NACCHO Prison Health News : Prisons are a poor substitute for primary and mental health care

 

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“An ongoing issue in Australia, which we have failed to reverse – just as we have failed to close the gap – is the over-representation of Aboriginal and Torres Strait Islander people in our prisons.

Nationally, the rate of imprisonment for ATSI people was 13 times higher than for non-Indigenous people at June 30, 2014. This figure covers a diverse situation across the nation. In Western Australia, ATSI men and women are 18 times more times likely than non-Indigenous Australians to be imprisoned in WA, whereas in Tasmania the rate is four times higher.”

From The Conversation state of imprisonment series more info

Aboriginal prisoners were at greater risk of chronic illness, mental illness and substance abuse.

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We aim to solve these problems by looking at alternatives to prison for minor offences, reducing the rate of ex-prisoners returning to prison, and paving the way for ex-offenders to better integrate back into society, Prison should be treated as a last resort.”

NACCHO Deputy chair and GAMS chairman Sandy Davies Speaking at Prison health Conference WA last week

“As well as a bipartisan approach to reduce the use of remand, we need to lower our very high reoffending rates, which are higher than most other comparable countries. We need to make sure people in jail receive help. This especially applies to literacy and numeracy, and also with regard to alcohol and drug programs. Moreover, inmates ought to continue to receive assistance after being released.”

If that (mass incarceration) occurred, and as a result Aboriginal Australians had a similar incarceration rate as non-­Aboriginal Australians, just imagine the funds that would become available for improving the health and wellbeing of indigenous people.

From “Decriminalise personal drug use to reduce prison population” full article below

Ross Fitzgerald was for 20 years a member of the Queensland Parole Board and the NSW State Parole Authority.

Australia has reached a decade-high rate of imprisonment. The Australian Bureau of Statistics’ announcement of this last year created little impact or interest.

Across Australia, 33,791 persons were in adult corrective services custody at June 30 2014. That was a 10% increase from 2013. By the December quarter 2014, the average daily number of prisoners had risen to 34,647.

For both men and women in custody, the most frequent serious offence was an act intended to cause injury (21% for men, 20% for women).

The next most common offences differed according to gender. Men were equally likely to be in custody for a most serious offence of sexual assault, unlawful entry with intent and illicit drug offences (all 12%). For women, the next most likely reasons were illicit drug offences (17%) and offences against justice procedures, government security and operations (11%).

The circumstances that lead to imprisonment and the context of the crime cannot be ascertained from such data. It still raises important questions about the use of imprisonment for non-violent offences.

The number of people imprisoned in Australia continues to grow strongly. Australian Bureau of Statistics, CC BY
Click to enlarge

Indigenous Australians suffer punitive approach

An ongoing issue in Australia, which we have failed to reverse – just as we have failed to close the gap – is the over-representation of Aboriginal and Torres Strait Islander people in our prisons.

Nationally, the rate of imprisonment for ATSI people was 13 times higher than for non-Indigenous people at June 30, 2014. This figure covers a diverse situation across the nation. In Western Australia, ATSI men and women are 18 times more times likely than non-Indigenous Australians to be imprisoned in WA, whereas in Tasmania the rate is four times higher.

In 2013, Chris Cunneen articulated the concern in The Conversation that:

… too many Indigenous Australians will remain second-class citizens in their own country … remaining the object of law when it comes to criminalisation and incarceration.

The most recent statistics affirm that Cunneen’s predictions are unfolding with little sign of abating.

Prisons are a poor substitute for mental health care

An emerging concern is the recognition and realisation that mental illness and mental impairment are diagnosed at much higher rates within our imprisoned population than in the wider community.

Data on this issue is less easily accessed nationally. What we do know is that there is a “higher incidence of mental health problems in the Australian prison population than in the general population” and that “almost two in five prison entrants (38%) reported having been told that they have a mental health disorder”.

Prison is fast becoming a significant location for individuals with high mental health needs to be supported and managed. This reflects a national malaise, stemming from the responsibility we must all bear for decisions to remove so many of the support networks that were in place decades ago – and to remove them without any replacement or alternative. The result has been the criminalisation of an increasing number of people.

Public debate ignores need for change

This brief review of current data and trends raises several important questions: why is imprisonment being used, for what purpose, and to what ends?

This series aims to offer a snapshot of incarceration trends across Australia and to identify imprisonment policies and practices that we need to change.

Each state and territory has different issues of most concern. These may relate to rates of imprisonment of particular marginalised populations, or legislative changes resulting in remand rates skyrocketing and/or parole being virtually unobtainable.

While Australian trends in imprisonment can always be favourably compared to other nations such as the US, it is clear that current trends across the nation have significant short-and long-term consequences. Attracting public attention and engagement with these consequences is challenging in a political, social, and media environment dominated by law-and-order politics.

This series aims to provide a platform for public discussion via a critical mass of articles that take stock of the situation in each state and territory, and as a nation.

