Presentation on theme: "Keeping Prisoners Out- We Don’t Take “NO” for an Answer Puzzle Reintegration Conference Hobart - June, 2010 Dr Sandra Sunjic & Stephen Ward Justice Health."— Presentation transcript:
Keeping Prisoners Out- We Don’t Take “NO” for an Answer Puzzle Reintegration Conference Hobart - June, 2010 Dr Sandra Sunjic & Stephen Ward Justice Health
Case Scenario 36 year old Iranian Man Arrived in Australia at 13 years old Cannabis, MDMA use from 21 years old In custody 4 months on remand
Case Scenario Current charges: Take /detain to obtain advantage/attempt to choke Use offensive weapon X 4 Common assault X 4 Possess unregistered firearm/unauthorised pistol Goods in custody Not keep firearm safe Drive vehicle furiously/recklessly Assault Occasioning Actual Bodily Harm X 2
Case Scenario Referred by Solicitor via NSW Housing Bahai faith Circumstances of charges Mental Health Issues Supreme Court Bail Post release progress Court outcome
Strengths model Rapp et al (2007) Denial as a result of: Hopelessness about ability to change Difficulty prioritising and organising solutions to multiple life problems Problems utilising needed resources
Personal Strengths Model of Care Use client strengths, abilities, assets Focus on positives Clients control goal setting No goal is unrealistic – broken down Client-Worker relationship primary Workers assist – do not treat Assertive outreach/advocacy
Connections Project Commenced September 2007 State-wide No eligibility criteria – offences Problematic drug use Pre-release assessment & comprehensive care planning Post-release linkage – health & welfare services One month post-release support - with option of extended care Immediate extended care
What the Research says: >80% inmates ever used illicit drugs (Butler & Milner, 2001) (Sample:7674 inmates) Almost half used illicit drugs in prison (Butler & Milner, 2001) ~1/3 co-morbid disorder (D&A & Mental Health) (Sunjic et al 2007) Remain OTP 8/12 post release – significant in recidivism & mortality (Dolan et al 2005)
Deaths Post Release 1988-2002 Record linkage Cohort 85,203 (4,714 males, 423 females) Total deaths 5,137 (6%) Drug Related Deaths post-release: 31% males (1,477) 47% females (197) 26% all drug related deaths in NSW (Kariminia et al, 2006)
“…. part of the answer lay in the Australian prison, and the men I’d met there. Some of the men, too many of them, were serving their fourth or fifth prison sentences. Many of them had begun their imprisonment in reform schools – Boy’s Homes, they were called, and Youth Training Centres. Some of them had been beaten, starved, and locked in solitary confinement. Some of them, too many of them had been sexually abused. Ask any man with a long enough experience of prisons, and he’ll tell you that all it takes to harden a man’s heart is a system of justice.” Gregory David Roberts Shantaram, 2003, p81.
Assistance Provided ID, Medicare Cards Liaise with Department of Community Services –access to children Book medical appointments Advocate for patients to access services Arrange accommodation Attend appointments with patients Meeting basic needs – food vouchers, furniture Re-engage with family Orientation to the community New legal matters
Serious Offenders Assessment, preparation & care planning several years before release De-institutionalisation Advocacy/assistance – to co-ordinate requirements for release e.g. VOTP & OTP Reports to Serious Offenders Review Council (SORC) and State Parole Authority (SPA) Post release support for 3 months
Program Data September 2007 – May 2010 (2yrs 8months) Assessment & Care Plan 3,224 (~1200pa) Completed/Current (83%) Returned to Custody (8%) Lost to follow/up (6%)
Health Status Physical Health 70% existing physical health problems 56% required ongoing healthcare post-release >50% patients had head injury in the past 17% shared injecting equipment in gaol
Health Status Mental Health 56% receiving mental health treatment 35% Depression 20% Anxiety 68% of female patients experiencing mental health problems 28% considered or attempted suicide & 14% considered or attempted self harm
Corinne I use, because I am so afraid of “Life”, I’m lonely, alone scared of society, of Authority figures? Who pretend to help; But everything “they” say they are doing for me HA, has still not been done? – people, just do Not understand how hard it is for me? Every single time I have been out of prison – I just can’t cope? The longest time of Freedom I have had? Was 5 1/2 months – Parole have all this information? What am I supposed to do Corinne, I’ve laid awake at Night and cried, and thinking?
