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In Research Link Australia (RLA), "Research Topics" refer to ANZSRC FOR and SEO codes. These topics are either sourced from ANZSRC FOR and SEO codes listed in researchers' related grants or generated by a large language model (LLM) based on their publications.
Criminology | Causes and Prevention of Crime | Epidemiology | Public Economics- Publically Provided Goods | Correctional Theory, Offender Treatment and Rehabilitation |
Crime Prevention | Aboriginal and Torres Strait Islander Development and Welfare | Families and Family Services | Rehabilitation and Correctional Services
Publisher: Swansea University
Date: 07-06-2023
Abstract: The use of administrative health data for research, monitoring, and quality improvement has proliferated in recent decades, leading to improvements in health across many disease areas and across the life course. However, not all populations are equally visible in administrative health data, and those that are less visible may be excluded from the benefits of associated research. Socially excluded populations -- including the homeless, people with substance dependence, people involved in sex work, migrants or asylum seekers, and people with a history of incarceration -- are typically characterised by health inequity. Yet people who experience social exclusion are often invisible within routinely collected administrative health data because information on their markers of social exclusion are not routinely recorded by healthcare providers. These circumstances make it difficult to understand the often complex health needs of socially excluded populations, evaluate and improve the quality of health services that they interact with, provide more accessible and appropriate health services, and develop effective and integrated responses to reduce health inequity. In this commentary we discuss how linking data from multiple sectors with administrative health data, often called cross-sectoral data linkage, is a key method for systematically identifying socially excluded populations in administrative health data and addressing other issues related to data quality and representativeness. We discuss how cross-sectoral data linkage can improve the representation of socially excluded populations in research, monitoring, and quality improvement initiatives, which can in turn inform coordinated responses across multiple sectors of service delivery. Finally, we articulate key challenges and potential solutions for advancing the use of cross-sectoral data linkage to improve the health of socially excluded populations, using international ex les.
Publisher: SAGE Publications
Date: 2009
DOI: 10.1080/10398560902948696
Abstract: Objective: Despite recognition of the extremely high rates of mental illness among custodial populations and the fact that Indigenous people represent around one-quarter of Australia's custodial population, little is known about the mental health of Aboriginal and Torres Strait Islander people in custody. Mental health is an important component of social and emotional wellbeing for Indigenous people and this paper considers current evidence regarding the mental health status of Indigenous Australians in custody. Method: A systematic review was undertaken of the quantitative literature relating to the mental health problems of Indigenous people in custody in Australia. Results: Despite high incarceration rates for Indigenous people and evidence that both mental health problems and rates of mental illness are extremely high in this group, studies in this area are few and limited in scope. Conclusion: The first step toward addressing the marked social and mental health problems for Indigenous people in custody is to systematically identify the nature and extent of these problems.
Publisher: Elsevier BV
Date: 10-2023
Publisher: Elsevier BV
Date: 2020
DOI: 10.1016/J.DRUGALCDEP.2019.107707
Abstract: Adults released from prison are at increased risk of poor health outcomes and preventable mortality, including from overdose. Non-fatal overdose (NFOD) is a strong predictor of future overdose and associated with considerable morbidity. This study aims to the determine the incidence, predictors and clinical characteristics of NFOD following release from prison. We used pre-release interview data collected for a randomised controlled trial in 2008-2010, and linked person-level, state-wide ambulance, emergency department, and hospital records, from a representative s le of 1307 adults incarcerated in Queensland, Australia. The incidence of NFOD following release from prison was calculated. A multivariate Andersen-Gill model was used to identify demographic, health, social, and criminal justice predictors of NFOD. The crude incidence rate (IR) of NFOD was 47.6 (95%CI 41.1-55.0) per 1000 person-years and was highest in the first 14 days after release from prison (IR = 296 per 1000 person-years, 95%CI 206-426). In multivariate analyses, NFOD after release from prison was positively associated with a recent history of substance use disorder (SUD), dual diagnosis of mental illness and SUD, lifetime history of injecting drug use, lifetime history of NFOD, being dispensed benzodiazepines after release, a shorter index incarceration, and low perceived social support. The risk of NFOD was lower for people with high-risk alcohol use and while incarcerated. Adults released from prison are at high risk of non-fatal overdose, particularly in the first 14 days after release. Providing coordinated transitional care between prison and the community is likely critical to reduce the risk of overdose.
