Brain-injured prisoners may finally get treatment thanks to a new "social bond" designed to tap some of New Zealand's richest private investors.
A consortium led by Ranui-based ABI Rehabilitation believes that treating brain injuries is a key to stopping ex-prisoners reoffending because a 2005 Health Ministry survey found that 74 per cent of male Maori prisoners, and 55 per cent of male non-Maori prisoners, had suffered head injuries that left them unconscious.
Its proposal for a social bond to reduce reoffending in Auckland is believed to be one of three still in the running for the country's second social bond.
The first bond, proposed by the Hamilton-based Wise Group and ANZ Bank to support people with mental illness looking for paid work in Wellington, is in the final negotiating stages.
Private investors who fund the bonds will get their money back plus a profit from the Government if the projects achieve agreed milestones.
A document obtained by Labour health spokeswoman Annette King shows that the Government is budgeting to pay gradually increasing amounts to investors, rising from $6.6 million in 2016-17 to $11.6 million in 2018-19.
ABI (Acquired Brain Injury) Rehabilitation, owned by its managing director Max Cavit and his wife Marie Cavit, has a contract with ACC to rehabilitate all victims of acute traumatic brain injury in Northland, Auckland and the Waikato.
Most victims are young males injured in car accidents, falls and assaults.
A neuropsychologist specialising in brain injuries, James Cunningham, said victims often became "less mindful of the consequences of their actions, less empathetic". Some had "severely reduced frustration tolerance and rapid rise to anger".
He has helped some offenders to manage the situations that anger them and to deal with other problems such as addictions and other health-related issues.
Alison McLellan of the Auckland Brain Injury Association said she had worked with many offenders since 1981.
"I've had a quite a few gentleman who have had problems with the law over the years and so far none of them have reoffended," she said. "If they look as though they're heading for trouble they contact me and we meet with their lawyer and if need be mediate with the court. This assists in solving the problem before it escalates."
A 2010 ABI paper said a court-ordered rehabilitation programme for offenders with brain injuries in Victoria had cut reoffending by 20 per cent through "multi-disciplinary assessment, needs-based support, traumatic brain injury rehabilitation, and linkages to disability, mental health, addiction treatment and cultural liaison services".
They have put together a similar consortium for the NZ social bond including Odyssey House for addictions, Australian-owned APM Workcare to support people in work and Waipareira Trust for "cultural liaison".
Auckland merchant bank Cranleigh, the NZ Society on Alcohol and Drug Dependence (NSAD) and Sydney-based health consultants Synergia have formed an intermediary called CNS to connect the consortium with investors.
• Supporting people with mental illness to secure and sustain work in Wellington (Wise Group, ANZ Bank).
Next on shortlist:
• Reducing adult reoffending in Auckland (ABI Rehabilitation, Odyssey House, APM Workcare, Waipareira Trust, Cranleigh, NSAD, Synergia).
• Reducing youth offending in South Auckland (Genesis Youth Trust, ANZ Bank, possibly Cranleigh, NSAD, Synergia).
• Managing chronic illness in Bay of Plenty/Lakes (Healthcare of NZ, ANZ Bank).
Steve Pugh often holds his head when he's talking, but it's not because of a specific pain.
"It's not sore, it's not like a toothache," he says.
"It's just something that doesn't go away. Tension, you can kind of feel the tension."
Now 56, he has felt the tension in his head ever since a bad motorbike accident when he was 18. He was in a coma for days afterwards, woke up to find that he couldn't talk or walk properly, and had occupational therapy for months.
"I still don't remember anything, I don't even remember being in hospital," he says.
Before the accident, his father had lined him up for an apprenticeship. The accident made that impossible.
Eventually he found labouring work, and a partner. He had three children now aged 28, 26 and 24.
In 1990 he moved up north to a whanau-owned farm at Whananaki. But he has never been the same as he was before the accident.
"My parents and sisters and brothers tell me that there was quite a noted change in my behaviour, a bit of Jekyll and Hyde I suppose. I was much less tolerant," he says.
In the late 1990s he was jailed for assaulting his partner. He appealed successfully against the sentence and was released.
He has "a long list" of drink-driving convictions, and has just come out of jail in June after serving four and a half years for assaulting another partner. Again he maintains his innocence and plans another appeal.
"I was unable to effectively express myself," he says. "The Brain Injury Association and my doctor advised that I use notes as memory aides, I have been doing that for 20-odd years, but at the trial I was not allowed to use my notes."
His original brain injury has been exacerbated by another vehicle accident in 2001, a couple of assaults and a recent accident in jail when he slipped on a wet floor and hit his head on a steel table.
He has found supported housing with a Christian agency in South Auckland and plans to go back to the farm when his probation ends.
"I'll pick up my life where I left it off," he says. "I have my own dwelling there -- a caravan and a bit of a lean-to at the back. It's home."