Australian Prisons Research Articles

Necropolitics and the violence of Indigenous incarceration

Since the Royal Commission into Aboriginal Deaths in Custody, over thirty years ago, there have been over 400 Indigenous deaths in custody, with 28% of the Australian prison population identifying as Indigenous. Indigenous over-representation in the criminal justice system continues to be an unresolved issue despite varying attempts to reduce the high incidence of incarceration experienced by Indigenous Australians. This paper proposes a fresh approach to analysing the violence of Indigenous incarceration using the theory of necropolitics. The paper represents a critical discussion of a work-in-progress of how an analytical framework based on necropolitics has the potential to elevate the often-silenced voices of vulnerable populations, such as Indigenous Australians, within the criminal justice system. This is because the proposed study will present a multi-level analysis of the overt and covert forms of violence perpetrated against Indigenous Australians within the criminal justice system and unlock the potential of exposing the extent to which unequal relations of power contribute to these forms of violence. The significance of this research therefore lies in its capacity to provide policymakers with deeper insights into how such forms of violence impact upon and further disempower Indigenous Australians in the Australian criminal justice system.

Considering treatment-as-prevention scale-up for Australian prisons: a qualitative sub-study of expert stakeholders from the Australian \u2018surveillance and treatment of prisoners with hepatitis C\u2019 project (SToP-C)

BackgroundWith direct-acting antivirals dramatically reshaping the public health response to the hepatitis C virus (HCV), prisons are set to play a critical role in elimination efforts. Despite the theoretical demonstration of HCV treatment-as-prevention in prison in mathematical modeling, limited empirical data exist. The Australian ‘Surveillance and Treatment of Prisoners with Hepatitis C’ project (SToP-C) is the world’s first trial of HCV treatment-as-prevention in prison. Drawing on interviews with HCV expert stakeholders, this paper explores the factors respondents identified as crucial to the success of future scale-up. Accounting for such perspectives matters because of the influence expert discourse has in shaping implementation.MethodsSemi-structured interviews were conducted with nineteen HCV experts working across key policy, advocacy, research and clinical dimensions of the Australian HCV response. Data were coded using qualitative data management software (NVivo 11). Analysis proceeded via a hybrid deductive and inductive approach.ResultsNotwithstanding concerns regarding the lack of primary prevention in Australian prisons, stakeholders reported broad levels of support for the intervention and for the future scale-up of HCV treatment. A number of considerations, both external and internal to the prison system, were identified as key. The principal external factor was an enabling political-cum-policy environment; internal factors included: obtaining support from prisons’ executive and custodial staff; promoting health within a security-first institutional culture; allocating time for treatment within prisoners’ tightly regulated schedules; ensuring institutional stability during treatment given the routine movement of prisoners between prisons; prioritizing the availability of retreatment given the paucity of primary prevention; and securing sufficient clinical space for treatment.ConclusionThe challenges to implementation are considerable, ranging from macrolevel concerns to in-prison logistical matters. Nonetheless, we argue that prisons remain an obvious setting for treatment scale-up, not only for prevention and potential elimination benefit, but for the treatment opportunities they afford a socially disadvantaged and underserved population. While noting widespread concerns among respondents regarding the paucity of primary prevention in Australian prisons, results indicate broad levels of support among expert stakeholders for HCV treatment scale-up in prison.

Expert stakeholder perspectives on the acceptability of treatment-as-prevention in prison: a qualitative substudy of the 'Surveillance and Treatment of Prisoners with Hepatitis C' project (SToP-C).

Mathematical modelling has demonstrated the theoretical feasibility of HCV treatment-as-prevention strategies in custodial settings, yet limited empirical data exists. The Australian 'Surveillance and Treatment of Prisoners with Hepatitis C' study is the world's first trial of hepatitis C virus (HCV) treatment-as-prevention in prison. This study aimed to analyse how expert stakeholders involved in the Australian HCV response assessed the acceptability of HCV treatment-as-prevention in prison using interview data from the SToP-C qualitative substudy. Qualitative analysis using semi-structured interviews in Australia. Nineteen key HCV experts. Drawing upon Sekhon's theoretical framework of acceptability, data were organized thematically under four component constructs of acceptability: affective attitude; ethicality; opportunity costs; and perceived effectiveness. Most differences in participant assessments of acceptability were a matter of relative emphasis and prioritization rather than absolute polarity. Nonetheless, a small minority of participants was overtly critical of the approach. Arguing against the focus on treatment, they instead advocated for prevention-as-prevention, including the improvement and expansion of existing harm reduction measures. Qualitative analysis of expert stakeholder assessments of the acceptability of hepatitis C virus treatment-as-prevention in Australian prisons found no opposition to the universal rollout of direct-acting anti-virals, but most voiced concern regarding the lack of effective primary prevention in Australian prisons.

