NACCHO Aboriginal Health and #FASD : Record Indigenous incarceration #justjustice rates could be avoided with early clinical assessment: experts


 “Australia’s prison population recently reached a record 33,791 with 27 per cent of those identifying as Aboriginal or Torres Strait Islanders

Leading experts in Fetal Alcohol Spectrum Disorder (FASD) believe Australia’s record rates of Indigenous incarceration could be dramatically reduced if children were clinically assessed when their troubled behaviour first emerged in the classroom or at home.

In one form or another, Federal, State and Territory Governments have been inquiring into Indigenous prison rates since the 1987 leaving behind a long list of mostly-ignored recommendations “

As reported by Russell Skelton ABC


NACCHO partnered with the Menzies School of Health Research and the Telethon Kids Institute (TKI) to develop and implement health promotion resources and interventions to prevent and reduce the impacts of Fetal Alcohol Spectrum Disorders (FASD) on Aboriginal and Torres Strait Islander families and young children.

NACCHO Report 1 of 4 :Prevent and reduce the impacts of Fetal Alcohol Spectrum Disorders (FASD)

Key points:

  • Experts say Indigenous incarceration rates could be reduced with early behavioural assessment
  • Fetal Alcohol Spectrum Disorder (FASD) affects many of those incarcerated
  • People with FASD are often unable to instruct a lawyer, understand court procedures and even the decisions handed down when convicted

The facts about FASD

  • FASD covers a range of conditions that can occur in children whose mothers drink during pregnancy
  • Conditions vary from mild to severe
  • The effects can include learning difficulties, behavourial problems, growth defects and facial abnormalities
  • The Australian Drug Foundation believes the condition is “significantly under-reported” in Australia
  • National Health and Medical Research Council guidelines say not drinking at all all during pregnancy is the safest option

A major issue in recent months:

  • Last month the Northern Territory’s adult prison population hit an alarming 15-year high. According to Corrections Commissioner Mark Payne 958 people are being held — almost half aboriginal and Torres Strait Islanders. He expects half will reoffend within two years of being released.
  • A report by Amnesty International Australia found, and ABC Fact Check confirmed, that incarceration rates for Indigenous children were 24 times higher than they were for non-Indigenous children.In WA the rate is 76 per 10,000, in the US, where rates of black incarceration are regarded as the highest in the western world, it is 52.
  • Attorney-General George Brandis and the Indigenous Affairs Minister Nigel Scullion announced the Federal Government have commissioned the Australian Law Reform Commission to investigate factors behind the over representation of Indigenous Australians in prison and to recommend reforms to “ameliorate the national tragedy”.
  • The appointment of a Royal Commission to investigate brutal treatment and years of detainee abuse at Darwin’s Don Dale Youth detention facility.The move followed detailed allegations of mistreatment by the ABC’s Four Corner program.


The #JustJustice book is was launched  at Gleebooks in Sydney yesterday by Professor Tom Calma AO, and NACCHO readers are invited to download the 242-page e-version

The Federal Government must make good on its promise to listen to, and work with, Aboriginal and Torres Strait Islander people, including engaging with the solutions put forward in the forthcoming #JustJustice essay collection.

The book includes more than 90 articles on solutions to protect the rights of Australia’s First Peoples.

The experts said parents, teachers and health workers were often well aware of unacceptable behaviour in young people — both Indigenous and non-Indigenous — long before they appeared before the courts.

Around 70 per cent of young people in the juvenile justice system are Aboriginal, and research shows rates of the disorder amongst Aboriginal communities are significantly higher than non-Aboriginal communities.

Elizabeth Elliot, professor of Paediatrics and Child Health a Sydney University, said: “What we need is screening tool so teachers and health workers can assess a child’s executive functions and red flag cognitive impairments early on before they encounter the justice system.”

Paediatrician and clinical research fellow at Perth’s Telethon Kids Institute Dr Raewyn Mutch agreed, saying there was a growing need to identify serious behavioural issues associated with FASD and other developmental disorders such as autism so affected children can be better managed.