Publisher: Elsevier BV
Date: 10-2021
Publisher: Wiley
Date: 12-09-2022
DOI: 10.1111/DAR.13380
Abstract: People released from prison have an increased risk of morbidity, including from nonfatal violence. We examined the incidence and predictors of violence‐related morbidity after release from prison and investigated whether there are differences according to sex and Indigenous status. Baseline data were collected from 1325 people within 6 weeks of release from prisons in Queensland, Australia, between 1 August 2008 and 31 July 2010. Data were linked to state‐wide health (ambulance, emergency department and hospital) and prison records, and national death records until 31 July 2012. Predictors were identified using a multivariable Andersen‐Gill model. Differences according to sex and Indigenous status were investigated using effect modification. A total of 225 (18.2%) people experienced 410 violence‐related events that were recorded in health records. The incidence was 12.8 per 100 person‐years [95% confidence interval (CI) 11.7, 14.1]. Risk factors for violence‐related morbidity included diagnosed mental illness [hazard ratio (HR) = 2.0, 95% CI 1.1, 3.8], substance use disorder (HR = 1.6, 95% CI 1.1, 2.3) or dual diagnosis (HR = 3.2, 95% CI 2.2, 4.8) high‐risk alcohol use (HR = 2.1, 95% CI 1.5, 2.8) being Indigenous (HR = 1.7, 95% CI 1.2, 2.5) and two or more prison releases (HR = 1.7, 95% CI 1.2, 2.6). Indigenous status modified the risk of violence‐related morbidity, with Indigenous men having twice the risk of non‐Indigenous men (HR = 1.9, 95% CI 1.3, 2.8). Approximately one in five people released from prisons in Queensland experienced violence‐related morbidity. Coordinated and continuous mental health and substance use treatment from prison to the community may reduce the risk of violence‐related morbidity in this population.
Publisher: Wiley
Date: 24-03-2020
DOI: 10.1111/DAR.13062
Publisher: Wiley
Date: 05-2008
DOI: 10.1080/09595230801950572
Abstract: There has been considerable media attention recently upon possible increases in meth hetamine use in Australia. Much of this debate has focused upon extreme cases of problematic crystal meth hetamine use, without reference to the broader population context. This paper provides data on meth hetamine use in Australia, and documents trends in meth hetamine-related harms. Data used were from: (1) Australian Customs Service drug detections (2) Australian Crime Commission drug seizure, arrest and clandestine laboratory detections data (3) National Drug Strategy Household Survey (NDSHS) and Australian Secondary Student Alcohol and Drug Survey (ASSADS) (4) data from the Illicit Drug Reporting System (IDRS) and Ecstasy and related Drug Reporting System (EDRS) and (5) data from NSW Emergency Department Information System, National Hospital Morbidity Database and Australian Bureau of Statistics causes of death databases. There appears to have been an increase in both importation and local manufacture of meth/ hetamine. Population data show that meth/ hetamine use remains low and stable. However, clear increases in crystal meth hetamine use have occurred among sentinel groups of regular drug users. Frequent crystal use among regular injecting drug users is associated with earlier initiation to injecting, greater injection risk behaviours and more extensive criminal activity. In recent years, indicators of meth/ hetamine-related harm have stabilised, following steady increases in earlier years. Some meth hetamine users experience significant problems related to their use harms are particularly prevalent among regular IDU. Meth hetamine users, however, are a erse group, and strategies need to be appropriately targeted towards different kinds of users.
Publisher: Wiley
Date: 06-06-2022
DOI: 10.1111/ADD.15580
Abstract: To estimate the treated prevalence of mental illness, substance use disorder (SUD) and dual diagnosis and the association between dual diagnosis and fatal and non‐fatal overdose among residents of British Columbia (BC), Canada. A retrospective cohort study using linked health, income assistance, corrections and death records. British Columbia (BC), Canada. A total of 921 346 BC residents (455 549 males and 465 797 females) aged 10 years and older. Hospital and primary‐care administrative data were used to identify a history of mental illness only, SUD only, dual diagnosis or no history of SUD or mental illness (2010–14) and overdoses resulting in medical care (2015–17). We calculated crude incidence rates of non‐fatal and fatal overdose by dual diagnosis history. Andersen–Gill and competing risks regression were used to examine the association between dual diagnosis and non‐fatal and fatal overdose, respectively, adjusting for age, sex, comorbidities, incarceration history, social assistance, history of prescription opioid and benzodiazepine dispensing and region of residence. Of the 921 346 people in the cohort, 176 780 (19.2%), 6147 (0.7%) and 15 269 (1.7%) had a history of mental illness only, SUD only and dual diagnosis, respectively 4696 (0.5%) people experienced 688 fatal and 6938 non‐fatal overdoses. In multivariable analyses, mental illness only, SUD only and dual diagnosis were associated with increased rate of non‐fatal [hazard ratio (HR) = 1.8, 95% confidence interval (CI) = 1.6–2.1 HR = 9.0, 95% CI = 7.0–11.5, HR = 8.7, 95% CI = 6.9–10.9, respectively] and fatal overdose (HR = 1.6, 95% CI = 1.3–2.0, HR = 4.3, 95% CI = 2.8–6.5, HR = 4.1, 95% CI = 2.8–6.0, respectively) compared with no history. In a large s le of residents of British Columbia (Canada), approximately one in five people had sought care for a substance use disorder or mental illness in the past 5 years. The rate of overdose was elevated in people with a mental illness alone, higher again in people with a substance use disorder alone and highest in people with a dual diagnosis. The adjusted hazard rates were similar for people with substance use disorder only and people with a dual diagnosis.
