Healthcare

Morbidity, recidivism and re-incarceration for at-risk populations in correctional settings

5 Aug 2014, by Informa Australia

Transition programmes are designed to equip prisoners with the skills and support to manage their transition from prison to the community. Creating person-centred programs with long-lasting impact continues to be a difficult challenge, particularly when we consider the multiple and complex care needs of many prisoners.

In the lead up to the 5th Annual Correctional Services Healthcare Conference 2014, we had the chance to speak to Associate Professor Mark Stoové, Head of HIV Research Program & Head of Justice Health Research Program at the Burnet Institute, who will be presenting at the event on the topic “Exploiting Incarceration as an Opportunity to Change the Health and Criminogenic Trajectories of People who Inject Drugs”.

Mark has extensive experience researching health outcomes associated with most at-risk populations for blood borne viruses and sexually transmitted infections, in particular, people who inject drugs and men who have sex with men. His research focuses on establishing evidence for effective policy and practice with an emphasis on the development of record linkage and bio-behavioural data collection in prospective studies and disease surveillance systems.

What do you think makes up the key elements of an effective transition programme for individuals who are leaving prison?

Mark: Effective transition programmes must involve close collaboration between correctional and community service providers.  ‘In-reach’ programs provided by community organisations are key, and should link closely with prison program services to ensure continuity of care and service provision as people transition from prison to the community.

Release from prison is a highly vulnerable period characterised by multiple and complex needs. Although such needs are unlikely to be met by a single service provider, it is important that individuals are assisted in negotiating what is often a fractured and uncoordinated support and service system.

Having an individual case worker – preferably one who can establish a relationship with a prisoner in the weeks prior to their release and continue to work with them in the community – who is able to broker appropriate service access is therefore a vital element to successful transition programs.

In reality, such a best-practice approach will be resource intense. If such a programme is unable to be implemented universally, transition programmes should target those with particularly complex needs or those at high risk of harm or of re-offending to have greatest impact.

Should correctional facilities take more responsibility for preventative healthcare and improving education for prisoners?

Mark: Incarceration should be considered a service delivery opportunity. In addition to barriers to care in the community faced by those at risk of incarceration, people may become more acutely aware of their health problems when in prison.

In the community, factors associated with lifestyle such as drug use, homelessness and nutrition can obfuscate the perceived need to specific care. In this way, correctional facilities providing opportunities to access preventive and clinical care is important. There is also a burgeoning body of evidence to suggest a positive impact on criminogenic trajectories resulting from addressing prisoner health needs.

An ideal example of an opportunity for health interventions in prison is in the area of hepatitis C monitoring and treatment. New therapies in this area which are of shorter duration and highly tolerable and effective are likely to result more efficient nurse-led models of care that are ideally suited to prison settings.

You will be speaking in the upcoming Correctional Services Healthcare conference. What are you hoping to get out of the event and are there any particular presentations or discussions you are particularly looking forward to?

Mark: The Correctional Services Healthcare conference provides an unique opportunity to share experiences around multidisciplinary approaches to the provision of healthcare to prison populations. I am confident the forum will provide an opportunity for the sector to learn from the experiences of others and potentially energise policy and practice to achieve better outcomes for those moving through the correctional system and the community more broadly.

I am particularly looking forward to hearing the experiences of those providing services and care related to mental health, which is too often a key component in the complex care needs of prisoners. This issue of human rights and the provision of care in prisons that is commensurate with what is offered in the community is also a major are of interest for my research with people with injecting drug use histories.

The 5th Annual Correctional Services Healthcare Summit 2014 will take place on the 28th and 29th August in Melbourne. For more information about the conference program and to register, please visit the Correctional Services Healthcare Conference website.

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