knows and to what is more certain to him, with an obvious lack of faith in the promises of an after-life. This factor, plus the rural background in which most Maoris live, with their rutted back roads, old ramshackle trucks crowded with people, and what the Statistics Book calls “general carelessness”, all produce a very heavy accident rate. 3. Anxiety Neurosis. In most countries in the world there is no increase in the amount of psychosis. This is a disease which results in a complete change of personality. All over the world, however, there is an increase in neurosis: a state where there is no change in personality but an alteration of the emotional centre of the brain, resulting in chronic tension and fear and a great variety of physical complaints. We do not know how frequently neurotic conditions exist among the Maori people, because if we examine their physical complaints, we see that very frequently he does not take his illness to his doctor. He suffers his illness until it is too late to do anything about it. This is the reason why, when he is attacked by a disease such as cancer or diabetes, he usually dies because the treatment comes to him too late for anything to be done. We know, however, that neurosis is increasing in countries such as China and Kenya. In most countries in the world, anxiety states arise in this way, and many points are applicable to the Maoris. Two-thirds of the world's population is underfed, and with easier communications between countries such as radio, planes and ships, these people realise that chronic hunger is by no means the state of things in some other countries. People in other countries want food; they associate education with an improved economy; they send their children to school where they speak not in their own language but in English, French or Portuguese; they learn other customs. Communication between parents and children becomes difficult. In Asia and Latin America they have lived like the Maoris in what is called an extended family system which includes grandparents, uncles and aunts and there is a wonderful sense of security because there are several mothers and fathers to look after all the children. Now this extended family system is beginning to crumble and people are beginning to suffer from what is known as “identity confusion”; they do not know to what group they should give their loyalty, with what group they should identify themselves. Perhaps they feel they would like to identify themselves with one group and yet when they return to their own families, they feel different there, too, and don't fit in. This causes anxiety and breakdown, social unrest and industrial unrest. We need a very positive sense of our own identity; we need to know that we belong to a certain racial group, that it is a remarkably organised group and very important in its own world. If you know the important things about your own racial group, not just the waiatas and hakas but the sort of things that were important to our ancestors—the history of the race, the knowledge of the birds and the forests, and the knowledge of the stars and the seasons, then you can see that it was a very well-developed racial group and you feel a security that makes you feel that you don't have to compare yourself with any other racial group. To know this is to know the security of exactly where you belong. 4. Delinquency. The obvious breakdown in the mental health of the Maori people occurs in their delinquency problem. This differs from the European in that Maori crime, like European crime, which is almost entirely centred about the urban area, occurs 50% in urban areas and 50% in rural areas attached to their home situation. While most Europeans suffering from delinquency come within normal intelligence, the Maori intelligence level is lower than normal. I feel that this is probably not a true indication of the intelligence of the Maori but rather a depressed I.Q. level, indicating that the Maori has not yet adapted himself to the European culture and is finding difficulty in adjusting himself to it, and also difficulty in expressing himself in the English language. In his own cultural background, the activities of the Maori have previously been controlled by a group, by the strength of his religion and by the strength of his tribal leaders. In most districts, the tribal leaders no longer have a strong control over their people. The extended family system that we have spoken of earlier is disintegrating, sometimes for economic reasons. People are finding it difficult to live on a farm that will support one

small family unit only, but not all their aunts and uncles, their cousins and perhaps their grandparents. Another difficulty is also one which we have mentioned earlier, with children gradually changing so that they have not a great deal in common with their parents. Then we have this state of identity confusion arising. People do not quite know where they belong, and they feel at home in no society. Man is a gregarious animal and when he does not feel secure in any situation, he suffers from fears and tensions. The neurotic, when he suffers from these fears and tensions, keeps his anxiety within himself and perhaps he might not be an efficient economic unit, but on the whole he usually manages to keep going. A delinquent, on the other hand, will suffer anxiety only to the point of discomfort, and then get rid of all these anxieties, these fears and these tensions in acts of aggression against the environment which he feels is so hostile towards him. When he suffers from this anxiety and expiates it in the form of aggression he feels a bit guilty about it and his guilt feelings again build up into anxiety feelings and you have this pattern of insecurity—anxiety—aggression—guilt—back to anxiety again. This is the reason for the type of crime we have among the Maoris; the crimes of assault, rape and homicide which are so high. It is the casting out of all his fears and his insecurity against society. This form of acting out is something which I think the Maori has been practising for many years. When he goes into battle for instance, he works out any fears and tensions he might have in performing his hakas. When he has his tangis, he works out his sorrow and grief in the form of weeping and wailing. For many generations, therefore, it has not been his habit to contain unpleasant emotions within him. Many psychiatrists think that this acting out is perhaps a healthier method of living, because emotions do not build themselves up to create unhappiness in the person. With the lack of group control among the Maoris, however, you can see that it can take this unfortunate form of delinquency. I feel very strongly that this pattern of Maori crime should be treated as a mental illness of the people and that the community should insist on treatment so that they can be assisted in their adjustment to society rather than a purely punitive attitude taken towards them. I had in mind the training schools instead of the enclosed prison system which exists at present. Because Maoris, in working out their difficulties in this manner, tend to aggressive crime, then they are frequently confined to closed prisons; a better adjustment might be made in a training school. These people, once they have been confined for an aggressive crime, suffer under grave disabilities, because all too frequently, their own people turn against them and disown them. I