Publisher: Elsevier BV
Date: 06-2019
DOI: 10.1016/J.DRUGPO.2019.03.018
Abstract: The prevalence of smoking among people entering prisons is high. Despite increasing adoption of prison smoke-free policies, relapse to smoking after release from prison is nearly universal, and policy to effectively mitigate this is largely absent. Informed by a risk environment framework, we aimed to identify key barriers and facilitators to maintaining smoking abstinence among former smokers released from smoke-free prisons. Twenty-one people released from smoke-free prisons in Queensland, Australia, were followed up from a larger survey of 114 former prisoners. Semi-structured interviews were used to explore the perceived barriers and facilitators of maintained smoking abstinence. Identified barriers to continued abstinence included pre-release intention to resume smoking normalisation of smoking in home or social environments, resumption of smoking as a symbolic act of freedom and resistance from and to a restrictive environment a perception that smoking provides stress relief to their difficult lives, and the use of tobacco/smoking to cope with cravings experienced on release for illicit substances. A number of interviewees were unable to provide clear reflective reasons for relapse. For those who did manage to remain abstinent for a period of time, identified facilitators included an awareness of the health and financial benefits of smoking abstinence, the use of intrinsic motivation, distraction from nicotine cravings using alternative activities, and social support from family and peers. Interventions promoting continued smoking abstinence among people exiting smoke-free prisons should focus on targeting the perceived in idual- and environmental-level barriers to maintained smoking abstinence while simultaneously promoting perceived facilitators, so as to reduce smoking-related health and economic disparities in this marginalised population.
Publisher: Elsevier BV
Date: 05-2014
DOI: 10.1016/J.JADOHEALTH.2013.10.003
Abstract: Estimate the prevalence and annual frequency of health risk indicators in young people serving community-based orders (CBOs) and custodial orders in the state of Victoria, Australia. Cross-sectional survey of 242 young people serving CBOs and 273 serving custodial orders in Victoria in 2002-2003. Validated measures included the Composite International Diagnostic Interview for substance dependence, Short Mood and Feelings Questionnaire for depression, and Psychosis Screening Questionnaire for psychosis symptoms. Prevalence estimates were adjusted for s ling bias and age- and sex-adjusted for between-group comparisons. Prevalence estimates were applied to 2010-2011 Victorian youth justice data to estimate annual frequencies at the state level. The prevalence of substance dependence, poor mental health, and risky sexual behavior was high in both groups. Age- and sex-adjusted prevalence estimates were generally higher among those serving custodial orders however, extrapolating prevalence estimates to statewide youth justice data generally resulted in higher estimated annual frequencies among CBOs. For ex le, the estimated prevalence of any substance dependence was 66% (95% confidence interval [CI], 60-72) in those serving custodial orders and 34% (95% CI, 26-42) in CBOs, but the estimated frequency of substance dependence in CBOs in 2010-2011 was 970 (95% CI, 750-1,180), compared with 490 (95% CI, 450-530) in those serving a custodial order. There is a compelling case for scaling up health services for young offenders in custody and in the community, and for routinely monitoring the health of young offenders serving custodial and community orders.
Publisher: Wiley
Date: 25-07-2021
DOI: 10.1111/DAR.12179
Abstract: Young offenders are at increased risk of preventable death after release from custody, but risk factors for death in this population are poorly understood. Despite their poor health profiles, no studies have examined mortality outcomes in young people who have served community-based orders. The aims of this study were to describe the causes and identify risk factors for death in a cohort of young offenders in Victoria, Australia. We interviewed young people serving a custodial (n = 273) or community-based order (n = 242) in Victoria, Australia in 2002-2003. Measures included demographics and family history, offence history, experience of victimisation, mental illness, self-harm and substance use. Deaths up to 31 December 2011 were identified through a probabilistic linkage with the National Death Index. The all-cause crude mortality rate was 4.2 (95% confidence interval 2.7-6.8) per 1000 person years and was not significantly different for those who had served custodial and community-based orders. Most deaths were due to drug overdose, traffic accidents or suicide. Adjusting for age, sex and order type, risk factors for death from the baseline interview included weekly use of opioids, sleeping pills or painkillers, polydrug use and injecting drug use. Young people who have served community-based and custodial orders are at an increased risk of preventable death. Those engaging in risky substance use, particularly injecting drug use and use of multiple central nervous system depressants, are at greatest risk. There is an urgent need to develop and rigorously evaluate preventive interventions.
