Prisons In Queensland Research Articles

Accuracy and predictive value of incarcerated adults' accounts of their self-harm histories: findings froman Australian prospective data linkage study.

Self-harm is prevalent in prison populations and is a well-established risk factor for suicide. Researchers typically rely on self-report to measure self-harm, yet the accuracy and predictive value of self-report in prison populations is unclear. Using a large, representative sample of incarcerated men and women, we aimed to examine the level of agreement between self-reported self-harm history and historical medical records, and investigate the association between self-harm history and medically verified self-harm after release from prison. During confidential interviews with 1315 adults conducted within 6 weeks of expected release from 1 of 7 prisons in Queensland, Australia, participants were asked about the occurrence of lifetime self-harm. Responses were compared with prison medical records and linked both retrospectively and prospectively with ambulance, emergency department and hospital records to identify instances of medically verified self-harm. Follow-up interviews roughly 1, 3 and 6 months after release covered the same domains assessed in the baseline interview as well as self-reported criminal activity and contact with health care, social and criminal justice services since release. Agreement between self-reported and medically verified history of self-harm was poor, with 64 (37.6%) of 170 participants with a history of medically verified self-harm disclosing a history of self-harm at baseline. Participants with a medically verified history of self-harm were more likely than other participants to self-harm during the follow-up period. Compared to the unconfirmed-negative group, the true-positive (adjusted hazard ratio [HR] 6.2 [95% confidence interval (CI) 3.3-10.4]), false-negative (adjusted HR 4.0 [95% CI 2.2-6.7]) and unconfirmed-positive (adjusted HR 2.2 [95% CI 1.2-3.9]) groups were at increased risk for self-harm after release from prison. Self-reported history of self-harm should not be considered a sensitive indicator of prior self-harm or of future self-harm risk in incarcerated adults. To identify those who should be targeted for preventive strategies, triangulation of data from multiple verifiable sources should be performed whenever possible.

Do Libraries in Queensland Prisons Align with Australian Library and Information Association Minimum Standard Guidelines for Library Services for Prisoners?

The Australian Library and Information Association (ALIA) produced guidelines for library services in prisons in 2015. Written by a working group of academics, law librarians and prison librarians,...

High rates of general practice attendance by former prisoners: a prospective cohort study.

To determine the rates at which people recently released from prison attend general practitioners, and to describe service users and their encounters. Prospective cohort study of 1190 prisoners in Queensland, interviewed up to 6 weeks before expected release from custody (August 2008 - July 2010); their responses were linked prospectively with Medicare and Pharmaceutical Benefits Scheme data for the 2 years after their release. General practice attendance was compared with that of members of the general Queensland population of the same sex and in the same age groups. Rates of general practice attendance by former prisoners during the 2 years following their release from prison. In the 2 years following release from custody, former prisoners attended general practice services twice as frequently (standardised rate ratio, 2.04; 95% CI, 2.00-2.07) as other Queenslanders; 87% of participants visited a GP at least once during this time. 42% of encounters resulted in a filled prescription, and 12% in diagnostic testing. Factors associated with higher rates of general practice attendance included history of risky opiate use (incidence rate ratio [IRR], 2.09; 95% CI, 1.65-2.65), having ever been diagnosed with a mental disorder (IRR, 1.32; 95% CI, 1.14-1.53), and receiving medication while in prison (IRR, 1.82; 95% CI, 1.58-2.10). Former prisoners visited general practice services with greater frequency than the general Queensland population. This is consistent with their complex health needs, and suggests that increasing access to primary care to improve the health of former prisoners may be insufficient, and should be accompanied by improving the quality, continuity, and cultural appropriateness of care.