Maternal incarceration: Impact on parent-child relationships.

Female incarceration is rising steeply in Australia and other high-income countries. The majority of incarcerated women are mothers. Their children represent a particularly vulnerable group, often subject to adverse experiences due to their family's disadvantaged circumstances involving inadequate housing, food insecurity, poverty, poor health, a lack of personal safety due to violence and resulting trauma. This qualitative study explores parenting experiences of incarcerated mothers separated from their children. Interviews involved 65 mothers in three Australian prisons and 19 stakeholders providing correctional services and support for incarcerated women. Data were analysed using interpretive description. Mothers' accounts highlighted frustrations resulting from trying to maintain relationships with their children, often exacerbating their separation and compounding parenting difficulties. Two major themes emerged from the data: 'protecting their children' and 'at the mercy of the system'. Mothers described how they tried to protect their children from the consequences of their incarceration, yet many of the correctional system processes and procedures made it even harder to maintain connection. Incarcerated mothers need support in their parenting role. Ideally, this support should commence during incarceration. Further, changes within prison routines could enhance mothers' efforts to keep in contact with their children, through visits and phone calls.

Crims and crooks: automatization, communicative capitalism, fandom, and promotion for Wentworth

ABSTRACT This essay examines domestic and international marketing campaigns for the Australian prison drama, Wentworth (Foxtel, 2013–Present), as an intervention into the relationship between (digital) marketing strategies and fan engagement with televisual ideologies. We comment on how three manifestations of marketing (via two campaigns) connect back to automatization, capitalism, incarceration, and media using both technological automation and fan labor—and argue that the campaigns’ use of automation and participatory culture exploited fan communication and fetishized incarceration for capitalistic gain. Extending previous scholarship around participatory culture’s reliance on audience labor and applying a critical cultural studies lens, we elucidate how the show utilized cross-cultural marketing approaches that stood at ideological odds with the show’s content. The first campaign, Australia’s Foxtel promotion of Season Five, employed full automatization to alter the fan viewing experience and maximize profits. The second campaign by Spain’s Calle 13 promoted the series’ Spanish debut. The backdrop for Calle 13’s campaign was drastically different, including only partial automation. It reduced fan interaction and used participatory culture to collect audience information. Both campaigns commercialized fan culture and utilized varying levels of automation to more firmly position prison as an entertainment landscape, simultaneously de-humanizing the experiences of women inmates offscreen.

Hepatitis C treatment strategies in prisons: A cost-effectiveness analysis.

In Australian prisons approximately 20% of inmates are chronically infected with hepatitis C virus (HCV), providing an important population for targeted treatment and prevention. A dynamic mathematical model of HCV transmission was used to assess the impact of increasing direct-acting antiviral (DAA) treatment uptake on HCV incidence and prevalence in the prisons in New South Wales, Australia, and to assess the cost-effectiveness of alternate treatment strategies. We developed four separate models reflecting different average prison lengths of stay (LOS) of 2, 6, 24, and 36 months. Each model considered four DAA treatment coverage scenarios of 10% (status-quo), 25%, 50%, and 90% over 2016–2045. For each model and scenario, we estimated the lifetime burden of disease, costs and changes in quality-adjusted life years (QALYs) in prison and in the community during 2016–2075. Costs and QALYs were discounted 3.5% annually and adjusted to 2015 Australian dollars. Compared to treating 10% of infected prisoners, increasing DAA coverage to 25%, 50%, and 90% reduced HCV incidence in prisons by 9–33% (2-months LOS), 26–65% (6-months LOS), 37–70% (24-months LOS), and 35–65% (36-months LOS). DAA treatment was highly cost-effective among all LOS models at conservative willingness-to-pay thresholds. DAA therapy became increasingly cost-effective with increasing coverage. Compared to 10% treatment coverage, the incremental cost per QALY ranged from $497-$569 (2-months LOS), -$280–$323 (6-months LOS), -$432–$426 (24-months LOS), and -$245–$477 (36-months LOS). Treating more than 25% of HCV-infected prisoners with DAA therapy is highly cost-effective. This study shows that treating HCV-infected prisoners is highly cost-effective and should be a government priority for the global HCV elimination effort.

