Risk and protective factors for violent behaviour and incarceration for Indigenous and non-Indigenous men in North Queensland

Principal Objectives Very high rates of interpersonal violence and incarceration are reported for men in North Queensland, with very little empirical research existing investigating the factors influencing these phenomena. To investigate these factors, a two-phase exploratory research project was designed and implemented. Phase 1 included conducting in-depth interviews to gather qualitative data, which was then used to inform development of surveys used for Phase 2, the quantitative study. Research question: "What are the risk and protective factors associated with perpetrating violence and incarceration for Indigenous and non-Indigenous men in North Queensland, Australia?" The aims of the project were to explore factors for men in North Queensland that may be associated with an: (1) increase the risk of violent behaviour; (2) reduce the risk of violent behaviour; (3) increase the risk of incarceration; (4) reduce the risk of incarceration; and (5) that may differ for Indigenous compared with non-Indigenous men. Methodology Phase 1 included conducting in depth interviews with participants to provide qualitative data; while Phase 2, informed by the data from Phase 1, involved surveying a larger group of participants to enable quantitative analysis of data. A manager from Lotus Glen Correctional Centre (LGCC) was delegated to recruit inmates from within the prison. Eligibility criteria included being aged 18 years or over, able to read and write English, and sentenced or on remand for violent offences. Excluded were those with mental or physical health issues and if deemed unsuitable for any reason by the LGCC manager. Information sheets were provided to the inmates by the manager, and consent forms were signed. The researcher was then contacted to arrange a time to conduct data collection. A non-randomised recruitment method was used for community participants for Phase 1, as information was sought from a small, 'expert' group for whom the research question was significant. Snowball sampling was used to recruit survey participants for Phase 2. Eligibility for Phase 2 included being male, aged over 18 years, and residing or having grown up in North Queensland, including the Torres Strait Islands. Indigenous Australian research advisors were consulted to ensure cultural appropriateness for all phases of the project. Phase 1. Using an Interpretative Phenomenological Analysis (IPA) framework, interviews were conducted, then transcribed verbatim. Data was managed and coded using NVivo software. Phase 2. The survey was developed using demographic information, interview data from Phase 1 and existing research. The online survey (including information sheet and electronic consent) was accessed by community participants via SurveyMonkey, while prison inmates completed a paper survey. Univariate and multivariate logistic regressions were used to estimate odds ratios (ORs) for each independent variable for violent compared with non-violent and incarcerated compared with non-incarcerated participants. Cross tabulations were used to determine if differences in significant associations existed for Indigenous and non-Indigenous participants between both of the dependent variables and each categorical independent variable. Results Phase 1. The sample included 26 Indigenous and 13 non-Indigenous Australian participants, including 19 prison inmates. Overall, for Indigenous participants, and for incarcerated participants adverse family and childhood factors were the most influential category of risk factors for violent behaviour and incarceration, while socio-economic factors were the most important theme for non-Indigenous participants. The next most important themes were personal attributes, socio-economic factors, witnessing or a history of violence, and peer group and social influences. Non-Indigenous participants also frequently mentioned substance use and abuse. Overall, the most common protective factor themes were having good role models and mentors. Next were personal attributes, family and childhood factors, coping skills, and socioeconomic factors. For Indigenous participants extracurricular activities were commonly mentioned, while non-Indigenous participants believed socio-economic factors were very important. A common trajectory from trauma to incarceration was also identified for a sample of incarcerated participants (n=11) during this study. This trajectory, while not identified as a causal path for violence or incarceration per se, included childhood or adolescent trauma, a lack of support or treatment for trauma, substance abuse to mask the pain, and a 'brain snap' (sudden action, without conscious thought) precipitating a violent offence, resulting in incarceration. Phase 2. The survey was completed by 85 men (of whom 30 were Indigenous) from North and Far North Queensland, including 37 inmates, and 48 community members. Frequent cannabis use increased the risk of perpetration of violence towards others, while a higher education level reduced the risk. When comparing cultural groups, significant associations were revealed for both alcohol and cannabis use with violence for non-Indigenous, but not for Indigenous participants. Cannabis use and religious beliefs increased the risk of incarceration, while higher education levels, positive childhood events and being in a relationship were protective. Comparison of cultural groups revealed significant associations between religious beliefs and incarceration for Indigenous but not for non-Indigenous participants. Alcohol and cannabis use were significantly associated with incarceration for non-Indigenous, but not for Indigenous participants. Principal Conclusions This is one of the first explorative studies of this kind conducted in North Queensland, with Indigenous and non-Indigenous Australians, including prison inmates. Early intervention and treatment efforts focusing on young males, particularly users, or those at risk of using cannabis, could help to reduce violence and incarceration rates for future generations. The use of culturally appropriate assessment tools is also critical, as many tools are not validated for use with Indigenous Australians, or with prison inmates. This would aid diagnosis, treatment plans and, for inmates, rehabilitation management. The importance of social determinants, including childhood upbringing and experiences, and education to a tertiary or vocational level are highlighted in this study. The socioeconomic indicators of regional and remote communities, particularly Indigenous communities, are often far worse than urban populations, with little or no constructive economic activity, educational, or employment options available. Assisting men to gain meaningful employment, identifying needs, and developing individual strengths to reduce violent behaviour and incarceration may allow more men to become constructive, functioning contributors to society. Breaking the cycle of violence and incarceration for these men requires the public health community, educators, legislators, community leaders and young people to work towards reducing risks and increasing strengths and presenting alternate pathways for disadvantaged young people

Alcohol management plans in Aboriginal and Torres Strait Islander (Indigenous) Australian communities in Queensland: community residents have experienced favourable impacts but also suffered unfavourable ones

Background: In Australia, 'Alcohol Management Plans' (AMPs) provide the policy infrastructure for State and Commonwealth Governments to address problematic alcohol use among Aboriginal and Torres Strait Islanders. We report community residents' experiences of AMPs in 10 of Queensland's 15 remote Indigenous communities.\ud \ud Methods: This cross-sectional study used a two-stage sampling strategy: N = 1211; 588 (48%) males, 623 (52%) females aged ≥18 years in 10 communities. Seven propositions about 'favourable' impacts and seven about 'unfavourable' impacts were developed from semi-structured interviews. For each proposition, one-sample tests of proportions examined participant agreement and multivariable binary logistic regressions assessed influences of gender, age (18–24, 25–44, 45–64, ≥65 years), residence (≥6 years), current drinking and Indigenous status. Confirmatory factor analyses estimated scale reliability (ρ), item loadings and covariances.\ud \ud Results: Slim majorities agreed that: AMPs reduced violence (53%, p = 0.024); community a better place to live (54%, 0.012); and children were safer (56%, p < 0.001). More agreed that: school attendance improved (66%, p < 0.001); and awareness of alcohol's harms increased (71%, p < 0.001). Participants were equivocal about improved personal safety (53%, p = 0.097) and reduced violence against women (49%, p = 0.362). The seven 'favourable' items reliably summarized participants' experiences of reduced violence and improved community amenity (ρ = 0.90).\ud \ud Stronger agreement was found for six 'unfavourable' items: alcohol availability not reduced (58%, p < 0.001); drinking not reduced (56%, p < 0.001)); cannabis use increased (69%, p < 0.001); more binge drinking (73%, p < 0.001); discrimination experienced (77%, p < 0.001); increased fines, convictions and criminal records for breaching restrictions (90%, p < 0.001). Participants were equivocal (51% agreed, p = 0.365) that police could enforce restrictions effectively. 'Unfavourable' items were not reliably reflected in one group (ρ = 0.48) but in: i) alcohol availability and consumption not reduced and ii) criminalization and discrimination.\ud \ud In logistic regressions, longer-term (≥ 6 years) residents more likely agreed that violence against women had reduced and that personal safety had improved but also that criminalization and binge drinking had increased. Younger people disagreed that their community was a better place to live and strongly agreed about discrimination. Current drinkers' views differed little from the sample overall.\ud \ud Conclusions: The present Government review provides an opportunity to reinforce 'favourable' outcomes while targeting: illicit alcohol, treatment and diversion services and reconciliation of criminalization and discrimination issues.\ud \u

Alcohol management plans in Aboriginal and Torres Strait Islander (Indigenous) Australian communities in Queensland: Community residents have experienced favourable impacts but also suffered unfavourable ones

