Dr Hinemoa Elder at Piritahi Marae, Te Huruhi Bay on Waiheke Island (Photo: Ellie Richards; additional design: Tina Tiller)
Dr Hinemoa Elder at Piritahi Marae, Te Huruhi Bay on Waiheke Island (Photo: Ellie Richards; additional design: Tina Tiller)

PartnersMarch 6, 2022

Hinemoa Elder on tackling child poverty with empathy and mātauranga Māori

Dr Hinemoa Elder at Piritahi Marae, Te Huruhi Bay on Waiheke Island (Photo: Ellie Richards; additional design: Tina Tiller)
Dr Hinemoa Elder at Piritahi Marae, Te Huruhi Bay on Waiheke Island (Photo: Ellie Richards; additional design: Tina Tiller)

Sunday March 6 is Children’s Day. The Spinoff spoke to child and adolescent psychiatrist Dr Hinemoa Elder about what New Zealanders can do to tackle child poverty.

Dr Hinemoa Elder (Ngāti Kuri, Te Aupōuri, Te Rarawa, Ngāpuhi) describes poverty as a disease. It’s a disease that affects all aspects of a young person’s life. While it’s most visible in its economic impact, it also infects a child’s identity, their sense of self worth, their aspirations. Elder calls this “poverty of the mind”.  

Elder is New Zealand’s only Māori child and adolescent psychiatrist. Her work identifies the effects of trauma – physical, psychological and environmental – on the way young New Zealanders, and especially young Māori, are able to navigate through life. Her mission is to change the path for those impacted by poverty.  

Med school and her early career as a doctor were important in helping her think broadly about the multiple causes and impacts of her patients’ health problems. Now, her work as a psychiatrist is about examining the interconnected impacts causing distress, and providing a holistic response to treat that young person’s mental health.  

“Psychiatry trains us in the pathology of the mind and how the mind is part of the entire organism, the entire experience of being human. Psychiatry focuses on the disruption to the functioning of the mind and how that impacts on people’s lives,” she says. 

Dr Hinemoa Elder at Piritahi Marae at Te Huruhi Bay on Waiheke Island (Photo: Ellie Richards)

Her work takes her to the sharpest point of poverty’s impact. She writes youth forensic reports for the courts, to provide insight into the mental health of young people who enter the justice system and unpack what led them to that point. And then she is part of the collective effort to support them to never come back to court again. She also works at Starship Hospital in the child and family and mother and baby units. Here she sees 12- to 18-year-olds and new and expectant mothers who are suffering from severe mental health issues and helps them get better. 

This position gives her a unique perspective on the causes, impacts and solutions to child poverty in Aotearoa. Which was why in 2021, Elder was invited to join the charity Share My Super as patron. Share My Super helps channel New Zealanders’ surplus superannuation to trusted charities working on the ground in communities in response to child poverty. Elder chose to join Share My Super because she saw an alignment with the way she works. 

“They’re practical. I’m a practitioner. I’m a doctor. I want to see things get done. I want to see things change. Share My Super is about giving the people who already know what to do the money to do it. Let’s get rid of the barriers and fund those people who already know their communities and are known by their communities and trusted by them,” she says.  

The Spinoff spoke to Elder about how we solve child poverty in New Zealand, why that starts with empathy and humanising the issue, and the role of mātauranga Māori in supporting rangatahi

Share My Super’s charity partners work together to impact children’s lives. Join the community uniting against child poverty today at www.sharemysuper.org.nz

You see a disproportionate number of Māori in your work. Why is that?

We know that around 40% of those referrals to the child and family unit are for our rangatahi Māori. And also in the youth justice settings, we know that we are vastly overrepresented and much more likely to come to the court end of things.

We’ve got lots of robust research that shows that our youth justice systems and the things that feed into those systems are racist. So when a Māori young person is apprehended by the police, the police make different discretionary decisions. Our young people are much less likely to be offered a family group conference and are much more likely to be charged and to go to court. And we know that once people go to court, the outcomes are not as good. 

In terms of presentation to inpatient units, there’s a whole range of factors. One is that we know that our young tamariki, mokopuna, rangatahi are less likely to access primary mental health and secondary mental health services in the community where the progression of their illness might be prevented and reduce the need for them to go to hospital. We also know that our rangatahi have more complex presentations. And that very much touches on the kaupapa of poverty. 

When we say the words “child poverty”, we can say those two words quite quickly, and we can miss all the layers of human suffering and pain that are embedded in those two short words. We know that tamariki, mokopuna who grow up in poverty have an increased risk of developing mental health problems throughout their lives. That poverty is a disease. And it infects all aspects of how children grow up. It affects how they think about their futures; the poverty of mind that comes alongside the poverty of economics and of opportunity.