COVID-19, crisis and imagination

ABSTRACT The prison, as the centrepiece of our justice system, is seen as fixed, unassailable, necessary. Yet, globally, COVID-19 has opened safety valves in previously impregnable, impermeable institutions, from maximum-security prisons to immigration detention. Some Australian prisons – bursting at record-high levels with our most dispossessed, wounded and reviled – have created space in ways that bring cautious hope. Might the crisis license/allow a reimagining of how we might do justice differently? The pandemic has given us pause to consider what ‘justice’ means, what we expect of our penal system, and to rethink our justice machinery. As never-imprisoned and formerly imprisoned co-authors, we reflect critically on COVID-19 inspired commentary, scholarly arguments for decarceration, and the lived experience of criminalisation and imprisonment. We weigh the social and economic costs of a system of punishment that dehumanises, reproduces violence, and causes countless harms to countless lives. We find it unable to rehabilitate, unable to keep us safe, unable to justify its vast expenditure. We find it unsustainable. We reflect on the UN call for a global ceasefire amid the pandemic to imagine a justice system that represents both a ‘ceasefire’, in the short-term, and an architecture of sustainable justice practices into the future.

No news is no news: COVID-19 and the opacity of Australian prisons

ABSTRACT The abysmal conditions facing people inside Australian prisons are often difficult to draw public interest on. During COVID-19, when these conditions pose an even greater danger to the dignity, wellbeing and lives of people inside, why has mainstream media reporting on conditions – including personal protective equipment (PPE) and soap provision, lockdown, health resources and communication – been so sparse? This article will explore the tightening regulatory and legal net of communications and media coming from inside prisons to families, community, and media during COVID-19, and in the years preceding it. It will then outline the significance of these communications, access, and publication restrictions to the media and policy advocacy for COVID-19 decarceration in Australian prisons and the Australian abolition conversation generally.

Why practices that could be torture or cruel, inhuman and degrading treatment should never have formed part of the public health response to the COVID-19 pandemic in prisons

ABSTRACT In this article, we consider the use of restrictive practices in Australian prisons in response to the COVID-19 pandemic, focusing on solitary confinement. We explore the health and human rights implications for people subjected to the practice. An overview is provided of the expansion of powers that have increased the risk of people being detained in conditions that amount to solitary confinement during the pandemic. Australian governments’ use of quarantine and lockdowns as tools to address the risks posed by COVID-19 to people in prison is examined and critiqued. To safeguard against the normalisation of these practices, the use of solitary confinement in prisons should be prohibited in law, and any exceptional circumstances in which a person may be separated from others in prison should be clearly defined, with appropriate safeguards. There also needs to be immediate and effective oversight of prisons in compliance with the Optional Protocol to the Convention Against Torture and other Cruel, Inhuman or Degrading Treatment or Punishment.

COVID-19 and Australian Prisons: Human Rights, Risks, and Responses.

Australian prisons are overpopulated with people suffering from numerous health problems. COVID-19 presents a significant threat to prisoner health. This article examines the current regulatory responses from Australian state and territory governments to COVID-19 and a recent case which tested the human rights of prisoners during a pandemic.

Human rights guidance for Australian prisons: Complementing implementation of the OPCAT

In 2018, the Corrective Services Administrators’ Council updated the Standard Guidelines for Corrections in Australia (2012), renaming them the Guiding Principles for Corrections in Australia. This was an opportunity to ensure alignment with the 2015 United Nations Mandela Rules. However, the Guiding Principles are less aligned with the Mandela Rules than the 2012 Guidelines were. That is, they represent a step backwards. This article examines this missed opportunity to improve prison practice in three areas of frequent human rights violations of imprisoned people: (1) solitary confinement, (2) bodily searches and (3) use of restraints. It argues that the ACT Standards for Adult Correctional Services provide an excellent model for national guidance that should replace the Guiding Principles.