Publisher: Springer Science and Business Media LLC
Date: 07-07-2022
DOI: 10.1186/S12913-022-08209-6
Abstract: The period after release from prison can be challenging, especially due to a higher risk of morbidity and mortality despite commonly increased use of healthcare services. However, little is known about the quality of the healthcare offered to this population, which limits the possibility of addressing this important health inequity. This study characterised multimorbidity and investigated the relationship between multimorbidity and quality of primary healthcare in adults within 2 years after release from prison. This was a prospective cohort study of 1046 participants of a service brokerage intervention after release from prison between August 2008 and July 2010 in Queensland, Australia. Participants had their baseline survey and clinical data linked prospectively with their medical, correctional and death records. Multimorbidity was ascertained using the Cumulative Illness Rating Scale and classified into three categories: none, moderate (morbidity in 2–3 domains) and complex (morbidity in 4 or more domains). Outcomes were Usual Provider Continuity Index (UPCI), Continuity of Care (COC) Index, and having at least one extended primary care consultation ( 20 minutes). Descriptive statistics and logistic regression were used in the analyses. Multimorbidity was present for 761 (73%) participants, being more prevalent among females (85%) than males (69%), p 0.001. Moderate multimorbidity was not associated with UPCI or COC, but was associated with having at least one long consultation (AOR = 1.64 95% CI:1.14–2.39), after adjusting for covariates. Complex multimorbidity was positively associated with all outcomes in the adjusted models. Indigenous status was negatively associated with UPCI (AOR = 0.54 95% CI: 0.37–0.80) and COC (AOR = 0.53 95% CI: 0.36–0.77), and people younger than 25 years were at 36% lower odds (AOR = 0.64 95% CI: 0.44–0.93) of having a long consultation than the middle-aged group (25–44 years) in the adjusted models. Moderate multimorbidity was associated with having at least one extended primary care consultation, but not with adequate continuity of care, for adults within 2 years of being released from prison. Nearly half of those with complex multimorbidity did not receive adequate continuity of care. The quality of primary care is inadequate for a large proportion of adults released from prison, constituting an important and actionable health inequity.
Publisher: Wiley
Date: 16-10-2023
DOI: 10.1002/AJS4.296
Publisher: Wiley
Date: 21-09-2022
DOI: 10.1111/ADD.15679
Publisher: Cambridge University Press (CUP)
Date: 12-08-2017
DOI: 10.1017/S2045796016000585
Abstract: There are growing calls to reduce, and where possible eliminate, the use of seclusion and restraint in mental health settings, but the attitudes and beliefs of consumers, carers and mental health professionals towards these practices are not well understood. The aim of this study was to compare the attitudes of mental health service consumers, carers and mental health professionals towards seclusion and restraint in mental health settings. In particular, it aimed to explore beliefs regarding whether elimination of seclusion and restraint was desirable and possible. In 2014, an online survey was developed and widely advertised in Australia via the National Mental Health Commission and through mental health networks. The survey adopted a mixed-methods design, including both quantitative and qualitative questions concerning participants’ demographic details, the use of seclusion and restraint in practice and their views on strategies for reducing and eliminating these practices. In total 1150 survey responses were analysed. A large majority of participants believed that seclusion and restraint practices were likely to cause harm, breach human rights, compromise trust and potentially cause or trigger past trauma. Consumers were more likely than professionals to view these practices as harmful. The vast majority of participants believed that it was both desirable and feasible to eliminate mechanical restraint. Many participants, particularly professionals, believed that seclusion and some forms of restraint were likely to produce some benefits, including increasing consumer safety, increasing the safety of staff and others and setting behavioural boundaries. There was strong agreement across participant groups that the use of seclusion and restraint is harmful, breaches human rights and compromises the therapeutic relationship and trust between mental health service providers and those who experience these restrictive practices. However, some benefits were also identified, particularly by professionals. Participants had mixed views regarding the feasibility and desirability of eliminating these practices.