Fetal Alcohol Spectrum Disorder, known as FASD, occurs in the children whose mothers consumed alcohol during pregnancy.

Symptoms include lifelong physical, mental, behavioural and learning difficulties. It can cause severe intellectual impairment, learning and memory disorders, high-risk and violent behaviour.

Professor Elliott said reform in Australia had been “glacial” compared with Canada and the United States, as authorities have been slow to acknowledge the extent of the problem.

“In Canada it is estimated that 60 per cent of kids in the juvenile justice system are FASD, it is a huge number,” she said.

“We don’t need another inquiry into the justice system, we need governments to act on the evidence before them from past inquiries,

Professor Elliott was the paediatric specialist involved the ground-breaking Lililwan study initiated by Aboriginal women. The study that found that one in five Indigenous children living in WA Fitzroy River Valley had FASD. Although still teenagers, many were before the juvenile justice.

“For children suffering from FASD, it’s like having the umpire removed from an AFL match, they have difficulties deciding best choices or understanding cause and effect,” Dr Mutch said.

“A person with FASD may have cognitive impairment, language difficulties as severe as being illiterate.”

Professor Elliott, a widely acknowledged authority on FASD, said offenders — non-Indigenous and Indigenous — with fetal alcohol brain damage were often incapable of changing their behaviour and learning from mistakes.

“These are young people who can be easily led, are incapable of understanding the consequences of their actions, have difficulty understanding the boundaries for acceptable behaviour. They can confess to crimes they did not commit.”

Dr Mutch said not only FASD affected individuals ended up in the justice system, but children with developmental difficulties and also children traumatised by conflict and abuse.

She is involved in landmark study of young offenders in WA’s Banksia Hill Detention Centre to establish the prevalence of FASD and other neurological disorders. The study is likely to revolutionise strategies for handling juveniles with “neurodevelopmental” issues.

The study will establish the first authoritative estimate in Australia of FASD among young people in detention. It involves a two day multi-disciplined clinical assessment of children with the hope of developing a screening tool for application among all young people entering the juvenile justice system.

“Children in the juvenile justice system have ended up there for a variety of reasons, many of these kids have learning and memory problems,” Dr Mutch said.

“They may also have speech and language problems. Not all are FASD affected, but all I would predict have experienced severe trauma.”

A ‘national tragedy’

A Productivity Commission report into Indigenous disadvantage released last week confirmed rates of incarceration had failed to drop despite a string of reports, inquiries and recommendations dating back to 1987 Deaths in Custody Royal Commission.

Dr Mutch said children were being excluded from society because their behaviour.

“The central question is what are the factors that caused them to be like that and how best to rehabilitate them,” she said.

Both Professor Elliott and Dr Mutch believe screening and clinical assessments in childhood would identify cognitive problems, enable early treatment and result in profound improvements in troublesome behaviours.

This would have an impact on child protection placements including foster care and the management of group homes where evidence has emerged of inappropriate placements and poor supervision.

Offenders with FASD are easily led, coerced by their peers. They can be incapable of providing a record of events, names of associates and often confabulate even to the extent of making false confessions.

They are often unable to instruct a lawyer, understand court procedures and even the decisions handed down when convicted.

In one form or another, Federal, State and Territory Governments have been inquiring into Indigenous prison rates since the 1987 leaving behind a long list of mostly-ignored recommendations.

The Senate is also inquiring into the indefinite detention of people with cognitive impairments — a central issue when it comes to explaining the “national tragedy”.

The Telethon Kids Institute noted in a submission to Senate inquiry into the indefinite detention of people with cognitive and psychiatric impairment that diagnosis of FASD has been limited by a lack of knowledge and until recently an absence of accepted national diagnostic framework.

Australia’s prison population recently reached a record 33,791 with 27 per cent of those identifying as Aboriginal or Torres Strait Islanders.


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