Reduced Hepatitis C Incidence Associated with Rapid Treatment Scale-Up in Australian Prisons: Treatment-as-Prevention in the SToP-C Study

Background: Limited empirical evidence exists for hepatitis C virus (HCV) treatment-as-prevention. The Surveillance and Treatment of Prisoners with hepatitis C (SToP-C) study assessed HCV treatment-as-prevention in four Australian prisons. Methods: Prisoners in two maximum- (male) and two medium-security prisons (one male, one female) were enrolled from late-2014 to 2019. Following HCV testing, participants were monitored for risk behaviors and HCV, among three sub-populations: 1) uninfected (HCV antibody negative); 2) previously infected (HCV antibody positive, HCV RNA negative); 3) infected (HCV antibody and HCV RNA positive). Uninfected and previously infected (at-risk) participants were followed every 3-6 months for HCV primary infection and re-infection, respectively. Infected participants were assessed for treatment, initially standard of care treatment (by prison health services), followed by direct-acting antiviral (DAA) treatment scale-up from mid-2017 (12 weeks sofosbuvir/velpatasvir, through SToP-C). HCV incidence was compared between pre- and post-treatment scale-up periods. Findings: Of 3,691 participants, 719 (19%) had detectable HCV RNA and 2,965 were at-risk of primary infection (n=2,240) or re-infection (n=725) at baseline. DAA treatment was initiated in 349/499 eligible participants during scale-up. Among at-risk population with longitudinal follow-up (n=1,643; median age 33 years; 82% male), 31% reported injecting drug use in prison. HCV incidence declined by 48%, from 8.31 to 4.35/100 person-years between pre- and post-treatment scale-up periods [Incidence Rate Ratio (IRR): 0.52, 95%CI: 0.36, 0.78]. The incidence of primary infection declined from 6.64 to 2.85/100 person-years (IRR: 0.43, 95%CI: 0.25, 0.74), while incidence of re-infection declined from 12.36 to 7.27/100 person-years (IRR: 0.59, 95%CI: 0.35, 1.00). Adjusted analysis indicated 50% reduction in HCV risk between pre- and post-treatment scale-up periods (adjusted Hazard Ratio: 0.50, 95% CI: 0.33, 0.76). Interpretation: DAA treatment scale-up was associated with reduced HCV incidence in prison, indicative of HCV treatment-as-prevention. The findings support broad DAA treatment scale-up among incarcerated populations. Trial Registration: Clinicaltrials.gov Identifier: NCT02064049. Funding Statement: The SToP-C study was funded by an Australian National Health and Medical Research Council (NHMRC) Partnership Project Grant (APP1092547), including support from Gilead Sciences. Declaration of Interests: GJD is a consultant/advisor and has received research grants from Gilead, Abbvie, Merck, Bristol-Myers Squibb, and Cepheid. ARL a consultant/adviser and has received investigator-initiated research grants from Gilead, Merck, and Bristol-Myers Squibb. JG a consultant/advisor and has received research grants from Gilead, Abbvie, Merck, and Cepheid. PV has received investigator-initiated untied grants from Gilead and honorarium from Gilead and Merck. NKM has received unrestricted research grants from Gilead and Merck. JGMc is a stockholder and ex-employee of Gilead Sciences. DMB is a stockholder and employee of Gilead Sciences. None of the other authors has commercial relationships that might pose a conflict of interest in connection with this study. Ethics Approval Statement: All participants provided written informed consent before study procedures. The study protocol was approved by New South Wales Justice Health and Forensic Mental Health Network Human Research Ethics Committee (HREC/14/JH/7), Aboriginal Health and Medical Research Council Human Research Ethics Committee (1047/14 and 1253/17) and New South Wales Corrective Services Ethics Committee. The study was conducted according to the Declaration of Helsinki and International Conference on Harmonization Good Clinical Practice (ICH/GCP) guidelines.