Publisher: Public Library of Science (PLoS)
Date: 07-09-2022
DOI: 10.1371/JOURNAL.PONE.0272870
Abstract: People released from prison who experience mental health and substance use problems are at high risk of reincarceration. This study aimed to examine the association between contact with mental health and substance use treatment services, and reincarceration, among adults released from prison. Pre-release survey data from 1,115 adults released from prisons in Queensland, Australia were linked with administrative health and correctional records covering a median of 787 days post-release. We constructed marginal structural Cox proportional hazards models, adjusting for pre-release variables and time-varying indicators of emergent mental health and substance use problems, to examine the association between contact with mental health and substance use treatment services, and reincarceration. The adjusted hazard ratio (AHR) for reincarceration associated with mental health service contact was 1.76 (95%CI 1.23,2.51). Among those not on parole following release, the AHR for reincarceration associated with substance use treatment service contact was 3.16 (95%CI 2.09,4.77) we found no evidence for an association among those who were released on parole (AHR = 1.07 95%CI 0.80,1.43). Although we cannot eliminate the possibility of residual confounding, our findings suggest that infrequent or unsustained contact with community-based mental health and substance use treatment services is not protective against reincarceration, and may even be iatrogenic. Increased investment in high-quality and timely behavioural health services for people released from prison may simultaneously improve health outcomes, and reduce reincarceration.
Publisher: Wiley
Date: 19-10-2023
DOI: 10.1111/ADD.16365
Publisher: S. Karger AG
Date: 2009
DOI: 10.1159/000253553
Abstract: i Aims: /i This paper examines the epidemiology of ecstasy use and harm in Australia using multiple data sources. i Design: /i The data included (1) Australian Customs Service 3,4-methylenedioxymeth hetamine (MDMA) detections (2) the National Drug Strategy Household and Australian Secondary Student Alcohol and Drug Surveys (3) data from Australia’s ecstasy and Related Drugs Reporting System (4) the number of recorded police incidents for ecstasy possession and distribution collated by the N.S.W. Bureau of Crime Statistics and Research (5) the number of calls to the Alcohol and Drug Information Service and Family Drug Support relating to ecstasy (6) the Alcohol and Other Drug Treatment Services National Minimum Dataset on number of treatment episodes for ecstasy, and (7) N.S.W. Division of Analytical Laboratories toxicology data on number of deaths where MDMA was detected. i Findings: /i Recent ecstasy use among adults in the general population has increased, whereas among secondary students it has remained low and stable. The patterns of ecstasy consumption among regular ecstasy users have changed over time. Polydrug use and use for extended periods of time ( h) remain common among this group. Frequent ecstasy use is associated with a range of risk behaviours and other problems, which tend to be attributed to a number of drugs along with ecstasy. Few ecstasy users present for treatment for problems related to their ecstasy consumption. i Conclusions: /i Messages and interventions to reduce the risks associated with polydrug use and patterns of extended periods of use are clearly warranted. These messages should be delivered outside of traditional health care settings, as few of these users are engaged with such services.
Publisher: Elsevier BV
Date: 03-2018
Publisher: Wiley
Date: 04-04-2023
DOI: 10.1111/DAR.13651
Abstract: Despite long‐standing recommendations to integrate mental health care and alcohol and other drug (AOD) treatment, no prior study has synthesised evidence on the impact of physically co‐locating these specialist services on health outcomes. We searched Medline, PsycINFO, Embase, Web of Science and CINAHL for studies examining health outcomes associated with co‐located outpatient mental health care and AOD specialist treatment for adults with a dual diagnosis of substance use disorder and mental illness. Due to ersity in study designs, patient populations and outcome measures among the included studies, we conducted a narrative synthesis. Risk of bias was assessed using the MASTER scale. Twenty‐eight studies met our inclusion criteria. We found provisional evidence that integrated care that includes co‐located mental health care and AOD specialist treatment is associated with reductions in substance use and related harms and mental health symptom severity, improved quality of life, decreased emergency department presentations/hospital admissions and reduced health system expenditure. Many studies had a relatively high risk of bias and it was not possible to disaggregate the independent effect of physical co‐location from other common aspects of integrated care models such as care coordination and the integration of service processes. There are few high‐quality, peer‐reviewed studies establishing the impact of co‐located mental health care and AOD specialist treatment on health outcomes. Further research is required to inform policy, guide implementation and optimise practice. Integrated care that includes the co‐location of mental health care and AOD specialist treatment may yield health and economic benefits.
