Dr Waikaremoana Waitoki looks at the long awaited report from the Mental Health Inquiry.

It offered 'a once in a generation opportunity' and the ears that would 'listen to the people'. The report in many ways simply resurfaces recommendations made in countless other reports. It walks past the voices of those who cried, bled and died, and those left to pick up the pieces. The 40 recommendations missed an opportunity to promote Maori-led, sustainable solutions that will save, and improve Maori lives. Maori need bold recommendations, not sprinkles of rhetoric.

The He Ara Whakawātea  (clearing the pathway) offered for Maori rehashes decades of repeated calls to address disparities in mental health. The responsibility lies with those who create and maintain barriers that impact on Maori flourishing. Maori are more likely to encounter racism and lower standards of care at every level in society. Broader systems in society influence Maori wellbeing outcomes: education, health, justice, housing and employment sectors. The report needed to link the structural racism that impacts on Maori mental health and addiction.

A stark omission are the voices of takatapui and wāhine Māori. Māori women experience significantly more sexual, physical and structural violence than other women, yet specific services for them are missing. The same has been said for takatapui, who are distinct from the Rainbow community.

There is hope in the report. Reform the Mental Health Act; implement stronger legislation on the sale and supply of alcohol, (this could also include removing alcohol stores located near dairies); remove criminal sanctions for personal drug use; increase availability of, and access to kaupapa Maori services; and extend service contracts for Maori organisations. Reducing suicide is also a critical goal. As Maori are over-represented in death by suicide, the report needed to show a stronger commitment to supporting Maori, and their whanau and could have recommended a National Maori Suicide Prevention Strategy.

It is also concerning that a repeated commentary is to teach children and families to learn mindfulness and to be more resilient. Families need to be resourced and supported to provide a nexus of care. How does a child manage mindfulness when, for example, WINZ deals harsh and punitive penalties to single mothers; when education systems stand-down Maori more readily than non-Maori, or when children have to sleep in a car? When there is not enough food, and families get sick, or mothers have their babies uplifted in the birthing room they experience trauma. It is also widely known that mental health and addictions in prison populations underlie unresolved trauma, and repeated exposure to discrimination. The report could have made strong recommendations to counter these issues. Addressing trauma requires deeper understanding of the multiple layers that make up the way society treats its most at risk.    

The report offers a piecemeal approach to addressing Maori unmet need. Without a strong voice backing Maori, it is hard to see when, and how the recommendations will deliver. What is needed is Māori-leadership across all the recommendations, and in particular within the Mental Health and Wellbeing Commission.

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