No involuntary treatment of mental illness in Australian and New Zealand prisons

ABSTRACT Reflecting worldwide trends, as the prison population in Australia and New Zealand has risen over the past decade, the number of inpatient beds available for the involuntary treatment of mentally ill prisoners transferred from correctional custody has not increased commensurately. In this context, there have been calls to allow involuntary treatment of serious mental illness in prisons. This narrative review considers the extent of unmet psychiatric need within prisons in Australia and New Zealand and considers whether there is any evidence base for involuntary treatment of serious mental illness in prisons. The review concludes that the involuntary treatment of serious mental illness in custodial settings is likely to compromise clinical care, carries a significant risk of serious harms, encourages inappropriate management of prisoners and breaches human rights conventions. The authors found no evidence of improved clinical outcomes or any other benefits directly or indirectly linked to involuntary treatment of serious mental illness in correctional settings. Finally, the review describes the Prison Mental Health Service in the Australian jurisdiction of Queensland and suggests that this represents a ‘best practice’ model for the management of mentally ill prisoners.

The Effect of Dietary Supplementation on Aggressive Behaviour in Australian Adult Male Prisoners: A Feasibility and Pilot Study for a Randomised, Double Blind Placebo Controlled Trial.

This study aimed to assess the feasibility of conducting a nutrition trial in adult male prisoners. Adult male prisoners were recruited for a 16-week randomised control trial comparing the effect of ingestion of omega-3 long chain polyunsaturated fatty acids (n-3 LCPUFA) and multivitamin supplements versus placebo on aggressive behaviour. The baseline and post-intervention assessments from the participant blood samples were the erythrocyte n-3 LCPUFA levels as well as measures of aggressive behaviour determined through institutional records of misconduct (IRM), the Inmate Behaviour Observation Scale (IBOS), and questionnaires. A total of 136 adult male prisoners consented to the study with a retention rate of 60%, and 93% of blood samples were successfully collected. The IRM and IBOS scores were collected for 100% of participants, whilst 82–97% of participants completed the questionnaires. From the baseline data, the Odds Ratio shows that prisoners are 4.3 times more likely to have an IBOS >2 if they are below the 6% cut off on the omega-3 index. Both groups improved across all outcome measures and, at the current sample size, no significant differences were seen between them. A power calculation suggests a total sample size of 600 participants is required to detect the effects of this dietary supplementation, and that this supplementation study is feasible in a Correctional Centre. Important criteria for the exclusion and consideration of logistics and compliance are presented.

Risky alcohol consumption prior to incarceration: A cross-sectional study of drinking patterns among Australian prison entrants.

Risky alcohol consumption is linked to poor health and criminal justice outcomes. This study aims to assess the prevalence and correlates of risky drinking in a sample of recently incarcerated Australians. Consecutive cross-sectional data were collected from prisoners residing in 19 correctional facilities in six Australian states and territories as part of the National Prison Entrants' Bloodborne Virus and Risk Behaviour Survey Report. The sample consisted of 389 prisoners (339 men, 50 women). Risky alcohol consumption was estimated using the Alcohol Use Disorders Identification Test-Condensed questionnaire, with a cut-off score of ≥6. Potential correlates of risky alcohol consumption were assessed utilising univariate and multivariate analyses. Over one-third (34.5%) of prisoners who were screened met the criteria for risky alcohol consumption. The five factors found to be independently and positively associated with risky alcohol consumption were Aboriginal and Torres Strait Islander (Indigenous) status, incarceration in prison in the Northern Territory, heavy tobacco use, cannabis use and abstinence from drugs in the 4 weeks prior to incarceration. Additionally, risky alcohol consumption was associated with current or past hepatitis B or hepatitis C infection. The findings highlight that risky alcohol consumption is common among prisoners across Australia. This is known to be associated with adverse health outcomes and re-offending, suggesting a need for alcohol interventions targeting prisoners.

Is tougher sentencing and bail policy the cause of rising imprisonment rates? A NSW case study

Between 2000 and 2019, the number of inmates in Australian prisons grew from 21,714 in 2000 to 43,028 in 2019, an increase of 98%, or in per capita terms, 48%. Much of this increase occurred between 2012 and 2019. In New South Wales (NSW), for example, the prison population rose by 17% in the 11 years between 2000 and 2011, but then grew a further 39% in the eight years between 2012 and 2019. A similar acceleration in inmate numbers occurred in other States and Territories after 2011. In this article, we examine the contribution of sentencing, bail, policing policy and crime to the rapid rise in NSW imprisonment rates. We cite evidence showing that the likelihood of bail refusal has changed very little over the period when imprisonment rates rose, we find no evidence of a significant change in the length of sentences and no evidence of an increase in the likelihood of a prison sentence once changes in sentence-relevant factors are taken into account. Most of the increase in imprisonment rates appears to be due to changes in policing policy and (to a lesser extent) certain types of crime.