Publisher: Wiley
Date: 19-12-2019
DOI: 10.1111/DAR.12881
Abstract: Once involved in the criminal justice system, people who inject drugs (PWID) have a high probability of multiple system encounters. Imprisonment typically fails to rehabilitate PWID, who upon return to the community are at considerable risk of returning to injecting drug use (IDU) and poor health and social outcomes. We examined the effect of IDU resumption, and a suite of other sociodemographic, criminogenic, health and behavioural indicators, on the timing of reincarceration among adults with a history of IDU following release from prison. Structured interviews were conducted with 561 PWID in Queensland, Australia prior to release from prison and approximately 1, 3 and 6 months post-release. Data were linked prospectively with correctional records and the National Death Index. Data collected at multiple time-points were treated as time-varying covariates. Kaplan-Meier survival estimates and Cox proportional hazards models were used to estimate the rate and hazards of reincarceration. Sixty-eight percent of participants (n = 350) were reincarcerated over a combined observation time of 1043.5 years, representing a rate of 33.5 per 100 person-years (95% confidence interval [CI] 30.2-37.2). Time-invariant predictors of reincarceration in PWID were: male gender (adjusted hazard ratio [AHR] = 1.62, 95% CI 1.19-2.21), older age at release (AHR = 0.97, 95% CI 0.95-1.00), previous adult (AHR = 2.00, 95% CI 1.41-2.84) or juvenile (AHR = 1.78, 95% CI 1.27-2.49) imprisonment, shorter imprisonment (≤90 days vs. >365 days, AHR = 2.09, 95% CI 1.30-3.34), release on parole (AHR = 2.29, 95% CI 1.82-2.88) and drug-related sentence (AHR = 1.84, 95% CI 1.34-2.53). Time-varying predictors included resumption of IDU (AHR = 2.04, 95% CI 1.60-2.61), unemployment (AHR = 1.53, 95% CI 1.07-2.19) and low perceived social support (AHR = 1.41, 95% CI 1.05-1.90). Very-high psychological distress at the most recent interview was protective against reincarceration (AHR = 0.65, 95% CI 0.44-0.95). Efforts to prevent resumption of IDU and address disadvantage, social inclusion and health service access in ex-prisoners through the scale-up and integration of prison-based and post-release interventions are likely to reap both public health and criminal justice benefits.
Publisher: Wiley
Date: 18-06-2015
DOI: 10.1111/DAR.12280
Abstract: Substance use and psychotic symptoms/disorders are associated. There has been little examination of this issue in young offenders, despite elevated substance use in this group. Semistructured interviews were conducted by trained researchers with 514 young offenders. Psychotic symptoms were assessed using a previously validated screening measure, with scores ≥3 indicative of possible psychotic disorder. Associations between this indicator and patterns of offending, common symptoms of mental disorders and health risk behaviours, including substance use were examined. The extent to which substance use and psychotic symptoms remained associated after adjustment for possible confounding was evaluated. Thirteen percent screened positive for psychosis. Participants who screened positive for psychosis were more likely than those who did not to have: unstable housing been expelled from school a family history of substance use/mental health problems, and depressive symptoms. Amphetamine, sedative and cannabis dependence were all strongly associated with screening positive for psychosis. Screening positive remained significantly associated with hetamine and sedative dependence, and daily cannabis and sedative use, in multivariable regressions. One in eight young offenders reported symptoms consistent with psychosis. Symptomatology was strongly associated with heavy use of a range of illicit drugs. Given the frequency of these symptoms and the potential for them to be related to or exacerbated by drug use, this study highlights the importance of co-ordinated alcohol and other drugs and mental health treatment for young offenders, both due to co-occurrence and given the possibility that treating SUDs may impact on mental health symptoms.
Publisher: Wiley
Date: 14-03-2023
DOI: 10.1111/DAR.13636
Abstract: Meth hetamine use is more common than opioid use among prison entrants in some countries, including Australia, yet most research and policy focuses on opioid use. This suggests that traditional opioid‐focused interventions are no longer appropriate for the majority of this group in countries such as Australia. To inform policy and practice, we compared socio‐demographic characteristics and health needs of people leaving prison with a history of meth hetamine use and/or opioid use. A cross‐sectional survey of incarcerated adults administered the World Health Organization Alcohol, Smoking and Substance Involvement Screening Test was used to identify moderate‐/high‐risk meth hetamine use ( n = 909), opioid use ( n = 115) or combined meth hetamine/opioid use ( n = 356) before incarceration. We compared groups using modified log‐linked Poisson regression with robust error variance. Compared to the opioid‐only group, the meth hetamine‐only group were: significantly more often aged years significantly more likely to identify as Indigenous significantly less likely to have a history of prior incarceration, drug injection or overdose. A significantly lower proportion of meth hetamine‐only and meth hetamine‐and‐opioid participants self‐reported current hepatitis C infection compared to opioid‐only participants. A majority of participants in all groups screened positive for current psychological distress according to the K10. People leaving prison with a history of meth hetamine use differ from opioid users with respect to demographics, patterns of substance use and related health concerns. Treatment and harm reduction efforts for people who experience incarceration must respond to patterns of drug use in this population, and invest at scale in coordinated, continuous services for co‐occurring substance use and mental health problems.
