386. Clause 31(c) of the Terms of Reference requires the Inquiry to make findings on the impact of the abuse and neglect on individuals and their families, whānau, hapū, iwi, and communities during the Inquiry.

387. The Inquiry finds: 

a. Many survivors who were abused or neglected in care have gone on to lead fulfilling lives, and some have worked courageously to improve the future for children, young people and adults in care in Aotearoa.
b. Some people who were abused or neglected in care took their own lives or died as a result of their experiences in care. 
c. Evidence of unmarked graves for patients who died at some psychiatric hospitals across Aotearoa New Zealand, particularly at Porirua, Tokanui and Sunnyside Hospitals.
d. Most survivors suffered harm and have not been able to live their lives to their full potential. The impacts have been life-long or temporary. These were and are co-occurring, where one type of impact of abuse or neglect will intersect with other impacts.  Impacts have included:

i. difficulty with establishing intimate relationships
ii. difficulty with maintaining family relationships
iii. devastating effects on their health and wellbeing
iv. damaged mental health and emotional wellbeing
v. lack of education opportunities impacting on ability to participate in society
vi. reduced opportunities for gaining and maintaining employment opportunities
vii. increased financial insecurity
viii. experiencing periods of homelessness
ix. reduced trust in authority
x. for some, pathways into addiction
xi. for some, pathways into sex work
xii. for some, pathways into criminality and prison
xiii. for some, pathways into gang membership
xiv. for some, entrapped in institutional care
xv. struggles with sexual and gender identity.

e. For Māori survivors in addition to the impacts outlined above, they experienced:

i. disconnection from whakapapa and te ao Māori
ii. loss of identity as Māori, te reo, tikanga and matauranga Māori
iii. loss of confidence resulting from this loss of identity.

f. Survivors struggled to understand their identity.
g. Many survivors were already at risk of poor life outcomes before they went into care due to poverty, trauma, and the need for additional support from others. Instead of receiving support and protection in care, these survivors experienced abuse and neglect.
h. During the Inquiry period, harm was pervasive in social welfare institutions. over 30 percent of children and young people went on to serve prison sentences later in life. Tamariki and rangatahi Māori were significantly over-represented in these numbers.
i. Māori survivors, including tāngata Turi Māori, tāngata kāpō Māori, whānau hauā Māori, tāngata whaikaha Māori and tāngata whaiaora Māori often experienced disconnection and isolation from their whānau, hapū, iwi and whenua, and their ability to access and participate in te ao Māori. This disconnected them from their tūrangawaewae, causing many to feel a deep sense of whakamā and isolation. This disconnection and the ongoing impacts of colonisation and urbanisation, compounded the impacts of the abuse and neglect they suffered. These impacts were felt intergenerationally, particular by survivors' children and grandchildren, and collectively by hapū and iwi.
j. The intergenerational impact of abuse and neglect has been experienced by their children, grandchildren, whānau and future generations.  The impacts have also affected their support networks, hapū, iwi and communities. 
k. Some whānau, support networks, hapū, iwi or communities of survivors experienced guilt and regret for the harm experienced by their loved-ones while they were in care.
l. Whānau, hapū and iwi were deprived of exercising tino rangatiratanga over kāinga (home) by caring for and nurturing the next generation.
m.   For tamariki, rangatahi and pakeke Māori, the impacts of abuse and neglect in care caused a disruption to the collective ability of Māori to live as Māori and to participate and contribute to Māori social, cultural and political life within whānau, hapū and iwi.  There has been a loss of members to transfer cultural practices, tikanga, te reo and mātauranga Māori which also has inter-generational impacts, a loss of potential leadership to sit on taumata or on the paepae and is a transgression of whakapapa.
n. Often when children, young people and adults in care returned home reintegration was difficult, or never achieved. Some people were never able to return or have any ongoing connection with their whānau, support networks, hapū, iwi or communities. 
o. Deaf, disabled, and mentally distressed survivors, including tāngata Turi Māori, tāngata kāpō Māori, whānau hauā Māori, tāngata whaikaha Māori and tāngata whaiaora Māori experienced ongoing daily discrimination which further impacted their lives, led to invisibility and sometimes limited or restricted their ability to leave care.
p. Pacific survivors often experienced a loss of connection to their kainga, culture, language and cultural identity.  This breached the vā, resulting in trauma that has been carried from generation to generation.
q. The lack of acknowledgement or apology from those in power creates further trauma for survivors. Where acknowledgements have been made, they were often too little and too late.
r. Abuse and neglect, and the ongoing associated intergenerational harm and trauma, have contributed to social inequities.  
s. The average lifetime cost to the survivor of the loss of enjoyment of things that New Zealanders think are normal day-to-day activities was estimated in 2019 to be approximately $673,000 which is almost 80 percent of the estimated lifetime costs of abuse per survivor of $857,000. 
t. Based on the estimated number of people abused and neglected in care between 1950 and 2019, the total cost is estimated to be between $97.5 billion and $219 billion. Of this the smallest proportion, estimated to be approximately at $47.1 billion is borne by the taxpayers of New Zealand. The largest cost, estimated to be approximately $172 billion, is borne by survivors.