We heard from Pacific peoples that the current system is not working for them – that the design of the system, the spirit of services and the dominance of mainstream models of practice have not enabled Pacific health and wellbeing.
Consistently, Pacific peoples spoke of a lack of quality and described services they found hostile, coercive, culturally incompetent, individualistic, cold and clinical. We heard many times of their experiences of pain, inequity, institutional racism and preventable loss.
The call from Pacific peoples was for transformation. They saw the solution to many existing problems as adoption of ‘Pacific ways’ of supporting people and their families. This was described as including a genuine, holistic approach, incorporating Pacific languages, identity, connectedness, spirituality, nutrition, physical activity and healthy relationships.
Relationships were seen as vital to Pacific health and wellbeing outcomes.
What we heard was a need for an extended village of Pacific services working cooperatively and collaboratively, with complete cultural integrity to adequately meet the needs of Pacific peoples. This village of services would be governed and managed in a way that meaningfully demonstrates Pacific authority and autonomy with decision-making that best serves the interests of Pacific families, clients and staff – entrenched in Pacific ways of knowing, being and doing. There was a call for services to be funded by Pacific peoples who would determine the procurement process and scope of contracts. We were told that, for real change to occur, contracting and funding must promote – not hinder – the ability to deliver services that will facilitate recovery, healing and resilience for Pacific peoples and their families.
The diversity of Pacific peoples was an important theme – they are multilingual, multigenerational, and of diverse sexualities and genders, represent many ethnic-specific interests, and hold various clinical, community and cultural skills. Pacific culture in all its diversity cannot be compromised.
At every corner of the system, people wanted a strong Pacific presence – an interconnected network of Pacific providers, or one large service, serving the needs of Pacific peoples. We heard that a Pacific integrated approach would reflect a commitment to like-mindedness, working seamlessly in partnership at all ends of the service spectrum: from acute beds and respite services, to secondary and primary mental health and addiction services right through to health promotion. We were encouraged to learn from Pacific approaches to peer support, which work well even with few resources.
Rather than a mere re-branding of services or forcing services to work with one another, Pacific peoples wanted an opportunity to do things differently, with optimal quality care and culturally effective options.