Onset and trajectory of alcohol and other drug use among Aboriginal men entering a prison treatment program: A qualitative study.

Aboriginal and Torres Strait Islander people are vastly over-represented in Australian prisons. Many people in prison attribute in some way their offences to alcohol and/or other drug (AOD) use. This paper aims to understand AOD use before first and between terms in prison, among a group of Aboriginal men enrolled in a prison-based AOD treatment program. It examines opportunities for prevention or treatment that might interrupt the cycle of alcohol consumption, offending and imprisonment. A thematic analysis of in-depth interviews with 14 Aboriginal men in an urban prison. Participants had low levels of formal education, none having completed high school and had spent limited or no time in the workforce. All 14 spoke of being negatively affected by AOD use within their families. First alcohol and cannabis use were around age 12-14 years, first amphetamines and/or heroin use was around age 15. As adults, they had unstable accommodation and when released from prison returned to the same situation they had been in previously. Most believed they would not have offended and subsequently imprisoned if they did not have a substance use disorder. Without further support post-prison, the men in this study are likely to return to the same situation and continue their AOD use. Further efforts are needed to support families with substance use disorders and to give young Aboriginal and Torres Strait Islander people better education and training opportunities.

Identifying significant contributors for smoking cessation among male prisoners in Australia: results from a randomised clinical trial

IntroductionIn Australia, an estimated 90% of those entering prison are current tobacco smokers and three-quarters of current prisoners are tobacco smokers.AimsTo identify factors and their relative contributions to smoking cessation...

Prisoners' experience and perceptions of health care in Australian prisons: a qualitative study.

Patient-centred care is a key approach used in Australia for the delivery of quality health care, and understanding experiences and perceptions is a key part to this. This paper aims to explore prisoners' experiences and perceptions of health-care service provision in New South Wales, Australia. In February and March 2017, 24 focus groups, consisting of 128 participants, were undertaken using semi-structured interviews that explored experiences of health care in prison. A conceptualisation of the prisoners' health-care experience around the core category of access to health care emerged from the data. Enablers or barriers to this access were driven by three categories: a prison construct - how the prisoners "see" the prison system influencing access to health care; a health-care system construct - how the prisoners "see" the prison health-care system and the pathways to navigate it; and personal factors. Communication was the category with the greatest number of relational connections. This study takes a pragmatic approach to the analysis of data, the findings forming the basis for a future quantitative study. The findings identify communication as a key issue for access to health care. This study provides first-hand accounts of enablers and barriers to accessing health-care services in the prison environment. To the best of the authors' knowledge, this study is the first of its kind to identify access to health care as a core category and is of value to health workers and researchers that work with the prison population.

Mental Health, Psychological Distress, and Coping in Australian Cross‐Cultural Prison Populations

The rates of mental illness are significantly higher in prison populations compared to the general community; however, little research has examined the rates of mental illness for cross-cultural groups of prisoners in Australia. This omission is concerning given the increasingly diverse nature of the Australian prison population. To address this gap in knowledge, the present study aimed to identify rates of key mental health factors and associated psychological processes in a cohort of 191 men from culturally and linguistically diverse, Indigenous Australian and English-speaking backgrounds who were incarcerated at a maximum-security prison in Victoria, Australia. We also explored differences in both psychological distress levels and predictors of psychological distress. Although no significant mental health differences were identified cross-culturally, the results revealed that several mental health factors predicted psychological distress for all prisoners, F(11, 147) = 33.23, p < .001, R2 = .71. The experiences of anxiety and sleep disturbance-related symptoms, β = .34; depressive symptoms, β = .19; posttraumatic stress disorder symptoms, β = .25; and the use of psychological processes, such as avoidance coping, β = .16; and engagement in cognitive fusion, β = .15, all predicted psychological distress. The use of positive thinking as a coping strategy was found to predict a reduced level of psychological distress for prisoners, β = -.13. The findings indicated that the mental health profiles of cross-cultural groups of prisoners are similar in nature, suggesting that justice involvement may be a more useful predictor than cultural differences concerning psychological health.