Investigators

Dr Ashleigh Stewart


Supervisors

Professor Paul Dietze, Professor Mark Stoové


Background

It is well-documented that mental illness and substance dependence is disproportionally represented within the prison setting. This high prevalence of mental illness underpins increased rates of self-harm and suicide attempts in those with a history of incarceration, whilst contributing to rates of preventable morbidity and mortality. While the prevalence of mental illness and substance dependence in men with a history of incarceration is well researched, the extent to which this population is accessing mental health services post-release from prison is less well documented.

Prisons can provide opportunities for intervention with untreated mental health concerns, yet currently the continuity of care for people leaving prison is fragmented. Improving these outcomes for ex-prisoners is a priority of the public health and criminal justice systems; however, as frequency and patterns of mental health service use by this population remains uncertain, the development of meaningful evidence-based interventions continues to be limited. 


Aims

The aim of the study is to describe patterns of service utilisation relating to mental health in a population of men leaving prison with histories of injecting drug use in Victoria, Australia. More specifically, we aim to:

  • Describe the prevalence of mental health morbidity in the cohort.
  • Explore patterns of mental health service utilisation and associated factors among those with frequent presentations with the primary and tertiary healthcare setting
  • Assess mortality within the cohort among participants exhibiting mental health morbidities. 

Methods

This study will use data from the Prison and Transition Health (PATH) Cohort Study. Recruitment commenced in September 2014 and ended in June 2016, participants were followed-up at periods of three, 12 and 24-months post release from prison. Follow-up interviews were completed in community or the prison setting if participants were re-incarcerated. All participants consented to record linkage at two, five and 10 years post-release to complement self-report data, including health, social housing and justice databases.

First round of record linkage will occur early 2019. 


Significance

The proposed research will contribute to the understanding of mental health service utilisation by men leaving prison with histories of injecting drug use. Prison release is characterized by an acute rise in psychosocial stressors and risk of preventable morbidity and mortality, and part of this may be exacerbated by ineffective care and management of mental health. 


Progress

Data cleaning and analysis is underway and active collaboration with supervisors and Chief Investigators for access to linked data sets is in progress. 


Presentations

Stewart, A., Scott, N., Dietze, P., Cossar, R., Butler, T., Kirwan, A., & Stoové, M. Longitudinal changes in psychiatric well-being among men leaving prison reporting histories of injecting drug use. Public Health Association of Australia, Justice Health Conference, Sydney, Australia, 9-10 April 2019.

Stewart, A., Cossar, R., Curtis, M., Dietze, P., Armstrong, G., Ogloff, J. RP., Kinner, S. A., Kirwan, A., & Stoové, M. Lifetime prevelance and correlates of self-harm and suicide attempts among male prisoners with histories of injecting drug use. Australasian Professionals Society on Alcohol and other Drugs. 4-7 November 2018.   


Publications

Stewart, A. C., Cossar, R., Dietze, P., Armstrong, G., Curtis, M., Kinner, S. A., Kirwan, A., Stoove, M. (2018). Lifetime prevalence and correlates of self-harm and suicide attempts among male prisoners with histories of injecting drug use. Health Justice, 6(1), 19. doi:10.1186/s40352-018-0077-2


Timeline

2017 – 2021

Contact

For more information relating to this project, please contact Ashleigh Stewart: