SPRINT: Primary health care services better meeting the health needs of Aboriginal Australians transitioning from prison to the community

The aim of the SPRINT project was to develop culturally specific understandings of how primary health care services can better meet the health care and social support coordination needs of Aboriginal Australians transitioning from the criminal justice system into the community, with a view to reducing reincarceration and improving quality of life. This report describes the factors influencing Aboriginal Australians' access to primary health care on release from custody and suggests ways to increase access to effective primary health care for Aboriginal people in contact with the criminal justice system.The research reported in this paper is a project of the Australian Primary Health Care Research Institute which is supported by a grant from the Australian Government Department of Health and Ageing under the Primary Health Care Research Evaluation and Development Strategy

The effectiveness of primary health care and social support services in meeting the needs of Aboriginal people released from the criminal justice system: A systematic literature review for the SPRINT Project

Whilst their need for social support and health interventions is high, Aboriginal people re-entering the community from prison face many barriers in accessing the services required to build lives in the community. This systematic literature review examined the physical, mental health and social support needs of Aboriginal people released from custody and the impact of pre and post release programs on Aboriginal people's access to primary health care once released from custody, and the barriers to accessing these programs.The research reported in this paper is a project of the Australian Primary Health Care Research Institute which is supported by a grant from the Australian Government Department of Health and Ageing under the Primary Health Care Research Evaluation and Development Strategy

Taking the research journey together: the insider and outsider experiences of aboriginal and non-aboriginal researchers

Aboriginal and Torres Strait Islander peoples of Australia are among the most researched in the world. Indigenous research methodologies reframe a historical colonial-centric and often exploitative research paradigm, to instead privilege the voices and perspectives of Indigenous peoples within a social justice framework. In this article, we describe the lessons learnt in a research partnership between an Aboriginal and two Anglo-Australian researchers conducting an arts-based action research project in collaboration with five Aboriginal communities in New South Wales, Australia. We identify the importance of reflexivity to shed light on the impact of insider and outsider status in order to design and conduct culturally and ethically informed research with Aboriginal communities. Reflexivity, and a collaborative, adaptive approach to research processes also operates to ensure cultural and professional integrity are embedded into such research projects

Mental disorder and cognitive disability in the criminal justice system

This chapter examines what is known about the prevalence of mental disorder and cognitive disability amongst Aboriginal and Torres Strait Islander peoples in contact with the criminal justice system and how these issues impact on individuals, families and communities. The literature in this area is reviewed; there is now a considerable body of evidence supporting the premise that mental disorders are a significant health challenge for Aboriginal and Torres Strait Islander peoples in contact with all aspects of the criminal justice system. There is emerging evidence to suggest that this is also the case for cognitive disability, however further research is required to fully articulate the extent of this challenge. With this understanding, we consider the important and complex implications for mental health and disability services in meeting the needs of Aboriginal and Torres Strait Islander peoples in the criminal justice system

Violence risk assessment in Australian Aboriginal offender populations: a review of the literature

The utilization of violence risk instruments in forensic populations is increasing and a plethora of empirical investigations support their ability to predict recidivistic outcomes. However, the generalizability of these findings to culturally diverse populations is problematic given dissimilarities in cultural traditions, norms, and experiences. The present study explored this subject in relation to Aboriginal Australians. First, a concert of violence risk markers that are more prevalent among Aboriginal Australian offenders compared with non-Aboriginal offenders were examined in light of their social and historical context. Next, studies employing violence risk instruments on cohorts of Aboriginal Australian offenders were reviewed. Findings demonstrated moderate predictive accuracy for violence and commensurate utility with non-Aboriginal offenders although results should be treated with caution due to the paucity of available studies for consideration. Implications for clinical practice and culturally appropriate assessment models are discussed

But-ton Kidn Doon-ga: Black Women Know - Re-presenting the lived realities of Australian Aboriginal women with mental and cognitive disabilities in criminal justice systems

The ease with which Australian Aboriginal women with serious mental (such as depression, anxiety and post traumatic stress disorders) and cognitive disabilities (such as intellectual disability and acquired brain injury) are cycling through Australia’s criminal justice systems, with little attention, proper treatments or culturally responsive care or assistance is truly remarkable. There is growing evidence to show that Aboriginal women with disabilities are involved with police, courts and prisons at much higher rates that are other groups and than their rates in the general community would predict. Almost no attention has been given to the lived realities of those Aboriginal women by state or territory governments, professional peak bodies, social work disability researchers and justice, health and disability service systems.Moreton-Robinson’s Indigenous women’s standpoint theory, which relates to my being as a Goori woman through Worimi and Wonnarua bloodlines who has cultural and communal ties to other Aboriginal women, and critical disability criminology theory, which relates to my professional position and reputation as a mental health and disability criminal justice social worker, are blended into critical Indigenous disability criminology to provide a depth of understanding and explanation of this group of women’s over-representation in criminal justice systems. To assist in arriving at a more complete understanding of their lives and to inform the development of theory and practice, narratives from criminal justice involved Aboriginal women with mental and cognitive disabilities who partnered with this study and Aboriginal and non-Aboriginal support women from families, communities, service providers and prisons were gathered. These narratives were thematically analysed using the theoretical lenses noted earlier to re-present the lived realities of those Aboriginal women. The key themes emerging were management and control of Aboriginal women; segmenting Aboriginal women; surviving and not living; everyone becomes affected; siloed services versus wrap around supports and role and place of Aboriginal women supporters. These drive theory development by suggesting a new way of understanding these groups of Aboriginal women’s lived realities. The thesis makes a crucial and unique contribution to this field, so that the perverse outcomes documented and discussed can be addressed and ultimately prevented

Treatment of opioid dependence with depot buprenorphine (CAM2038) in custodial settings.

BACKGROUND AND AIMS: Opioid agonist treatment is effective but resource intensive to administer safely in custodial settings, leading to significant under-treatment of opioid dependence in these settings world-wide. This study assessed the safety of subcutaneous slow-release depot buprenorphine in custody. SETTING: This is an open-label, non-randomized trial conducted in correctional centres in New South Wales, Australia. Sixty-seven men and women, aged ≥ 18 years of various security classifications with a diagnosis of moderate to severe DSM-5 opioid use disorder currently serving a custodial sentence of ≥ 6 months were recruited between November 2018 and July 2019. Patients not in opioid agonist treatment at recruitment commenced depot buprenorphine; patients already stable on oral methadone treatment were recruited to the comparison arm. INTERVENTION AND COMPARATOR: Depot buprenorphine (CAM2038 weekly for 4 weeks then monthly) and daily oral methadone. Safety was assessed by adverse event (AE) monitoring and physical examinations at every visit. Participants were administered a survey assessing self-reported diversion and substance use at baseline and weeks 4 and 16. FINDINGS: Retention in depot buprenorphine treatment was 92.3%. Ninety-four per cent of patients reported at least one adverse event, typically mild and transient. No diversion was identified. The prevalence of self-reported non-prescribed opioid use among depot buprenorphine patients decreased significantly between baseline (97%) and week 16 (12%, odds ratio = 0.0035, 95% confidence interval = 0.0007-0.018, P < 0.0001). CONCLUSIONS: This first study of depot buprenorphine in custodial settings showed treatment retention and outcomes comparable to those observed in community settings and for other opioid agonist treatment used in custodial settings, without increased risk of diversion