Investigators

Shelley Walker


Supervisors

Doctor Peter Higgs, Professor Mark Stoové


Background

Young men aged 18-24 years represent one-sixth of all adult male prisoners in Australia. Three-quarters report having used illicit drugs in the past - a rate much higher than for older male prisoners. Although it is unknown how many have a history of injecting drug use, estimates suggest they represent close to half of all prisoners in Australia.

Young male prisoners with a history of injecting drug use are amongst the most disadvantaged and vulnerable of prisoners. They typically experience extreme levels of socioeconomic disadvantage and a complex combination of physical and mental health comorbidities. Furthermore, they are less likely to access health services in the community and are more likely to return to prison than older prisoners and their non-injecting peers. Despite this, little academic literature about their lived experience and characteristics exists. 


Aims

The aim of this research is to address a significant knowledge gap about the lived experience of drug use, incarceration and release from prison for young male prisoners with histories of injecting drug use. Furthermore, it has been the aim of this study to examine how governmental policies and practices contribute to the production of ‘problems’ that can have harmful lived effects on particular groups of people, including those in this study. In doing so, it is hoped that findings will provide insights for government, policy makers and practitioners that can help to address the structural factors (such as discrimination, stigma and inequality) that produce disadvantage, marginalization and poor mental and physical health outcomes for this already marginalised group. 


Methods

Twenty-eight young men (aged 19-24 years) with histories of IDU participated in up to three in-depth face-to-face interviews (between 2015-2016), shortly after their release from adult prisons in Victoria. Participants were recruited from the Burnet Institute’s longitudinal Prisoner and Transition Health (PATH) study examining the post-release trajectories of 400 male prisoners who reported recent IDU prior to their incarceration.

Young men were invited to participate in the qualitative arm of the study whilst in adult prison and were followed up in the community in the first days and weeks after their release. Interviews were broadly focused on their history of drug use, experiences during incarceration and their lives after release from prison. They were conducted in locations of young men’s choosing including parks, health services, cars, libraries, back yards and cafes. Participants were paid $AUD40 for each interview. Interviews were audio-recorded and transcribed verbatim, and data were analysed to identify themes based on patterns of interest, areas of commonality, and inconsistencies in the data.

Research findings are presented via five key peer-reviewed journal articles (focusing on experiences of police custody detention, drug use in prison and the post-release experience). Journal articles draw on Bacchi’s ‘What’s the problem represented to be?’ approach, and Tim Rhodes ‘risk environment’ framework.


Significance

The health needs of young male prisoners with histories of injecting drugs are distinct to those of their older counterparts and more significant than their non-injecting peers. The prison setting provides a unique opportunity to address the physical and mental health needs of this disadvantaged group and yet this study points to an important opportunity being missed. Beyond improving health outcomes for marginalised prison groups such as the young men in this study, supporting the health needs of prisoners can have the added effect of reducing their risk of return to prison. 


Progress

Interviews conducted with 28 young men. Data analysed. Five first authors papers written (2 accepted for publication). Anticipated submission of thesis August 30, 2019.


Presentations

Walker, S. (2015.) Young men with injecting drug use histories leaving prison: Experiences of drug use. Population Health Seminar. Melbourne: Burnet Institute.

Walker, S. (2015). Preliminary findings of the PATH (Prisoner and Transition Health) cohort study.Australian Community Support Organisation (ACSO) International Criminal Justice Conference: Do prisons change lives? Melbourne: ACSO

Walker, S. (2017). “I know I’m going back”: Narratives of young men with injecting drug use histories leaving prison. Crime & Justice in Asia and the Global South. Cairns: QLD University of Technology.

Walker S. (2017). Connection to family while in prison for young men with injecting drug histories. Fourth Contemporary Drug Problems Conference: 'Making alcohol and other drug realities’. Helsinki: Contemporary Drug Problems.

Walker, S. (2018). Incarcerated young men who inject drugs: Health care provision in adult prisons. National Drug Research Institute (NDRI) Annual Symposium: AOD research, policy and practice. Melbourne: NDRI.

Walker, S. (2019). Young male prisoners and experiences of injecting drug use while incarcerated. Justice Health Conference: Justice health is public health. Sydney: Public Health Association of Australia.


Publications

Walker, S., Lancaster, K., Stoove, M., Higgs, P., & Wilson, M. (2018). “I lost me visits”: A critical examination of prison drug policy and its effects on connection to family for incarcerated young men with histories of Injecting drug use. Contemporary Drug Problems, 45(3), 303-328. 10.1177/0091450918777280

Walker, S., Higgs, P., Stoové, M., & Wilson, M. (2018). Narratives of young men with injecting drug use histories leaving adult prison. International Journal of Offender Therapy and Comparative Criminology, 62(12), 3681-3707. DOI: 10.1177/0306624X17747829

Walker, S., Stoové, M., Wilson, M., & Higgs, P. (2019). Understanding HIV and HCV risk amongst incarcerated young men with injecting drug use histories. The Lancet Infectious Diseases, 19, 130-131. DOI

Kirwan, A., Curtis, M., Dietze, P., Aitken, C., Woods, E., Walker, S., … Stoové, M. (2019). The Prison and Transition Health (PATH) cohort study: Study protocol and baseline characteristics of a cohort of men with a history of injecting drug use leaving prison in Australia. Journal of Urban Health. DOI

Walker, S. (2019). Pathways in and out of prison for young men with injecting drug use histories. Drug and alcohol research connections. Australia: National Drug and Alcohol Research Centre, National Drug Research Institute, and National Centre for Education and Training on Addiction.


Timeline

2014 – 2019

Contact

For more information relating to this project, please contact Shelley Walker:


Collaborators

  • Thumbnail_logo-burnet-institute
  • Thumbnail_logo-national-drug-research-institute