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  • Author or Editor: Stella Black x
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Background:

Ninety-one per cent of Aotearoa New Zealand prisoners have been diagnosed with either a mental health or substance use disorder within their lifetime. Challenges exist in how to meet their needs. Diverse pūrākau (stories) of success in whānau ora (wellbeing) and stopping offending are missing from academic and public discourse that should direct law and policy changes.

Aims and objectives:

We describe a kaupapa Māori co-production project called He Ture Kia Tika/Let the Law be Right. We highlight how kaumātua (Māori indigenous elders), academics, and practitioners merged their voices with people with lived experiences of mental health, addiction, and incarceration to create justice policy and solutions.

Methods:

We focus on the theory and application of our co-production, directed by kaupapa Māori methodology. We describe the work of a co-design group that actively guides the project, from inception towards completion, using rangahau kawa (research protocols) as culturally clear guidelines and ethically safe practices. We then detail our processes involved in the collection of co-created pūrākau (storytelling) with 40 whānau (family) participants, and describe our continued collaboration to ensure law and policy recommendations are centred on lived experiences.

Findings:

Kaupapa Māori informed co-production ensured rangahau kawa (research protocol and guidelines) were created that gave clear direction for an engagement at all levels of the project. We see this as bringing to life co-production, moving beyond theory to the practicalities of ‘being’ and ‘doing’ with each other in safe, ethical ways for all.

Discussions and conclusions:

A strong association exists between unmet mental health needs and reoffending. Tackling cultural, health, social and justice issues requires a multi-layered approach from a range of rangatira (leaders including kaumātua/elders) and tohunga, or experts, of their lived experiences to inform future policy and law reform.

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The 21st century marks the emergence of a new demography of death, one in which longevity and chronic illness rather than short lives and infant mortality define its parameters (Leeson, 2014). By 2050, lifespans will have risen from 65 years in 1950 to an expected 83 years in developed regions and from 42 years to 75 years in less developed regions (United Nations, 2013). Concurrently, it is expected that by 2050 there will be 434 million people 80 years of age and older with chronic and complex health conditions.

As a result of these shifts in ageing and disease prevalence it is reasonable to assume that palliative care will increasingly become part of the life course as people encounter death and dying in advanced age. (Palliative care may be defined as care and treatment that is meant to improve the quality of life of individuals with a life-limiting illness and their families (World Health Organization, 2016).) Yet despite the existence of policy calling for the ‘delivery of high quality [palliative] services in all locations’ (National Health Service, 2008: 11), ample evidence exists that older people are at risk of receiving sub-optimal care (Ahmed et al, 2004; Burt and Raine, 2006; Burt et al, 2010). Solutions to the problem often focus on the need for improvement within professional health services (Browne et al, 2014; Keim-Malpass et al, 2015), which suggests an underlying belief that change is best left to the experts in the healthcare profession and the statutory sector.

Emerging discourses in palliative care, however, offer a different perspective.

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