Should we decriminalise personal drug use to reduce prison population

Ross Fitzgerald was for 20 years a member of the Queensland Parole Board and the NSW State Parole Authority

The British established a prison colony in Australia in 1788 because they ran out of prison capacity in Britain, and America was no longer available after the 1776 revolution. But the fact incarceration had failed to dent Britain’s huge social and economic problems has not stopped successive Australian governments trying to solve our own problems by imprisoning more people.

It’s an admission of failure and a national disgrace. Recently in Australia, incarceration rates increased from 158.8 per 100,000 in 2004 to 185.6 last year. This is an area where growth is a serious problem. That’s a 17 per cent ­increase, and the situation is ­getting worse.

While Victoria has the highest percentage of privatised prisoners in the world, in NSW the number of adult inmates in prison is nearing a record 12,000. This represents not just an extravagant waste of money but also an enormous waste of human potential. At an estimated annual cost of at least $75,000 a prisoner, it is also a drain on the public purse when governments have been telling the community — some would argue incorrectly — that we are drowning in government debt.

The situation is much worse in the US, which imprisons a huge 754 per 100,000 — the highest in the world. This means that while the land of the free and the home of the brave has 4.4 per cent of the world’s population, it houses 22 per cent of the world’s inmates.

With 2.3 million incarcerated, there are more Americans imprisoned than in the military. Indeed, mass incarceration there gobbles up $US60.3 billion ($78bn) in ­annual budget expenditure.

In Australia, we urgently need to reduce the burgeoning numbers of our prison population, which is a direct result of “law and order auctions” at state and federal levels. This is promulgated by all major political parties, which — when crime rates are falling — try to outbid each other when it comes to tougher sentences.

 

This splurge on punishment is utterly unsustainable. But there are some clear-cut solutions that could save this waste. We should be looking to increase substantially the use of non-custodial ­sentences. And where our courts decide that they have no alternative except to send people to jail, in most cases we need shorter, not longer, sentences.

We also need to have far fewer people on remand. This is especially important as a significant number of these inmates — who comprise up to a third of our prison population — are eventually found not guilty.

As well as a bipartisan approach to reduce the use of remand, we need to lower our very high reoffending rates, which are higher than most other comparable countries. We need to make sure people in jail receive help. This especially applies to literacy and numeracy, and also with regard to alcohol and drug programs. Moreover, inmates ought to continue to receive assistance after being released.

More widely, we need to tackle structural inequality in our society. This is because the socially and economically disadvantaged sections of our nation have by far the highest rates of incarceration.

Without a doubt we need to reform our drug laws. In my opinion, this should be along the lines of Portugal, which in 2001 introduced laws that referred people found in possession of less than 10 days’ supply of any illegal drug for a health and social assessment and possible treatment. As a result, drug treatment fac­il­ities were expanded and improved. Not only has the crime rate fallen, but deaths from HIV and drug-use have declined markedly.

While a socialist government introduced the Portuguese scheme to decriminalise personal drug use, it was kept essentially intact when government changed hands. It has a high level of support across the political spectrum and throughout the wider community.

Importantly, in Portugal, all the huge savings made by reducing the costs of law enforcement and imprisonment are spent on public health.

To reduce the mass incarceration that occurs throughout Australia, we urgently need to adopt the Portuguese model. This especially applies to our disadvantaged communities, such as those in the Northern Territory.

The Portuguese scheme ought to be combined with raising the price of low-cost alcoholic bever­ages, which would reduce consumption significantly.

If that occurred, and as a result Aboriginal Australians had a similar incarceration rate as non-­Aboriginal Australians, just imagine the funds that would become available for improving the health and wellbeing of indigenous people.

Reducing the number of Australians behind bars is something that should appeal to all of us.

The savings in government expenditure would delight fiscal conservatives. People focused on social justice would be delighted to see less disparity between high and low-income groups.

Australians who focus on families would enjoy seeing fewer husbands and wives separated.

They would also rejoice in witnessing fewer parents and children separated and hence not caught up in a vicious cycle of crime and punishment.

In terms of meaningful solutions to mass incarceration we need look no further than the ideas of US Attorney-General Eric Holder. In a seminal article for ‘The Washington Post’ last month, Holder wrote, “a rare consensus has emerged in favour of ­reforming our federal drug ­sentencing laws”.

This presents, he argues, a historic opportunity to reform the criminal justice system in ­the US. Eighteen months ago, this enlightened federal official launched a “Smart on Crime” initiative that focused on reducing the use of draconian mandatory minimum sentences for low-level drug offences. It also involved ­substantial investment in alcohol and drug rehabilitation programs that reduced the likelihood of recidivism.

Preliminary results from this effort have been extremely encouraging. Remarkably, last year marked the first simultaneous ­reduction in crime and ­incarceration rates in more than four decades.

If they can do this in crime-­conscious America, there is surely nothing to stop us doing it here.

Author of 36 books, Ross Fitzgerald was for 20 years a member of the Queensland Parole Board and the NSW State Parole Authority.

The Weekend Australian, April 11-12, 2015, Inquirer, p 24.

One comment on “NACCHO Prison Health News : Prisons are a poor substitute for primary and mental health care

  1. Pingback: Indigenous Health – Health in Australian Prison Systems

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