Understanding How Incarceration Challenges Proximal Processes in Father-Child Relationships: Perspectives of Imprisoned Fathers

Parental incarceration is detrimental to most, but not all, children. The mechanisms that drive these findings are largely unknown, but may relate to changes in the parent-child relationship during imprisonment. Furthermore, a parent’s incarceration may serve to “knife off” or restrict opportunities for parenting post-release and for developing non-offending scripts for the future. Our aim was to examine proximal processes between fathers and their children during the imprisonment period in order to understand opportunities for, and disruptions to, parent and child development in the correctional context. Semi-structured interviews were conducted with 64 imprisoned fathers across three prisons in Queensland (Australia). Using Bronfenbrenner’s PPCT model, proximal processes were explored in relation to (1) the communication and parenting skills of the father; (2) the prison and family context; and (3) time intervals for exposure (i.e. father-child contact). An absence of developmentally promotive proximal processes characterised many father-child relationships, as well as proximal processes that have the potential to be disruptive to the development of both the father and child/ren. However, some men described high quality, meaningful exchanges with their children through regular visits in a setting conducive to play-based interactions, supplemented by frequent phone calls and letters, all of which was heavily supported by caregivers. Proximal processes were influenced most notably by context, specifically that of prison policies and for some, problematic relationships with caregivers. While further elucidation of the theory is required, the study highlights the need for prison to be considered as a developmental context for parenting.

Extending smoking abstinence after release from smoke-free prisons: protocol for a randomised controlled trial

BackgroundA smoking ban was implemented across all prisons in Queensland, Australia, in May 2014, with the aim of improving the health of prisoners and prison staff. However, relapse to smoking after release from prison is common. Only one previous study, conducted in the United States, has used a randomised design to evaluate an intervention to assist individuals in remaining abstinent from smoking following release from a smoke-free prison.MethodsThis paper describes the rationale for and design of a randomised controlled trial of an intervention to extend smoking abstinence in men after release from smoke-free prisons in the state of Queensland, Australia. Participants in the intervention group will receive a brief intervention involving four group sessions of motivational interviewing and cognitive behavioural therapy, initiated 4 weeks prior to release from prison. The comparison group will receive a pamphlet and brief verbal intervention at the time of baseline assessment. Assessment of self-reported, post-release smoking status will be conducted by parole officers at regular parole meetings with the primary outcome measured at 1 month post release.DiscussionThe prevalence of smoking and related health harms among people who experience incarceration is extremely high. Effective interventions that result in long-term smoking cessation are needed to reduce existing health disparities in this vulnerable population.Trial registrationCurrent Controlled Trials ACTRN12616000314426

The Concordance of Self-Reported and Officially Recorded Criminal Onset: Results From a Sample of Australian Prisoners

This study examines the concordance of self-reported and officially recorded criminal onset among a sample of prisoners in Queensland, Australia. Classified into one of four developmental stages, Gwet’s Agreement Coefficient 1 (AC1) is used to examine the concordance of these two popular data sources. Analysis is conducted across seven offense types, and comparisons are made between Indigenous and non-Indigenous offenders. Results indicate moderate agreement between self-reports and official records with greater concordance for violent and serious property offenses. With few exceptions, self-reported onset precedes officially recorded onset, and concordance was greater for Indigenous offenders. These findings have important methodological implications for criminological research, in particular, developmental and life-course theory, which emphasizes the theoretical importance of the timing and sequencing of criminal events.

Women's Health in Queensland Prisons.

Internationally, best practice for prison health care recommends transferring health service provision from corrections to health authorities. Although it is expected that this change will result in improved health care, there is little evidence of evaluation. This article used qualitative interviews with health service providers to gain insight into the health needs of women's prisons in Queensland, Australia, both prior to and after the transition in health care service provision. We found that service providers identified that problems persisted regardless of service provider and that improvement required increased resources and more fundamental structural changes within prison environments.

How the prison-to-community transition risk environment influences the experience of men with co-occurring mental health and substance use disorder

Previous research has established that people with severe mental illness and co-occurring substance use disorder leaving prison have multiple and complex health, social and economic challenges. How the criminal justice and mental health systems influence the individual prison-to-community transition experience of this population is less well understood. This paper draws on unique qualitative data from a study of 18 men with co-occurring severe mental illness and substance use disorder leaving prison in Queensland, Australia. A repeat in-depth interview method was used to explore the experiences of the men in prison just prior to release and at two points post-release. Two themes are discussed from analysis of interviews: “risk behaviour and relapse” and “once a criminal always a risk”. The findings suggest that individual risk behaviour is structured within a transition risk environment that reduces individual agency, thus facilitating a vicious cycle of release, relapse and reincarceration.

Epidemiology of Infectious Disease-Related Death After Release from Prison, Washington State, United States, and Queensland, Australia: A Cohort Study.