Why, is So hard? It’s hard, because I am 45 yrs of age, And for 36 of those 45 years I have been in and out of institutions and Prison from age Nine, over two thirds of my entire life. I am afraid of people, I can’t communicate with others. I want a life Corinne, but when you Know nothing but Prison and drugs, and really, no one has shown me any alternatives, or solutions and the people I ever have anything to do with? Are criminals. I have sat in this caravan, day after day, lonely and alone, and sinking deeper into fear of those who are supposed to be supporting and guiding me.
I’ve told you things that I have suffered and been subjected too throughout my life? If you knew everything? You would shed a tear. The bottom line is? People don’t “and never will” understand the psychological damage I have suffered from not only all the boy’s homes, And sexual and physical abuse as a child. I don’t have the skills to deal with so many things in society, yes, I am a MAN, and I am responsible for my actions? After all those years in and out of Prison living in a 12 by 8 foot cell? Then living in this caravan is making me unstable? My Brother has been good to me lately, we sorted out our differences But even though he is my Brother, I have been showering twice a week and living like a hermit?
I know my Brother cares But it goes back to what I said earlier “People don’t understand how damaged mentally I am, from a lifetime of hatred, violence, rejection, loneliness, fear. I am afraid to have showers and go inside; and this is my Brother’s house, my blood who loves me? So if I am like this with [name removed]? How afraid of Society, do you think I am? There are some good people in this world. You are the best of all those who have tried HA “Connections” deserves all the credit they get. I said to my Brother today, if it were not for yourself and Connections I would not be here –
I can Promise you this – on my Brother’s Grave – I will not go back to Prison So even though I have taken three Nights to write this – I just want people to understand I’m not a bad person, I just am so afraid of my life. Thankyou for all you have done [name withheld].
Patient Outcomes 70% continued necessary physical health treatment 71% continued necessary mental health treatment 45% reported using drugs in community (usually
"name": "Patient Outcomes 70% continued necessary physical health treatment 71% continued necessary mental health treatment 45% reported using drugs in community (usually
Completion v’s Return to Custody RTC group : Significantly less likely continue physical, mental, D&A Rx post-release Significantly more likely to remain in pre- arranged accommodation only initially Significantly more likely to have used drugs during post-release period, to have used daily and use more drugs
Completion v’s Return to Custody Completion group: Improved general health, RTC group – decline in general health Improved social functioning (SF-12) – RTC decline Fewer transitional changes than RTC group
Days in Community Pre v. Post Connections Return to Custody Group: Average days in community PreC = 132 (0-559 days) Average days in community PostC= 211 (0-552 days) Average difference = 79 days longer Post-Connections (at census, Sig p<.005, t = 11.39) Completed Group: Average difference = 7 months longer Post-Connections (80% remain in the community at 2 years) 65% of patients had more time in the community Post- Connections
State Parole Authority Outcomes (n=225) 123 (54%) of patients granted Parole A pplication supported by P&P. 63 (28%) of patients granted Parole Initial application was not supported by P&P. 17 (8%) of patients granted Parole Not supported by P&P. 22 (10%) of patients SPA requested further information and granted Parole Supported by P&P.
Patient Perceptions of Connections 90% “better prepared” this time (RTC significantly less likely) 86% “transition easier” this time (RTC significantly less likely) 95% cited positive aspects about Connections Project (avg. 3.28) 98% received assistance from Connections (avg. 2.5) 90% “satisfied” or “very satisfied” (RTC significantly less likely)
“Laws can embody standards. Governments can enforce laws – but the final task is not for the government. It is a task for each and every one of us. Every time we turn our heads the other way we see the law flouted – when we tolerate what we know to be wrong – when we close our eyes and ears to the corrupt because we are too busy, or too frightened – when we fail to speak up and speak out – we strike a blow against freedom and decency and justice.” Robert F. Kennedy, 21 June 1961.