The Australasian Society of Lifestyle Medicine's (ASLM) roadshow in Auckland offered a rich tapestry of insights into mental health and well-being, weaving together clinical evidence, cultural wisdom, and innovative, person-centered practices. The event underscored a collective call to move beyond traditional, often siloed, healthcare models towards more holistic and integrated approaches.
**Lifestyle Medicine as Foundational Care:**
Presentations consistently highlighted lifestyle medicine not as an add-on, but as a foundational element of mental health care. Dr. Sam Manger shared international guidelines demonstrating that interventions like **exercise can be 1.5 to twice as effective as antidepressants for depression**. Similarly, he noted that non-pharmacological sleep interventions can have a massive effect, up to four times that of antidepressants. The evidence for nutrition was also a key theme, with Professor Julia Rucklidge explaining that emotional dysregulation in teens responds significantly to micronutrient supplementation, especially in more severe cases. Her research showed that while many teens improved with attention and a placebo, those with the most severe dysregulation and from lower socioeconomic backgrounds saw the most dramatic benefits from micronutrients.
**Integrating Indigenous Knowledge and Holistic Well-being:**
A powerful theme throughout the event was the integration of Indigenous knowledge. Dr. Ihirangi Heke explained the Māori health framework *Atua Matua*, which is centered on the environment, not individuals. He argued that for Māori communities, framing initiatives around environmental connection and genealogy (*whakapapa*) is far more engaging than focusing on "health," a term often associated with punitive experiences. This approach uses ancestral stories (*pūrākau*) and environmental observation as guides for well-being.
Ariana Rangi-Sauni further elaborated on a Māori worldview, explaining that well-being is a collection of strengths, not an absence of deficits. Her personal motto, "I am the river, and the river is me," encapsulates this deep connection to the environment as a life force. She redefined ADHD as "Attention Dynamic and Hyper Diverse" to reclaim the narrative from one of deficit to one of strength. The importance of cultural practices like waiata (song) was demonstrated by John Lawrence Kereama, Dr. Robin Chan, and Anne-Marie Midwood-Murray, whose evaluation of a hospital waiata group showed it **improved team cohesion, reduced staff stress, and increased cultural competency**.
**Practical and Person-Centered Approaches:**
Professor Bruce Arroll advocated a "talk first, prescribe later" approach, emphasizing that **behavioural activation is a highly effective primary care treatment for low mood**, with 46% of patients feeling better in one week. He shared practical "killer narratives" to motivate patients, such as framing muscles as "endocrine factories" that create "hope chemicals".
The importance of tailoring interventions was a key takeaway:
* **Co-design:** Dr. Matt Jenkins presented a co-design project for young people with psychosis, where participants rejected a session on sleep but embraced activities connecting them to nature. This highlights the need to empower service users to shape their own care.
* **Trauma-Informed Exercise:** Ruth Troughton cautioned against a one-size-fits-all "FITT" model for exercise, particularly for clients with trauma histories. For some, aerobic exercise can mimic the physiological sensations of a threat response; therefore, starting with resistance or mindful movement may be more effective.
* **The Science of Sleep:** Dr. Sarah Hetrick and Dr. Nicola Ludin explained the science behind sleep and circadian rhythms, noting that the peak age for delayed sleep timing in youth coincides with the peak onset of mood disorders. They recommended simple, routine-based interventions like morning bright light and evening dim light to support the body's natural clock.
Ultimately, the event championed a shift in healthcare philosophy—from focusing on deficits to building on strengths, from individualised treatments to community connection, and from a purely biomedical lens to one that embraces culture, environment, and the whole person.