People in prison may be at high risk for infectious diseases and have an elevated risk of death immediately after release compared with later; their risk of death is elevated for at least a decade after release. We compared rates, characteristics, and prison-related risk factors for infectious disease-related mortality among people released from prisons in Queensland, Australia, and Washington State, United States, regions with analogous available data. We analyzed data from retrospective cohort studies of people released from prison in Queensland (1997-2007, n=37,180) and Washington State (1999-2009, n=76,208) and linked identifiers from each cohort to its respective national death index. We estimated infectious disease-related mortality rates (deaths per person-years in community) and examined associations using Cox proportional hazard models. The most frequent infectious disease-related underlying cause of death after release from prison was pneumonia (43%, 23/54 deaths) in the Australian cohort and viral hepatitis (40%, 69/171 deaths) in the U.S. cohort. The infectious disease-related mortality rate was significantly higher in the U.S. cohort than in the Australian cohort (51.2 vs. 26.5 deaths per 100,000 person-years; incidence rate ratio = 1.93, 95% confidence interval 1.42, 2.62). In both cohorts, increasing age was strongly associated with mortality from infectious diseases. Differences in the epidemiology of infectious disease-related mortality among people released from prison may reflect differences in patterns of community health service delivery in each region. These findings highlight the importance of preventing and treating hepatitis C and other infectious diseases during the transition from prison to the community.

The concordance of self-reported and officially recorded lifetime offending histories: Results from a sample of Australian prisoners

PurposeThis study examines the concordance of self-reported and officially recorded lifetime offending (prevalence and frequency) for seven offense types among a sample of prisoners in Queensland, Australia. MethodsPrevalence estimates, kappa coefficients and odds ratios are calculated as measures of concordance. Logistic regression models are used to calculate adjusted Odds Ratios, controlling for the time since last charge. The frequency of official records and the Indigenous-disparity is modelled using Negative Binomial Regression, controlling for self-reported offending and memory-recall effects. ResultsThere was satisfactory concordance between the self-reported and officially recorded prevalence of offending, although the strength of concordance varied by offense type. There was no difference in the degree of concordance between Indigenous and non-Indigenous offenders and controls for memory-recall did not substantially improve concordance. For frequencies, self-reported rates were higher than officially recorded rates for some offenses but not others. Indigenous offenders generally had a higher number of official records even after accounting for self-reports and memory-recall effects. ConclusionThese data provide further evidence that self-reports and official reports are not dissimilar and seem to be tapping similar behavior. In the Australian context, more effort is needed to ensure that self-report methods are culturally appropriate for Indigenous offenders.

Low-intensity case management increases contact with primary care in recently released prisoners: a single-blinded, multisite, randomised controlled trial

BackgroundThe world prison population is large and growing. Poor health outcomes after release from prison are common, but few programmes to improve health outcomes for ex-prisoners have been rigorously evaluated....

Factors Associated With Sexual Coercion in a Representative Sample of Men in Australian Prisons.

Very little research has focused on men or prisoners as victims of sexual violence. This study provides the first population-based analysis of factors associated with sexual coercion of men in Australian prisons, and the first to use a computer-assisted telephone interview to collect this information in a prison setting. A random sample of men in New South Wales and Queensland prisons were surveyed using computer-assisted telephone interviewing. We asked participants about sexual coercion, defined as being forced or frightened into doing something sexually that was unwanted while in prison. Associations between sexual coercion in prison and sociodemographics, sexual coercion history outside of prison, and prison-related factors were examined. Logistic regression was used to estimate adjusted odds ratios in examining factors associated with sexual coercion in prisons. Of 2626 eligible men, 2000 participated. Participants identifying as non-heterosexual and those with a history of sexual coercion outside prison were found to be most at risk. Those in prison for the first time and those who had spent more than 5years in prison ever were also more likely to report sexual coercion. Although prison policies and improving prison officer training may help address immediate safety and health concerns of those at risk, given the sensitivity of the issue and likely under-reporting to correctional staff, community-based organizations and prisoner peer-based groups arguably have a role too in providing both preventive and trauma-focused support.

Trajectories of psychological distress after prison release: implications for mental health service need in ex-prisoners.

