30 Jan 2020

Culture gap exists in traumatic brain injury assessments for Māori inmates, expert says

2:11 pm on 30 January 2020

Māori inmates who suffer from a traumatic brain injury need Māori-specific assessments, or will risk making the same poor decisions that led them to prison in the first place, according to a neuropsychologist.

Paremoremo Prison's ward in the new wing.

Photo: RNZ/Jessie Chiang

It follows a University of Canterbury study which found nearly every inmate at Christchurch Women's Prison who was interviewed had suffered a traumatic brain injury.

This hindered their ability to navigate the justice system, potentially kept them in the system longer and impacted their rehabilitation.

It also found there was a lack of cultural awareness, culturally targeted services and culturally diverse expectations of their behaviour.

Makarena Dudley - one of only four Māori neuropsychologists in the country - has worked with Māori inmates who have suffered a traumatic brain injury.

Dr Dudley said Māori were over-represented among those who suffered from a traumatic brain injury and were disadvantaged at the assessment stage.

"The tools that we assess in order to identify a traumatic brain injury or a neurological problem are all tools that have been developed in country's overseas with a Western world view," she said.

"Often misdiagnosis are the result of these tools that have not been developed within a Māori world view and then we don't have appropriate follow-up or appropriate treatment for that person."

She said more Māori needed to enter the field of neurology, and develop new tools.

"I think what we need to do is get more Māori working in this area, because it's us that will actually make the changes.

"We need to be able to develop our own skills, we need to go out to the people and find out what the issues are for them then we need to combine that with what we know from the scientific world.

"From combining those two worlds, we can create and develop and design assessments tools that are pertinent to Māori and then you're going to get more accurate diagnosis and more relevant recommendations."

She said Māori inmates who had a history of a traumatic brain injury were greatly impacted by the lack of culturally specific assessments.

"It's a double-edged sword for them, because not only are they disadvantaged by the assessment process and protocols that they need to go through, not only are they disadvantaged by some of the symptoms or some of the difficulties that they are experiencing from the result of a traumatic brain injury such as memory loss, difficulty of communicating, all those problems that exist, but they're also dealing with a cultural gap as well, so they're trying to navigate through a world that is somewhat foreign to them."

She said they were more at risk of staying in the system.

Corrections acting deputy chief executive of health Juanita Ryan said the agency had programmes available to support inmates.

"Having good mental and physical wellbeing are critical pre-requisites for people in prison to be able to engage fully in education, employment and rehabilitation programmes that reduce their risk of re-offending," she said.

"We have a diverse range of support and programmes for people in prison, including mental health and addictions interventions, literacy, Kaupapa Māori-based interventions and a nurse-led health service in every prison.

"We have a range of activities and interventions in place to assist them with these needs and enable them to participate in more in-depth offence-focused programmes."