Taiohi Māori, the Indigenous adolescents of Aotearoa, have inequitable mental health and addiction outcomes when compared to their Pākehā (New Zealand European/other European/“White”) counterparts, with unacceptably high levels of suicide. Despite the high levels of concern for the mental well-being of taiohi, they are less likely to access to the care they need, and experience worse outcomes. Understanding taiohi and whānau experiences when accessing acute mental health and addiction services is critical for improving equitable mental health and substance misuse outcomes for taiohi and their whānau. This thesis explores an Indigenous empirical exploration of taiohi and their whānau as they hīkoi (journey) from the community into acute mental health and addiction services.

An Indigenous paradigm philosophically underpinned this research, based on Kaupapa Māori Theory that anchored a distinct epistemological and metaphysical positioning reflective of Māori worldviews and contemporary realities. A qualitative research design enabled 19 participants, taiohi (n=9), whānau (n=5) and keyworkers (n=5), to share their experiences through interviews. Inductive questioning in semi-structured interviews with. A thematic analysis utilising a te ao Māori lens and key themes and sub-themes were generated.

The findings provide insights into the uniqueness of taiohi identities and the importance of Māori cultural engagement and wider social determinants in the recovery care pathway. The first key theme, ‘Surviving Socially’, includes the sub-themes of living with social pain and being heavy on drugs. The second key theme, Entering a Scary Place, includes the sub-themes of locking me in and clearing my thoughts. The final theme, Whānau Healing in the Community, includes these sub-themes providing hope, kotahitanga, and carrying on with life.

This research provides insight into taiohi lived realities of engaging with mental and addiction services. Colonisation, intergenerational trauma, racism, culture, and wider environmental factors significantly impact taiohi healing journeys. These social and cultural determinants make it challenging to address mental health and substance use issues for taiohi effectively, without challenging current colonial systems. Understanding the determinants of wellbeing for taiohi offer valuable levers for action, including prevention strategies, health service delivery and policy.