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The legacy of Kiwi mental health pioneer Ernest Beaglehole

Ernest Beaglehole. Photo/Alexander Turnbull Library

The work of Ernest Beaglehole, who wrote about post-colonial impoverishment of Māori and criticised the way we treated mental health, still resonates today.

Just before the NZ Listener went to press for the first time, Wellingtonian Ernest Beaglehole – who would in 1948 become the country’s first professor of psychology – was finishing a field study of the inheritance and ownership customs of northern Arizona’s Hopi people. An intriguing mixture of anthropology and psychology, Beaglehole’s work has parallels with some of the things still going on today.

This member of the local intellectual dynasty returned to New Zealand from his field study at the suggestion of Thomas Hunter to join the staff at Victoria University. Hunter, knighted in 1939, had established New Zealand’s first psychological laboratory before World War I and by the time the first Listener hit the shelves was the vice chancellor of the University of New Zealand.

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Frank Walkey, one of my academic role models who completed his doctoral studies at Victoria University in the 1960s, recalls Beaglehole – then head of the relatively newly named Psychology Department – asking him what his long-term plan was. Walkey said he rather hoped he’d get a job as a lecturer, to which Beaglehole replied along the lines of: “Well, you’ve got to have your dreams.” He appointed Walkey to a lectureship not long after.

These days, Beaglehole is probably better known among anthropologists than psychologists. Often collaborating with wife Pearl, he wrote accounts of the lives of various Pacific peoples, including those of Samoa, Tonga and Rarotonga. But he also wrote about Māori. In Some Modern Māoris, he detailed his conversations and observations of Māori living in an area he and Pearl referred to as Kowhai, conducted during World War II. It’s sobering in recounting a tale of the post-colonial impoverishment of Māori, the then-limited contact between Māori and Pākehā, and the reliance of Pākehā on stereotypes of Māori.

Beaglehole was troubled by the ongoing impact of colonisation on Māori. Photo/Getty Images
But Beaglehole didn’t just write about culture. In 1950, he wrote critically of the state of treatment of mental disorder. He wouldn’t have been alone at this time – internationally in the 1950s, pressure mounted to shift away from the century-long tradition of dumping the mentally ill, out of sight and mind of society at large, into institutions under the all-powerful gaze and primitive tools of the psychiatrist.

The forces leading to this change were political, scientific and philosophical. First, institutions were expensive to run and increasingly overpopulated. Second, a new wave of “effective” psychotropic drugs was discovered in the 1950s. For instance, chlorpromazine was developed as a sedative for people about to have surgery, but quickly caught the eye of psychiatrists as a less radical alternative to such things as lobotomy and electro-convulsive therapy – a treatment prescribed to author Janet Frame in the late 1940s and early 1950s.

The third ingredient was a shift in the way that people and institutions were starting to view mental disorder – the acknowledgement that long-term residential care often led to worse consequences than the problems for which people were institutionalised.

Like many fashions, it took a while for this shift to reach our shores – not until 1969 was legislation passed to allow the move to community-based mental healthcare. And, like many countries, we didn’t always get it right. “Asylums” remained and were necessary for the re-admission of significant numbers of those released into the community – we’d achieved dehospitalisation but not necessarily deinstitutionalisation.

Beaglehole was troubled by the ongoing impact of colonisation on Māori. Photo/Getty Images
The 1988 and 1996 Mason reports reflected critically upon these issues, and the 1991 Tolkien Report became the model for establishing a “model mental health service” designed to shift away from illness to helping people “live well in the presence or absence of their mental illness” and targeting the 3% of the community most seriously unwell.

Around this time and for the first time, the Government started a mental health budgetary pot, separate from the general health spend. In the context of “He Ara Oranga”, the recent report of the Government Inquiry into Mental Health and Addiction, it’s easy to see the flaws in the system that was ultimately set up, but it was a world-leading initiative at the time and was used as a blueprint by much of the UK and US, among others.

This well-intended and even somewhat successful approach shifted the emphasis from mitigating illness to promoting wellness. But it was also bitsy and poorly integrated and it started to creak under the pressure – it was not uncommon for people to fall through the cracks.

We’ve since seen efforts to tighten these linkages, and I suspect we will see greater investment in prevention – more ambulances at the top of the cliff rather than only at the bottom. But this is going to be expensive – you need many more ambulances while you shift the focus. This year’s “Wellbeing Budget” may mark a stark shift from previous governmental rhetoric to action. Here’s hoping.

But before we get too optimistic, let’s remember Beaglehole and his observations about the ongoing effects of colonisation, stereotyping and stigmatisation of Māori. Despite numerous reports by Mason and others, Māori have continued to be disproportionately represented among negative health and mental-health statistics.

In March 2018, a Waitangi Tribunal claim was lodged and subsequently accepted for investigation, arguing that negative Māori outcomes are a product of the failure to implement the recommendations of these numerous reports. From Beaglehole to the present, we appear to be coming full circle.

This article was first published in the August 17, 2019 issue of the New Zealand Listener.