The He Ara Oranga wellbeing outcomes framework is a conceptual framework that describes an aspirational vision of 'what good looks like' in the future. It is a holistic wellbeing framework that focuses on wellbeing for all and is also relevant to those with lived experience of mental distress and addiction.

Following a co-design and consultation process, the Board of the Initial Commission adopted a suite of conceptual outcomes that describe both te ao Maori and shared wellbeing perspectives.

What is a conceptual framework?

A conceptual framework sets out what wellbeing looks like for people and whānau in Aotearoa.

The conceptual framework has:

  • High-level outcomes
  • Descriptions of outcomes (what outcomes look like).

The data phase developed indicators to measure outcomes (how we measure and monitor wellbeing outcomes).

How was the framework developed?

The framework was informed by:

Feedback on the framework

In August and September 2020, the Initial Commission asked people for feedback on the draft He Ara Oranga outcomes framework

To read a full summary of the feedback, download a copy of the summary report:

When the Initial Commission started this work, they wanted everyone to be able to have their say on how the system will monitor, measure and improve our country's mental health and wellbeing. However, due to COVID-19 they had to change their approach and target organisations that represent the people and diversity of Aotearoa New Zealand.

The consultation involved over 150 groups, organisations and individuals.

What the Initial Commission asked

The Initial Commission asked people the following questions:

  • whether the draft outcomes framework resonated with people
  • what the six areas of wellbeing meant to people
  • whether ‘tū tangata mauri ora, flourishing together’ is a suitable aspirational vision
  • how well the Initial Commission's principles were reflected in the draft outcomes framework.

What the Initial Commission heard

The overwhelming majority of the feedback was positive. Other feedback offered valuable suggestions about how to improve the framework. The Initial Commission used a strengths and solutions-focused approach to interpret and action the feedback.

The outcomes framework resonated well with most people, and the domains largely covered what wellbeing means. People supported the framework because it:

  • is inclusive and aspirational and takes a strengths-based approach
  • includes structural and systemic factors that impact on wellbeing
  • takes a broad and interconnected approach to understanding wellbeing, with relevance to mental health and addiction.

Some people suggested that the wellbeing approach may be too broad and less relevant to people living with severe mental health and addiction issues.

People also suggested clarifying the connection between the high-level domains and the detailed descriptors, including the distinction between wellbeing domains. Also, we heard that the final framework needed to be in plain and concise language.

The dual-layered framework

Many Māori and non-Māori respondents supported the layered approach because it gives Te Tiriti o Waitangi ‘its rightful mana and place and acknowledges the importance of Māori as tangata whenua and the Crown’s Treaty partner’.

The Initial Commission heard that more work was needed to show how the two layers relate to each other. Some saw the ‘for Māori as tangata whenua’ domains having universal applicability.

As one of the priority groups identified in the He Ara Oranga report, it was agreed that a Pacific example would be appropriate to develop in addition to the dual-layered framework. Pacific respondents said the Pacific example resonated more with them than the ‘for everyone’ outcomes framework. Key suggestions were to make more use of Pacific languages, use Pacific models in the descriptors, and make faith and spirituality more explicit throughout.

Particular groups and outcomes

The Initial Commission heard that there should be (stronger) reference in the framework to:

  • addiction, substance use and gambling harm
  • outcomes for people in acute mental distress or for those who had severe and enduring ill health
  • the unique mental health and wellbeing needs of infants, children and youth
  • outcomes for Asian communities, refugees, prisoners and their families, and the mental health and addiction workforce.

Implementation of the framework

Respondents had questions about how the framework would translate into outcomes and how this framework would work with others.

Concepts that were missing or needed greater prominence

Suggestions were made to refine the domain descriptors. For example, recognising colonisation and its impacts, the importance of te reo Māori in relation to wellbeing for Māori, peoples’ and communities’ expression of cultural values, spirituality and belonging, equity and safety, economic resources, and role of socio-economic deprivation.

The vision and principles

The vision of ‘Tū tangata mauri ora, flourishing together’ was generally supported as a suitable aspirational vision. However, some respondents felt that flourishing could mean different things for different people. Also, flourishing is something that individuals may not have personal control over.

Most respondents felt the principles were ‘mostly’ or ‘completely’ reflected in the draft outcomes framework. Some respondents provided suggestions about how the principles could be better reflected in the draft outcomes framework.

 

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