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Three-quarters of people in prison have a history of hazardous use of alcohol and other drugs (AoD), yet there is a paucity of research into AoD use and prison-based treatment. This lack of prison-based AoD research exists despite the enormous body of research conducted over many decades into problematic AoD use generally in Australia. This research project adds to the limited evidence base for prison-based AoD treatment within Australia. It may also be of international relevance: given its focus on Australia’s Indigenous (Aboriginal and/or Torres Strait Islander ) peoples, the knowledge gained here could be useful in informing approaches to these issues for Indigenous/First Nations peoples in other countries.Theoretically, under the principle of equivalence of care (1), people in prison should receive health care to the same standard as they could access in the community. As Australia has a universal health care system, the full spectrum of health services should be available, including those for AoD use problems. However, this is not the case. The principal aim of this research is to inform better provision of AoD treatment services for people in prison in Australia. The research has a focus on Aboriginal people because, as is made clear within the thesis, this group is vastly over-represented in Australian prisons.While both quantitative and qualitative research methods have been utilised in this project, the primary methodology used for data collection and analysis is qualitative. Chapter One provides an overview of the research and its significance and potential benefits. Chapter Two examines the Australian and international published research into prison-based AoD treatment. Chapter Three describes the extent of AoD use and harms among prisoners in the state of New South Wales (NSW), which highlights the need for the availability of effective AoD treatment programs. Chapter Four describes the qualitative methodology used and the characteristics of the particip

Political ideology and populism are often thought to be major impediments to criminal justice reform. Our research has attempted to deconstruct these ideas so that the robustness of the 'punitive turn' in criminal justice policy can be better understood. This article reports upon in-depth interviews conducted with five very senior criminal justice policy-makers, each of whom was broadly sympathetic to reforming criminal justice policy to achieve the goal of lower incarceration levels. The interviews reveal that these policy-makers conceived of prison reform primarily in terms of political risk, especially when reform was related to the adoption of prison alternatives and models that focus on 'decarceration'. Furthermore, policymakers' perceptions of political risk were intricately bound up with concerns about potential public policy and program failure. This research indicates the need to develop political will for reform, alongside the further development of the myriad evaluation and policy development processes required to enable successful reform in the criminal justice space.

Social capital is a valuable social resource that has the potential to influence health outcomes at both the individual and community level. The mechanisms upon which this occurs are extensive and are explored within this thesis. Hepatitis C is highly prevalent in the prison setting, with an estimated HCV-antibody prevalence of 26% among the global prison population. Although HCV treatment is available in the prison setting, a number of barriers exist resulting in low treatment uptake. This PhD thesis explores the social capital of men in prison living with hepatitis C. Chapter 1 of this thesis provides an overview of social capital, presents prisoner demographics in the Australian setting, and outlines hepatitis C prevalence among the prisoner population, risk factors for hepatitis C, and changes in the hepatitis C treatment landscape. Chapter 2 (published in Health & Justice) is a systematic literature review of social capital in the prison setting. Chapter 3 (published in Health & Justice) draws on thirty qualitative interviews completed with male inmates living with hepatitis C to identify social capital dimensions in the prison setting (e.g., trust and safety, reciprocity, agency, formal and informal networks). Chapter 4 (published in Social Science & Medicine) explores contextual differences of social capital between Aboriginal and non-Aboriginal inmates living with hepatitis C. The fifth chapter (published in the Journal of Viral Hepatitis) explores social capital (specifically, bonding and linking social capital) and its influence on hepatitis C education and treatment access in the prison setting. Following on from the qualitative interviews, the Inmate Social Capital Questionnaire – HCV (ISCQ-HCV) was developed for use with male inmates. Chapter 6 reports on the piloting of the ISCQ-HCV (to be submitted for publication). Chapter 7 provides discussion of the overall work within this thesis and includes suggestions and recommendations for practical changes w

I would like to congratulate Dr Jill Guthrie, the representatives of the Cowra community and all those involved in this wonderful production which explores and tests the research methodology and theory of Justice Reinvestment (JR). This report is a valuable piece of research which will guide future JR initiatives, especially those in regional areas. In particular, this report highlights the importance and value in engaging all stakeholders in the JR process, including families, community groups, government and nongovernment agencies.

OBJECTIVE. To describe the design and implementation of a culturally mediated case management model at Winnunga Nimmityjah Aboriginal Health Service (Winnunga) for Indigenous clients who consume alcohol at problematic levels. METHODS. Our research took place from March 2008 to March 2010 in the Australian Capital Territory and built on previous research partnerships between Winnunga and The Australian National University’s National Centre for Epidemiology and Population Health. We conducted a review of existing models to determine elements for consideration in the community controlled setting, and conducted staff surveys to assess current levels of skill and confidence around alcohol screening, brief intervention and care planning. Using the information from the review and staff surveys, we then undertook staff capacity building to build confidence and skills in conducting alcohol screening, brief intervention and care planning. This process was driven by Winnunga’s social health team. To meet Medicare benefits schedule requirements, and frame the study within the Aboriginal and Torres Strait Islander Chronic Disease Package framework, we included team care arrangements, care planning and health checks. RESULTS. Elements of case management were suggested by staff and incorporated into the final model. Forty staff in the health service participated in identifying training needs for the development of the case management model and undertook a range of training before the model was implemented. Staff working within the social health team decided that the focus of the case management was to build a stronger future for their clients, hence the name of the case management model ‘Walan Girri’ (Wiradjuri language for strong future). The model included a package of screening instruments and brief intervention, related polices and discussion of ‘mob’ and ‘country.’ Changes in Winnunga management and staff, the composition of the research team and the way Walan Girri evolved l

OBJECTIVES: Information on the effectiveness of interventions regarding control in closed institutional settings, including prisons, is limited. This study gathered evidence relating to influenza control in an Australian prison. STUDY DESIGN: This study built on a 2009 H1N1 outbreak investigation at the Alexander Maconochie Centre (AMC) in the Australian Capital Territory (ACT). METHODS: Influenza surveillance data, ACT 2010 Inmate Health Survey data, New South Wales 2001 and 2009 Inmate Health Survey data, ACT Department of Corrective Services administrative data, and ACT Health clinical data were analysed. RESULTS: In 2011, the AMC was exposed to influenza virus, resulting in a single case. Public health activities included exclusion of symptomatic cases from the health facility, isolation of cases, and quarantine of contacts. Contact between prisoners and the ACT community was maintained; the AMC detainee visitor rate was one visitor per prisoner every 10 days. CONCLUSIONS: The rehabilitative benefits of human contact for AMC detainees were not compromised during the surveillance period, despite the potential that a higher visitor rate may suggest. This highlights some features of the AMC which make its operational context different from many other correctional settings, but gives some indication of how good public health practice supports human rights.