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Tupuānuku Research

Nourishing the physical health of tāngata whai ora

Advocating against the diagnostic overshadowing for people with mental health and addiction issues in Aotearoa

This is a three-year research study led by Ruth Cunningham, Debbie Peterson and Helen Lockett which is investigating the enablers and barriers that affect the access and quality of physical health care for people with mental health and addiction issues in Aotearoa.

The research project is split into three integrated strands of work:
1. the investigation and analysis of routinely collected data,
2. exploring the stories of people with experience of mental health and addiction issues, and;
3. using these findings to bring change.

The findings from this research will help Equally Well champions bring change

We are excited to see that the Tupuānuku research findings are starting to emerge through publications. This work by Otago University researchers provides a distinctive perspective on New Zealand’s data concerning individuals with mental health and addiction experiences as they seek access to healthcare services. The results of this research will help set the scene for future policy recommendations, workforce development strategies, and resources for health practitioners, policy makers, and people with lived experience.

We would like to thank those Equally Well champions who between February and April 2023 completed the survey that has provided the voices of lived experience in our findings and led to the publication of the results in three key papers so far.


This study investigated experiences of people with mental health and substance use issues who sought help for a physical health condition in primary healthcare services, examining quality of care attributes. The majority of people reported positive experiences of primary care services however, experiences differed by diagnosis, number of diagnoses, and some demographic characteristics.


The aims of this paper were to describe how people with mental health and addiction issues experienced discrimination in physical health services, and to explore the likely underlying beliefs of clinicians that lead to discrimination in physical healthcare.


Following on from the previous two papers, this paper used the survey data to identify strategies used by people with mental health and addiction issues to avoid or minimise the impact of discrimination from physical health services. Strategies identified often meant people did not seek help or compromised the quality of their care.

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