Understanding individual-level changes in mental health status after prison release is crucial to providing targeted and effective mental health care to ex-prisoners. We aimed to describe trajectories of psychological distress following prison discharge and compare these trajectories with mental health service use in the community. The Kessler Psychological Distress Scale (K10) was administered to 1216 sentenced adult prisoners in Queensland, Australia, before prison release and approximately 1, 3 and 6 months after release. We used group-based trajectory modeling to identify K10 trajectories after release. Contact with community mental health services in the year following release was assessed via data linkage. We identified five trajectory groups, representing consistently low (51.1% of the cohort), consistently moderate (29.8%), high increasing (11.6%), high declining (5.5%) and consistently very high (1.9%) psychological distress. Mood disorder, anxiety disorder, history of self-harm and risky drug use were risk factors for the high increasing, very high and high declining trajectory groups. Women were over-represented in the high increasing and high declining groups, but men were at higher risk of very high psychological distress. Within the high increasing and very high groups, 25% of participants accessed community mental health services in the first year post-release, for a median of 4.4 contact hours. For the majority of prisoners with high to very high psychological distress, distress persists after release. However, contact with mental health services in the community appears low. Further research is required to understand barriers to mental health service access among ex-prisoners.

Enhancing research quality through cultural competence: a case study in Queensland prisons.

To describe the processes undertaken to maximise cultural competence in a complex research project and illustrate how this enhanced the quality of the research and impact of the research outcomes. An epidemiological survey of the mental health of Indigenous people in custody in Queensland was conducted using culturally informed research processes. The research process that enhanced cultural competence is described. The research outcomes were positive in terms of participant and community experiences, participation rates, publications and other research outputs, capacity building and translation of research findings. This paper describes in practical terms how to conduct culturally informed research and how this approach enhanced the scientific rigour of a complex Indigenous health research project. Indigenous health research should be conducted using a culturally competent method.

Incidence and predictors of non-fatal drug overdose after release from prison among people who inject drugs in Queensland, Australia

IntroductionRelease from prison is a period of elevated risk for drug-related harms, particularly among people who inject drugs (PWID). Non-fatal overdose can cause serious morbidity and predicts future fatal overdose, however neither the incidence nor the risk factors for non-fatal overdose following release from prison are well understood. MethodsStructured health-related interviews were conducted with 1051 adult prisoners in Queensland, Australia prior to release and approximately 1, 3 and 6 months post-release. Incidence of self-reported overdose in the community was calculated for PWID and all prisoners for three discrete time periods. Negative binomial regression with robust error variance was used to identify pre-release predictors of overdose among PWID. ResultsThe incidence of reported overdose was highest between 1 and 3 months post-release (37.8 per 100 person-years (PY) among PWID; 24.5/100 PY among all ex-prisoners). In adjusted analyses, the risk of post-release non-fatal overdose was higher for PWID who reported: being unemployed for >6 months before prison, having been removed from family as a child, at least weekly use of benzodiazepines and/or pharmaceutical opiates in the 3 months prior to prison, and ever receiving opioid substitution therapy (OST). Pre-release psychological distress and a lifetime history of mental disorder also predicted overdose, whereas risky alcohol use in the year before prison was protective. ConclusionsPWID have a high risk of overdose following release from prison. Imprisonment is an opportunity to initiate targeted preventive interventions such as OST, overdose prevention training and peer-delivered naloxone for those with a high risk profile.

Early primary care physician contact and health service utilisation in a large sample of recently released ex-prisoners in Australia: prospective cohort study

ObjectiveTo describe the association between ex-prisoner primary care physician contact within 1 month of prison release and health service utilisation in the 6 months following release.DesignA cohort from the Passports...

Poor health and social outcomes for ex‐prisoners with a history of mental disorder: a longitudinal study

ObjectiveTo examine the association between self‐reported lifetime diagnosis of mental disorder and health‐related outcomes in prisoners during the first six months after release. MethodsWe interviewed 1,324 adult prisoners in Queensland, Australia, within six weeks of expected release and one, three and six months post‐release. Outcomes of interest included health service access, housing, employment, substance use and criminal activity. We used multivariate logistic regression to investigate the association between self‐reported, lifetime diagnosis of mental disorder and these health‐related outcomes post‐release, adjusting for pre‐existing disadvantage. Results43.4% of participants reported a lifetime diagnosis of mental disorder. This group had increased crude odds of poor outcomes across all evaluated domains. After adjusting for pre‐existing disadvantage, significantly increased odds of poor outcomes persisted in the substance use, mental health, crime and health service access domains. ConclusionsPeople with a history of mental disorder experience particularly poor outcomes following release from prison that are not fully explained by pre‐existing disadvantage. ImplicationsEvidence‐based transitional programs for prisoners with a history of mental disorder should be provided at a level commensurate with need.

