Pilot of Te Tomo mai, a child and adolescent mental health service evaluation tool for an indigenous rangatahi (youth) population

Abstract

The acceptability of Child and Adolescent Mental Health Services (CAMHS) to indigenous rangatahi (12-19-year-olds) requires investigation. Evaluation tools able to take account of the more holistic approach to the attainment of mental health that characterises Ma¯ori, the indigenous population of Aotearoa (New Zealand) with specificity to the rangatahi population are critical to this examination. The study aims were to: (1) develop an instrument and establish its psychometric properties; and (2) use the measure to establish rangatahi views on desirable CAMHS characteristics. A kaupapa Ma¯ori (Ma¯ori-driven) research paradigm, based on the traditional Po¯whiri process of engagement and participation, particularly the components of karanga, mihimihi, whaiko¯rero and koha guided this quantitative research approach. These components are essential to positive contact and commitment to the study processes by researchers and participants. A self-administered survey, Te Tomo mai, was developed by modifying a North American questionnaire, the Youth Services Survey for Youth. The intent of the tool was to record rangatahi experiences and views on service acceptability. The Te Tomo mai survey incorporates questions designed to examine CAMHS delivery in the light of the Whare Tapa Wha¯, a Ma¯ori comprehensive model of health with a focus on culturally responsive services. This survey was completed by a cohort of 69 Ma¯ori rangatahi who were referred to six CAMHS District Health Boards in Aotearoa. The Te Tomo mai instrument factor structure, specifically the cultural factor, had similarity to the North American questionnaire from which it had been derived. This work confirms the concept that Ma¯ori desire therapeutic methods consistent with the Whare Tapa Wha¯, such as the importance of culture and spirituality. It further identified issues relevant to Ma¯ori rangatahi acceptability with CAMHS such as access, satisfaction and appropriateness. The participants were generally positive about the services they received from the CAMHS, which shows good acceptability of CAMHS for Ma¯ori. The Te Tomo mai instrument can prove useful if applied in Aotearoa or other similar cultural settings. It is a means of determining the cultural acceptability which will contribute to improving CAMHS delivery to rangatahi from indigenous populations.