Hit and Miss: A Study of Post-Release Support Brendan Quinn and Amy Kirwan 23 rd June 2009

Overview Background and context Study aims and methods Preliminary results

Imprisonment and crime statistics Rates of imprisonment –Total of 27,224 prisoners in 2007 with a 6% increase since the previous year’s census and 42% increase since 1997* Prisoner demographics –Median age 33 years, 7% female and 24% Indigenous* Existing incarceration history –57% of prisoners have been previously incarcerated* * ABS, 2007

Imprisonment and crime statistics Crime –10% of charges for those imprisoned are for illicit drugs offences* –46.7% for property and drugs charges combined* Length of sentence –32% serving sentences less than 12 months* –16% less than six months* * DOJ, 2005

Health issues General health and wellbeing –Self-reported health status of prisoners is low (Butler et al, 2004) –95% of women prisoners and 78% of men prisoners have at least one chronic condition (Butler et al, 2001)

Health issues Mental health issues –28% of participants reported high or very high psychological distress prior to incarceration (Kinner, 2006) –All psychiatric disorders combined have a 31% prevalence in the community and 80% prevalence in prison (White et al, 2006)

Health issues Injecting drug use –Of 160 QLD prisoners, 92% reported a history of illicit drug use and 64% a history of injecting (Kinner, 2006) –Of 642 Victorian prisoners, 68.6% reported ever injecting drugs (Hellard, Crofts and Hocking, 2002)

Health issues HCV transmission risk –No prison NSPs in Australia –Unsafe barbering and tattooing practices (ACPS, 2004) –34% of prisoners HCV positive, 20% HBV positive, 1% HIV positive (Butler et al, 2007)

Health issues History of abuse –60% of women prisoners and 37% of men report sexual abuse before age sixteen; 30% of women and 10% of men report sexual abuse before age ten (Butler et al, 2001) –Approximately 1/3 of women prisoners and 1/5 of men prisoners had been through the childhood care system (Butler et al, 2001)

Risks Overdose death risk following release –60% of deaths of post release prisoners are drug related, with 25% of deaths occurring in the month following release (Graham, 2003) –25% of all people dying from heroin related causes from 1990 to 2000 were ex-prisoners (Graham, 2003)

Risks Other mortality risks –Rates of death for post release prisoners from all causes combined were up to 17.8 times greater than the general population (Stewart et al, 2004) –Ex-prisoners are 10 times more likely to die an unnatural death than the general Victorian population (Graham, 2003) –Survival rates decrease with number of releases from prison that an individual has experienced (Graham, 2003)

Risks Lack of accommodation –Most don’t have stable accommodation beyond the short term (Baldry et al, 2002) –Low success in obtaining private rental accommodation (Baldry et al, 2002) Reincarceration –Being highly transient (i.e. moving 2-3 times between interviews) and increasing problematic use of heroin were found to be a predictor of re-incarceration (Baldry et al, 2003)

Supports Parole vs. straight release –Of 30,000 people released each year, only 8400 are on supervision orders of any kind (Borzycki and Baldry, 2002) –Corrections staff may not be skilled to deal with AOD or mental health issues (Biles et al, 1999) Other programs

Hit and Miss: A Study of Post-Release Support Aims: Examine barriers/enablers linking people to health & support services post-release Examine risk behaviours in post-release prisoners with IDU history Identify gaps where service system does not meet actual/perceived post-release needs Map Melbourne services available to post-release individuals

Methods: Cohort of 150 recently released* ex-prisoners with IDU history, interviewed x3 over 6 months Family/key expert interviews Literature review Hit and Miss: A Study of Post-Release Support *Recruited within one month of release