Ms O’Hagan provided historical context of abuse in the psychiatric system, including as it relates to Te Tiriti o Waitangi, key milestones between 1950 and 1999 and the survivor movement. 

She described what ‘abuse in State care’ means within a psychiatric system context and the nature of abuses in State care, as well as addressing systems and factors leading well as to abuse in psychiatric care, and outlining the ways in which the Mental Health (Compulsory Assessment and Treatment) Act plays a role in abuse in care and the consequences for people subjected to the Act.

Ms O’Hagan demonstrated ways in which the psychiatric system and routine practice constitute abuse, provided evidence of the experience and impacts of abuses at an individual level, and addressed the social determinants of distress.

Recommendations were made for transformation at a social systems level, as well as new ways of conceptualising ‘distress’ and providing a range of supports generated by, or located within, communities (i.e. the Wellbeing Manifesto vision and the Māori Manifesto vision). Ms O’Hagan also provided some suggestions for redress and rehabilitation.