Publisher: CSIRO Publishing
Date: 15-05-2023
DOI: 10.1071/AH22229
Abstract: Objective This study aimed to identify factors associated with an emergency department (ED) length of stay ≥4 hours (h) and hospital admission for people with a mental health problem brought in by police. Methods We undertook a retrospective, observational cohort study of state-wide adult ED mental health presentations brought in by police from 1 January 2012 to 31 December 2017. We used multivariable logistic regression to determine factors associated with an ED length of stay ≥4 h and hospital admission. Results In total, 9325 ED presentations with a mental health problem brought in by police to Queensland EDs were included. Factors most strongly associated with an ED length of stay ≥4 h included an Australasian Triage Score (ATS) of 1, an age of 85 years or older, night shift arrival and subsequent hospital admission. For hospital admission, an ATS of 1, an age of 85 years or older and an ED length of stay ≥4 h were the strongest factors. Conclusion Findings indicate opportunities for targeted mental health models of care to better support people brought in by police to an ED. Such models should involve ED, pre-hospital providers (police and ambulance) and mental health services to support early intervention and potentially reduce the likelihood of a long ED length of stay and subsequent hospital admission.
Publisher: Wiley
Date: 06-02-2023
DOI: 10.1111/ADD.16138
Abstract: Illicit substance use is common among people entering prisons, as is returning to substance use after release from prison. We aimed to assess the predictive validity of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) for returning to substance use after release from prison. A longitudinal design with baseline survey conducted between 2008 and 2010 in the 6 weeks before expected prison release and up to three follow‐up surveys in the 6 months after release. Prisons in Queensland, Australia. A total of 1054 adults within 6 weeks of expected release from prison. The ASSIST was used to assess problematic use of cannabis, meth hetamine, heroin and other non‐prescribed opioids in the 3 months before incarceration. Post‐incarceration substance use was measured at 1, 3 and 6 months after release. We calculated the area under the receiver operating characteristic curve (AUROC) and the optimal ASSIST cut‐off score for each substance, using Youden’s index ( J ). Forty‐one per cent ( n = 434) of the cohort reported any substance use during follow‐up: 33% ( n = 344) used cannabis, 20% ( n = 209) meth hetamine, 10% ( n = 109) heroin and 9% ( n = 97) illicit other opioids. The optimal ASSIST cut‐off score was ≥ 4 for heroin, meth hetamine and cannabis and ≥ 1 for other opioids. Using these cut‐offs, the AUROC was highest for heroin in predicting both any use (AUROC = 0.82) and weekly use (AUROC = 0.88) in the past 4 weeks. AUROCs for other drugs ranged from 0.73 to 0.79. The ASSIST shows promise as an accurate and potentially scalable tool that may be useful for predicting a return to substance use after release from prison and could inform service delivery. The substantial rates of returning to substance use after release from prison suggest that prison serves to interrupt rather than cease substance use.
Publisher: Oxford University Press (OUP)
Date: 2018
Publisher: Informa UK Limited
Date: 2006
DOI: 10.1080/10826080500411528
Abstract: We examine alcohol use in conjunction with ecstasy use and risk-taking behaviors among regular ecstasy users in every capital city in Australia. Data on drug use and risks were collected in 2004 from a national s le of 852 regular ecstasy users (persons who had used ecstasy at least monthly in the preceding 6 months). Users were grouped according to their typical alcohol use when using ecstasy: no use, consumption of between one and five standard drinks, and consumption of more than five drinks ("binge" alcohol use). The s le was young, well educated, and mainly working or studying. Approximately two thirds (65%) of the regular ecstasy users reported drinking alcohol when taking ecstasy. Of these, 69% reported usually consuming more than five standard drinks. Those who did not drink alcohol were more disadvantaged, with greater levels of unemployment, less education, higher rates of drug user treatment, and prison history. They were also more likely than those who drank alcohol when using ecstasy to be drug injectors and to be hepatitis C positive. Excluding alcohol, drug use patterns were similar between groups, although the no alcohol group used cannabis and meth hetamine more frequently. Binge drinkers were more likely to report having had three or more sexual partners in the past 6 months and were less likely to report having safe sex with casual partners while under the influence of drugs. Despite some evidence that the no alcohol group were more entrenched drug users, those who typically drank alcohol when taking ecstasy were as likely to report risks and problems associated with their drug use. It appears that regular ecstasy users who binge drink are placing themselves at increased sexual risk when under the influence of drugs. Safe sex messages should address the sexual risk associated with substance use and should be tailored to reducing alcohol consumption, particularly targeting "heavy" alcohol users. The study's limitations are noted.
