Keeping our mob healthy in and out of prison

The prison health system presents an opportunity to improve Aboriginal prisoners’ health and wellbeing, diagnose and treat health and mental health problems, and mitigate the effects of harmful behaviours. Executive summary The prison health system presents an opportunity to improve Aboriginal prisoners’ health and wellbeing, diagnose and treat health and mental health problems, and mitigate the effects of harmful behaviours. Improving prison health systems for Aboriginal people can also reduce high rates of postrelease hospitalisation and mortality experienced by Aboriginal prisoners and improve quality of life. Aboriginal prisoners experience higher rates of health and mental health problems than non-Aboriginal prisoners. The impact on prison health care is foreshadowed by consistent increases in the number of Aboriginal people imprisoned in Victoria each year. One in 33 Aboriginal males is imprisoned in Victoria at any one time, and the rate of overrepresentation is increasing for both Aboriginal men and women. More than 50% of Aboriginal people released from Victorian prisons return within two years, which places increasing importance on continuity of care. With large numbers of Aboriginal people moving in and out of the prison system, a strong relationship should exist between prison health services and prisoners’ community health and mental health provider. The 28 Aboriginal Community Controlled health Organisations (ACCHOs) and their auspiced organisations across Victoria are located within 55km of all Victorian prisons. ACCHOs are a critical extension of prison health care given Aboriginal prisoners access ACCHOs more frequently than mainstream services in the community. ACCHOs’ comprehensive support and engagement of Aboriginal people plays a big part in improving quality of life and improving poor health and mental health outcomes by providing a holistic, healing health service. The Victorian Aboriginal Community Controlled Health Organisation (VACCHO), with support from the Victorian Government Department of Justice, explored ways to improve continuity of care for Aboriginal people in Victorian prisons and identify ways to improve relationships and partnerships between ACCHOs and prison health services. ACCHOs, prison health services, and Koori support staff members from the Department of Justice were interviewed and their responses analysed for common themes. We found no relationship or partnership between ACCHOs and prison health services interviewed despite policy references requiring it within the Justice Health Policy and Quality Framework (attached to the prison health services contracts). Responses also indicated that prison health service systems were not meeting cultural safety policy standards. ACCHOs identified several areas in need of improvement to assist Aboriginal prisoner health including prisoner release planning and the transfer of health information. Given the low level of contact between ACCHOs and prison health services there were few working examples that could be shared. A list of recommendations based on interview responses, a literature review and exploration of non-Victorian models is presented as a first step in improving health and mental health outcomes for Aboriginal prisoners