Commentary on Forsyth et al. (2014): Subgroup differences in post‐release mortality—implications for access to diverse and effective treatments

In their cohort study of more than 42 000 individuals released from prisons in Queensland, Australia, Forsyth and colleagues 1 extend the existing literature on post-release health outcomes in two important ways. First, the study highlights alcohol as an important cause of death among indigenous people from prison. International studies have demonstrated an early elevated risk of drug-related death after release from prison 2, 3. However, compared to drugs, alcohol use as a contributor to poor post-release health outcomes has received relatively less attention by researchers and policymakers. As highlighted by the authors, interventions that focus exclusively on reducing the complications of drug use may not adequately address the needs of many at risk for complications of alcohol use. Secondly, time trends in mortality after release from prison vary by cause of death and population. For instance, Forsyth and colleagues show no clear early peak in alcohol-related deaths among non-indigenous people and only a small early elevation in alcohol-related deaths in indigenous people after release from prison. Differences in substance use patterns, economic circumstances, community and family support and access to community services vary by culture, ethnicity, gender and regional context. Interventions to address post-release morbidity and mortality may show the most benefit when tailored to the cultural backgrounds of people returning from prison and the specific contexts to which they return. Unfortunately, there is a notable paucity of evidence-based, effective interventions designed to prevent post-release morbidity and mortality. It is critical to develop and test novel interventions, particularly tailored interventions, to prevent poor outcomes among individuals coming out of prisons. It would be expected that the benefits of interventions may be heterogeneous across medical diagnoses, mental health conditions, substances involved, time relative to release and populations studied. Epidemiological findings on post-release mortality provide some guidance on the diversity of potential health outcomes to consider, when they should be assessed relative to release and in which populations of people leaving prisons. In the meantime, there are many evidence-based treatments for substance use disorders that are systematically denied to individuals in prison and to which those leaving prisons have limited access. While enforced abstinence may be relatively feasible in prison, this approach does not prepare people well for the post-release environment and life in the community. In the community, individuals are faced with numerous triggers to use alcohol and drugs 4. Pharmacologically supported treatments for alcohol, tobacco and other drugs should be made available to those who need and want them in prisons and during the transition back to the community. It is critical that people in prisons have access to a broad range of effective treatment options, given that they may have previously failed some, have experienced adverse effects of others and may have strong individual (or cultural) preferences for the types of treatment they want. Decisions about which treatments are available to people with criminal justice involvement cannot be made based on long-standing biases against medication-assisted treatment; nor should they be made based on simplistic cost estimates that fail to account for the high cost of incarceration and uncontrolled substance use disorders. People involved in the criminal justice system, often as a result of problems with alcohol and drugs, are the people who need the very best treatment options we have to offer—but are the least likely to get them 5-7. At the same time, community access to evidence-based treatment is one approach to preventing incarceration in the first place. Without universal access to evidence-based addiction treatment in the community, having a truly ethical justice system is out of reach. None.

A comparison of risk factors for hepatitis C among young and older adult prisoners.

Internationally, the prevalence of hepatitis C infection is higher among prisoners when compared to the general population, particularly among people who inject drugs. This study estimates the prevalence of, and compares the risk factors for, hepatitis C in young (< 25 years) and older (≥ 25 years) prisoners with a history of injection drug use. Participants were 677 sentenced prisoners in Queensland, Australia, with a lifetime history of injection drug use, recruited in the 6 weeks prior to release from custody. The prevalence of hepatitis C exposure was significantly lower in young prisoners than in older prisoners (20.7% vs. 29.4%, p = .03). Risk factors for hepatitis C varied between young and older prisoners. Young people who inject drugs and who have had shorter time at risk of hepatitis C exposure are an important target group for hepatitis C prevention efforts.

Suicide in adults released from prison in Queensland, Australia: a cohort study

BackgroundPrevious research has demonstrated elevated mortality following release from prison. We contrasted the risk of opioid overdose death with the risk of suicide in a cohort of adults released from...