Publisher: Wiley
Date: 19-11-2012
DOI: 10.1111/ADD.12010
Abstract: World-wide, more than 30 million people move through prisons annually. Record linkage studies have identified an increased risk of death in ex-prisoners. In order to inform preventive interventions it is necessary to understand who is most at risk, when and why. Limitations of existing studies have rendered synthesis and interpretation of this literature difficult. The aim of this study was to describe methodological characteristics of existing studies and make recommendations for the design, analysis and reporting of future studies. Systematic review of studies using record linkage to explore mortality in ex-prisoners. Based on analysis of these studies we illustrate how methodological limitations and heterogeneity of design, analysis and reporting both h er data synthesis and create potential for misinterpretation of findings. Using data from a recent Australian study involving 42,015 ex-prisoners and 2329 observed deaths, we quantify the variation in findings associated with various approaches. We identified 29 publications based on 25 separate studies published 1998-2011, mainly from the United Kingdom, United States and Australia. Mortality estimates varied systematically according to features of study design and data analysis. A number of common, avoidable and significant methodological limitations were identified. Substantial heterogeneity in study design, methods of data analysis and reporting of findings was observed. Record linkage studies examining mortality in ex-prisoners show widely varying estimates that are influenced substantially by avoidable methodological limitations and reducible heterogeneity. Future studies should adopt best practice methods and more consistent methods of analysis and reporting, to maximize policy relevance and impact.
Publisher: Oxford University Press (OUP)
Date: 2018
Abstract: Prisoners engage in a range of risk behaviors that can lead to the transmission of viral infections, such as HIV, hepatitis B and hepatitis C. In this review, we summarize the epidemiologic literature from 2007 to 2017 on 4 key risk behaviors for human immunodeficiency virus and hepatitis C virus among prisoners globally: drug injection, sexual activity, tattooing, and piercing. Of 9,303 peer-reviewed and 4,150 gray literature publications, 140 and 14, respectively, met inclusion criteria covering 53 countries (28%). Regions with high levels of injection drug use were Asia Pacific (20.2%), Eastern Europe and Central Asia (17.3%), and Latin America and the Caribbean (11.3%), although the confidence interval for Latin America was high. Low levels of injection drug use in prison were found in African regions. The highest levels of sexual activity in prison were in Europe and North America (12.1%) and West and Central Africa (13.6%) low levels were reported from the Middle East and North African regions (1.5%). High levels of tattooing were reported from Europe and North America (14.7%), Asia Pacific (21.4%), and Latin America (45.4%). Prisons are burdened with a high prevalence of infectious diseases and risk behaviors for transmission of these diseases, and, commonly, a striking lack of evidence-based infection control measures, even when such measures are available in the surrounding community. Given that most prisoners return to these communities, failure to implement effective responses has repercussions not only prisoner health but also for public health.
Publisher: Wiley
Date: 05-2010
DOI: 10.1111/J.1465-3362.2009.00159.X
Abstract: Considerable concern has been raised about associations between ecstasy use and mental health. Studies of ecstasy users typically investigate varying levels of lifetime use of ecstasy, and often fail to account for other drug use and sociodemographic characteristics of participants, which may explain mixed findings. The current study aimed to examine the relationship between patterns of recent (last six months) ecstasy use and psychological distress among current, regular ecstasy users, controlling for sociodemographic risk factors and patterns of other drug use. Data were collected from regular ecstasy users (n = 752) recruited from each capital city in Australia as part of the Ecstasy and related Drugs Reporting System (EDRS). Psychological distress was assessed using the Kessler Psychological Distress Scale (K10). Data were analysed using multinomial logistic regression. Seven per cent of the s le scored in the 'high' distress category and 55% in the 'medium' distress category. Patterns of ecstasy use were not independently associated with psychological distress. The strongest predictors of distress were female sex, lower education, unemployment, 'binge' drug use including ecstasy (use for >48 h without sleep), frequent cannabis use and daily tobacco use. Regular ecstasy users have elevated levels of psychological distress compared with the general population however, ecstasy use per se was not independently related to such distress. Other factors, including sociodemographic characteristics and other drug use patterns, appear to be more important. These findings highlight the importance of targeting patterns of polydrug use in order to reduce drug-related harm among regular ecstasy users.
No related organisations have been discovered for Stuart Kinner.
Start Date: 06-2019
End Date: 12-2024
Amount: $427,234.00
Funder: Australian Research Council
View Funded ActivityStart Date: 01-2014
End Date: 12-2017
Amount: $390,000.00
Funder: Australian Research Council
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