How do we respond to this problem in a way that addresses that human side and changes experiences for individuals?

We want to respond in ways that are ecological. We live in a world which places a lot of emphasis on independence and individuality. But the tamariki who are most affected by poverty are Māori and Pasifika children, and we live in a much more collective and connected sense. So any actions that are going to impact effectively need to have that in mind. 

That’s one of the reasons I became involved with Share My Super, because they are taking a different approach. The organisation is a smart way for people who are getting superannuation to funnel their money into charities – 11 specific charities who are very much about the ecology around tamariki, whether it’s to do with their learning, whether it’s to do with the essentials of their daily life, having shoes and food and books. 

Dr Hinemoa Elder at Piritahi Marae at Te Huruhi Bay on Waiheke Island (Photo: Ellie Richards)

There are government and local authorities trying to address child poverty, but the pace of change is very slow. And I see children suffering every day. So I want to speed things up as much as I can and advocate for that. The Share My Super idea is about practical solutions that are being enacted now. 

The charity space is a highly contested one. There’s a lot of competition for money, and Share My Super is really aware of that. And they’re working with a different kind of networking amongst the charities to try to build a “we are bigger than the sum of our parts” approach, which I think is really smart. 

Because the people who are actually doing the work are in the communities, they’re well known, they’re well respected. Women’s Refuge, Wellington City Mission, Aka Mātātupu Teach First, Pillars, PARS, Child Poverty Action Group, Digital Future Aotearoa, KidsCan, First Foundation, Hillary Outdoors, Variety – the Children’s Charity. These are organisations who’ve been going for a long time and they are at the nitty gritty interface with our whānau. I am excited about the broad range of options that Share My Super provides.

You come to the problem with a te ao Māori lens. What role does mātauranga Māori have in responding to the issue?

I think knowing our history and making sure that Te Tiriti is very much front and centre is really important. And mātauranga is absolutely a part of that. It can be very practical, kitchen-table type, ordinary-life mātauranga Māori about how our people respond best. 

As well as food and shoes and warm houses, when our children who live in poverty have access to our reo and our tikanga and their own histories, immediately, you’re shifting their understanding of their value. Te reo and our history is a key component to get rid of child poverty of the mind and of their lives. 

Share My Super is really careful about how they continue to support the charities who are actually at the front end and move more money into the mahi that’s actually being done by the right people. They’re not trying to take over and say “we know better”. They know that they don’t know better. But they do know how to get the money and how to funnel that money into the right places. My work and experiences as a Māori doctor are essential parts of what I’m bringing to the table, and in supporting what is already embedded in the Māori organisations who are doing the mahi.

Why is compassion and empathy so important and powerful?

I think we have a lot of work to do to build a more compassionate, understanding society, which can actually reflect on the evidence as to why Māori and Pacific people are much more likely to live in poverty. To be a witness to the humanity of intergenerational poverty. 

In our country, people can live in their own socioeconomic bubble. And they can hear these words, “child poverty”, but they don’t really get to have contact with the reality of what that means. That’s what Share My Super is providing. I think it’s really brave and important – it’s a different way to do things that in just three years is already showing some robust efficacy in turning things around for our tamariki.

I think it’s critical to find ways, effective ways, honouring ways to help people stand in other people’s shoes. To really look into the eyes of those people and to recognise the privilege of not growing up like that. And to think about what’s a way to work with people and to make sure that they stand in their own mana, no matter what. Tamariki have their own mana. They are tūpuna of the future. 

I think it’s part of how we learn as a society to not turn away, and to not minimise, and to not be in denial. It’s been a huge problem in our country for so long. And we’ve had governments talk about how they’re going to change it and we don’t see much change. In fact, what we see is a growing entrenchment of child poverty. So it is hard to really face it because we’d really rather not. It’s hard, it’s painful and it forces us to reflect on the increasing divide and inequities in our society.

What are your aspirations for Aotearoa? 

My aspirations are for a bilingual country – te reo Māori and English. That our Māori history is taught in school throughout, from the womb, from pēpi and in developmentally appropriate ways. I think that that’s key. And I imagine an Aotearoa where everyone is bilingual, at the very least. We have more than 140 other languages in our country and that’s a testament to our rich, diverse cultural life. Let’s make sure the tūāpapa, let’s make sure the foundations are clear and solid and robust. And that is te reo Māori and English. I think it will also shift the political mindset. 

I am excited about our rangatira mō āpōpō, our young ones, our leaders of the future, and how vibrant they are and how they express their Māori identity in everything that they do. What these kinds of activities do is unlock all of that and throw away those chains and really create that freedom of decolonising our minds, of re-indigenising our lives.

Keep going!