feel that Maori people look upon crime as a shame and a stigma on the race, instead of realising that it is just part of the adjustment and part of the price we have to pay for this adjustment between two greatly different cultures. small family unit only, but not all their aunts and uncles, their cousins and perhaps their grandparents. Another difficulty is also one which we have mentioned earlier, with children gradually changing so that they have not a great deal in common with their parents. Then we have this state of identity confusion arising. People do not quite know where they belong, and they feel at home in no society. Man is a gregarious animal and when he does not feel secure in any situation, he suffers from fears and tensions. The neurotic, when he suffers from these fears and tensions, keeps his anxiety within himself and perhaps he might not be an efficient economic unit, but on the whole he usually manages to keep going. A delinquent, on the other hand, will suffer anxiety only to the point of discomfort, and then get rid of all these anxieties, these fears and these tensions in acts of aggression against the environment which he feels is so hostile towards him. When he suffers from this anxiety and expiates it in the form of aggression he feels a bit guilty about it and his guilt feelings again build up into anxiety feelings and you have this pattern of insecurity—anxiety—aggression—guilt—back to anxiety again. This is the reason for the type of crime we have among the Maoris; the crimes of assault, rape and homicide which are so high. It is the casting out of all his fears and his insecurity against society. This form of acting out is something which I think the Maori has been practising for many years. When he goes into battle for instance, he works out any fears and tensions he might have in performing his hakas. When he has his tangis, he works out his sorrow and grief in the form of weeping and wailing. For many generations, therefore, it has not been his habit to contain unpleasant emotions within him. Many psychiatrists think that this acting out is perhaps a healthier method of living, because emotions do not build themselves up to create unhappiness in the person. With the lack of group control among the Maoris, however, you can see that it can take this unfortunate form of delinquency. I feel very strongly that this pattern of Maori crime should be treated as a mental illness of the people and that the community should insist on treatment so that they can be assisted in their adjustment to society rather than a purely punitive attitude taken towards them. I had in mind the training schools instead of the enclosed prison system which exists at present. Because Maoris, in working out their difficulties in this manner, tend to aggressive crime, then they are frequently confined to closed prisons; a better adjustment might be made in a training school. These people, once they have been confined for an aggressive crime, suffer under grave disabilities, because all too frequently, their own people turn against them and disown them. I feel that Maori people look upon crime as a shame and a stigma on the race, instead of realising that it is just part of the adjustment and part of the price we have to pay for this adjustment between two greatly different cultures. Delinquency also frequently occurs when a child identifies himself with a parent who is also disturbed, and tends himself to act out his difficulties in impulsive and aggressive behaviour. I think this is the commonest reason for which Maoris come to see me professionally. It is most frequently a tired mother with several children who have arrived in rapid succession, who in her over-worked worn-out state becomes extremely aggressive and irritable towards her husband and children. She realises that she is providing an unsatisfactory home background for her family, but she cannot help herself. She wants to do the best for her family, but she can't, so she comes to me, to learn how to contain her fears and tensions within herself and keep this pattern of aggression from affecting the next generation. In conclusion, I think that a large proportion of our difficulties lies basically in our large birth-rate of 45:1000 people. If we have 50% of our population under the age of fifteen, then we must be tired, over-burdened, over-worked women who are not able to look after our children or provide them with the security, the loving care and affection that they need. It is because women are tired that they do not always dress their children properly, that they feel so enervated that they cannot hand out the necessary tablets. I am sure too, that the over-drinking of the men is caused by the lack of home comforts within the home where the noise of over-crowding cannot make for a peaceful life. The total picture is really not as bad as it sounds. With the natural increase rate of 37.57 per 1000, the Maori race is riding a great wave of expansion, but we must compare this figure with the figure of our birth-rate which, in 1958, was 46.25 per 1000 and realise the tremendous wastage in which we are involved. Pregnancy is a tiring, wearying business for most women, and we must realise that this energy would be better spent in raising fewer children, keeping more alive and educating these ones better, rather than these large numbers, trebling or quadrupling the European death-rate. We can only give health to people who want health. And so, the only way to make the Maori people want health is to talk to them in as many places and to as many groups as possible. I am quite sure that if the birth-rate were lowered, then women would have more energy to devote to the physical and natural needs of their children. Sir Maui Pomare, in his Official Report on Maori Health in 1906, stated: “We have looked into the question of the decline of the Maori and found that the causes were legion. Bad housing, feeding, clothing, nursing, unventilated rooms, unwholesome pas, were all opposed to the perpetuation of the race, but a deeper knowledge of the Maori reveals to us the fact that these are not the only potent factors in the causation of this decay. Like an imprisoned bird of the forest, he pines for the liberty and freedom of his Alpine Woods. This was a warrior race, used to fighting

for liberty or to death. All this has gone: fighting is no more. There is no alternative but to become a Pakeha. Was this saying not uttered by the mouth of a dying chief many generations ago: ‘Kei muri i te awe kapara he tangata ke, mana kao, he ma.’ (Shadowed behind the tattooed face a stranger stands, he who owns the earth and he is white.') The fear of extinction of the Maori race with its loss of morals and confidence has passed. There is a new resurgence of the Maori people who should now strive towards higher standards of health, better education and a better economic level for their children. No longer does the Pakeha stand “a stranger behind the tattooed face”, because the Maori should take into his hands the heritage of the culture of his forefathers, certain and proud of his own identity, so that he can mix freely with the Pakeha, knowing that he can offer something from his own background, in exchange for the European culture he has absorbed. This above all, to thine own self be true, And it must follow, as the night the day, Thou canst not then be false to any man. from Hamlet, by William Shakespeare.