Background: In Australia, ‘Alcohol Management Plans’ (AMPs) provide the policy infrastructure for State and Commonwealth Governments to address problematic alcohol use among Aboriginal and Torres Strait Islanders. We report community residents’ experiences of AMPs in 10 of Queensland’s 15 remote Indigenous communities. Methods: This cross-sectional study used a two-stage sampling strategy: N = 1211; 588 (48%) males, 623 (52%) females aged ≥18 years in 10 communities. Seven propositions about ‘favourable’ impacts and seven about ‘unfavourable’ impacts were developed from semi-structured interviews. For each proposition, one-sample tests of proportions examined participant agreement and multivariable binary logistic regressions assessed influences of gender, age (18–24, 25–44, 45–64, ≥65 years), residence (≥6 years), current drinking and Indigenous status. Confirmatory factor analyses estimated scale reliability (ρ), item loadings and covariances. Results: Slim majorities agreed that: AMPs reduced violence (53%, p = 0.024); community a better place to live (54%, 0.012); and children were safer (56%, p < 0.001). More agreed that: school attendance improved (66%, p < 0. 001); and awareness of alcohol’s harms increased (71%, p < 0.001). Participants were equivocal about improved personal safety (53%, p = 0.097) and reduced violence against women (49%, p = 0.362). The seven ‘favourable’ items reliably summarized participants’ experiences of reduced violence and improved community amenity (ρ = 0.90). Stronger agreement was found for six ‘unfavourable’ items: alcohol availability not reduced (58%, p < 0.001); drinking not reduced (56%, p < 0.001)); cannabis use increased (69%, p < 0.001); more binge drinking (73%, p < 0.001); discrimination experienced (77%, p < 0.001); increased fines, convictions and criminal records for breaching restrictions (90%, p < 0.001). Participants were equivocal (51% agreed, p = 0.365) that police could enforce restrictions effectively. ‘Unfavourable’ items were not reliably reflected in one group (ρ = 0.48) but in: i) alcohol availability and consumption not reduced and ii) criminalization and discrimination. In logistic regressions, longer-term (≥ 6 years) residents more likely agreed that violence against women had reduced and that personal safety had improved but also that criminalization and binge drinking had increased. Younger people disagreed that their community was a better place to live and strongly agreed about discrimination. Current drinkers’ views differed little from the sample overall. Conclusions: The present Government review provides an opportunity to reinforce ‘favourable’ outcomes while targeting: illicit alcohol, treatment and diversion services and reconciliation of criminalization and discrimination issues. Keywords: Alcohol, Indigenous, Aboriginal and Torres Strait Islander, Australian, Legal intervention, EvaluationThe study was funded by the National Health and Medical Research Council of Australia (NHMRC, Project Grant #APP1042532) with additional support from the Australian Primary Health Care Research Institute-funded Centre for Research Excellence for the Prevention of Chronic Conditions in Rural and Remote High Risk Populations at James Cook University & University Adelaide. Associate Professor Caryn West is a National Health and Medical Research Council of Australia Early Career Research Fellow (#APP1070931). Professor Clough holds a NHMRC Career Development Award (#APP1046773)

From trauma to incarceration: exploring the trajectory in a qualitative study in male prison inmates from north Queensland, Australia

Background: There were approximately 34,000 prisoners incarcerated in Australian correctional centres as of 2014. The most common offence type for these prisoners was 'acts intended to cause injury', comprising 18 % of the total offences. Of the various risk factors for violent offending and incarceration identified in international research, trauma - either single events or ongoing; and substance abuse - which is commonly associated with violent behaviour across many cultures, are major contributors.\ud \ud Method: This paper analyses qualitative data from 11 in-depth interviews with inmates from a high security male correctional centre in QLD, Australia. The aim of the study was to explore risk factors for violence and incarceration for men from far north Queensland.\ud \ud Results: A common trajectory to violent offending and incarceration was identified for these prisoners, including: childhood/adolescent trauma; a lack of support or treatment for trauma experiences; substance abuse to mask the pain; and a 'brain snap' precipitating a violent offence.\ud \ud Conclusion: Further research is required into factors leading to violent offending and incarceration generally. In particular early detection and intervention for trauma victims is imperative in order to reduce exposure to such a harmful trajectory from trauma to incarceration

Evaluation of the North Queensland Combined Women’s Service Sexual Assault Response Team Trial: Final report

The final report was the third report of the 18 month evaluation of a regional 24/7 Sexual Assault Response Team (SART) trial in regional Queensland. The report identified best practice models responding to sexual assault and the positioning of the regional SART, the short term outcomes for victims and the sustainability, transferability and applied learning to other complex systems

The NHMRC Road Map 'benchmark' principles: a formal evaluation process is needed to improve their application

[Extract] The appropriate conduct of health research in Indigenous communities is an ongoing topic of discussion, underpinned by ethical, epistemological and methodological issues. Data collected, analysed and disseminated from research in Indigenous communities has typically met the needs of the researcher first, with Indigenous communities often playing a passive role in the research process.\ud \ud Australia's National Health and Medical Research Council's (NHMRC) 'Road Maps I and II: Strategic Framework for Improving Aboriginal and Torres Strait Islander Health through Research' provide researcher guidelines to ensure the needs and concerns of Indigenous Australian (Aboriginal and Torres Strait Islander) communities are met. The guidelines' six principles relate to ethical research with the overall objective of making research relevant to the peoples and communities involved (see Table 1)