1. 1 Punishing the vulnerable: Women with Mental Health Disorders & Cognitive Disabilities in the NSW Criminal Justice System Presenter: Eileen Baldry, with Catriona McComish Team: Leanne Dowse, Melissa Clarence, Phillip Snoyman University of New South Wales

2. 2 A tale of 2 women Jen - a young Indigenous woman; raised in disadvantaged suburb outer Sydney; out of home care; very poor education background - truanting / expelled; unstable housing; petty crime; juvenile justice; adult prison; problematic alcohol use; 25 convictions by age 30; 10 custodial episodes; theft, minor assault, breaching orders; 3 dependent children; has borderline ID, PTSD, Alcohol problem; has never had stable supported housing when released or met the criteria for appropriate rehabilitation programs. Ann - a 35 year old non-Indigenous woman; has schizophrenia, some cognitive impairment (ABI?), PD and irregular drug use. History of childhood sexual and physical abuse. Whilst in psych unit 1 year ago threw coffee over a nurse; charged; 1st time in prison - remanded. Last 12 months in and out of prison 3 times; no service will take her; prison the only accommodation. These pathways into prison show the institutional and social failures experienced by women like Jen & Ann

3. 3 The Study Title: People with Mental Health Disorders and Cognitive Disabilities in the Criminal Justice System in NSW Objectives:  Create criminal justice life course histories, highlighting points of agency interactions, diversion and support  Identify gaps in policy, protocols and service delivery and areas of improvement for Criminal Justice and Human Service agencies  Describe individual and group experiences

4. 4 The Study Method:  Nature of sample – purposive and not representative  From Prisoner Health Survey & DCS SDS ID database  Detailed data set on the life-long CJ & HS involvement for cohort of prisoners using linked but de-identified extant administrative records from CJ & HS agencies - Police, Corrections, JH, Courts, JJ, Legal Aid, MH, DoCS, Disability, Housing, other Health services.  Pathway and multilevel analysis

5. 5 Cohort - Summary Full Cohort N=2,731 Intellectual disability N=680 Borderline cognitive disability N=783 Mental health N=965 No MHCD diagnosis N=339 Substance abuse disorder = 1276 Women = 11% N = 313 (30% Indigenous) Indigenous Australians = 25% N = 676; Females N = 93 Not representative - purposive sample

6. 6 Mental State of NSW prisoners

7. 7 Cognitive disability in prison Est. between 2-12% have Intellectual disability (ID) High borderline ID - UK study (Hayes et al 2007) ~ 25%; av IQ was 85% High acquired brain injury

8. 8 Study findings Identifying factors linked to full- time incarceration for women with MHD&CD (sentenced & remand)

9. Convictions Across the whole cohort: 9 ie. men and women in prison identified with cognitive disabilities and mental health disorders : As can seen in this graph there are significantly higher convictions for those with dual or co-occurring disorders (complex needs) than for those with a single diagnosis or no diagnosis The other major finding is that Indigenous persons have a significantly higher number and rate of convictions than non Indigenous people

10. 10 Further findings on convictions People with a history of substance use have a higher proportion of convictions than those with no history People with a borderline intellectual disability (BID) have a higher number of convictions than people without intellectual disability or those with an IQ < 70 There is a significant difference in overall rate of convictions with females having a higher rate of conviction than males Indigenous women have significantly higher rates of convictions than non-Indigenous

11. 11 Offence data: women with MHD&CD are predominantly convicted for … Theft and related offences Road traffic & regulatory Deception (fraud) Justice (breaching orders) Public order These offences are very low on the national severity scale and it is notable that within this cohort, across the different diagnostic groups, men commit offences with a more serious index rating than women.

12. Custodial Episodes by Personal Experience Individuals with complex needs have significantly higher number of custodial orders than those without complex needs Women have a higher rate of custodial episodes per year than men Women with complex needs higher number and rate of custodial episodes than men Indigenous women have the highest number & rate 12

13. Average Time Spent In Custody Men across the cohort categories spend a significantly greater number of days in custody than females in the cohort So although women have more custodial episodes these are shorter in duration - greater rate of cycling in and out of prison for women with complex needs 13

14. Average Days Per Episode In Custody Those with complex needs spend a significantly shorter time on each custodial episode than those with a single or no diagnosis Although they have more episodes in prison, the av. length of stay for Indigenous women is sig. shorter than for non-Indigenous suggesting these may be remand episodes 14

15. 15 Average Days On Remand By Gender Women with complex needs spend less time in remand but have higher number of remand episodes per person than the av in the cohort and than those with single or no diagnosis

16. 16 Which groups of women have the higher rates of incarceration? Complex needs – cognitive disability together with a mental health &/or AOD disorder – rather than single diagnosis Interim analysis is suggesting that being an Indigenous woman may not be associated with higher rates of custody

17. 17 Human services 75% of these women reliant on social housing 1/3rd of these women been through juvenile justice Only 7% of those women with cognitive disability supported by Disability Department

18. 18 What does all this mean? No safe place for disadvantaged girls and women with MHD &/or CD &/or AOD issues. Their self destructive, difficult and anti social behaviour leads to homelessness and social exclusion. Frequently assessed as high risk because of their behaviour though their ‘offending’ is rarely serious This is a social exclusionary and systemic response based upon risk management funneling them into the criminal justice system Starts a normalising cycle around a marginalised prison- community existence & space; no suitable post-release support; CJS repositioned as the ‘therapeutic’ punishing institution Although acknowledged to have high health and social support needs but a low risk to others, usually treated as a high security risk and isolated……. exacerbates mental health problems

19. 19 Further conclusions.. … Although Indigenous women with MHD&CD have the highest rate of custodial episodes, it may not be their Aboriginality that explains this – the critical variable appears to be their complex needs. This keeps them in the cycle. But these Indigenous women’s position of disadvantage and trauma in the first place IS due to their Aboriginality - colonial patriarchy dispossessed, stole, institutionalised and raped Indigenous girls and women and is ongoing.

20. 20 Response Outrage that prison the new therapeutic agency Prevent De-colonise human service and criminal justice agencies Support for vulnerable families & children Decarcerate Resource a variety of long-term, healing & culturally safe community wrap around support housing for women with complex needs (& their children where appropriate)