Social and Cultural Resilience and Emotional wellbeing of Aboriginal Mothers in prison (SCREAM)

Date Commenced:
08/2010
Project Status
Ongoing
Expected Date of Completion:
Ongoing
Project Supporters

NHMRC (#630653)

Currently recruiting
No
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About the Project

Project Collaborators: External

National Perinatal Epidemiology and Statistics Unit, School of Women’s and Children’s Health, Faculty of Medicine, University of New South Wales

National Drug Research Institute, Faculty of Health Sciences, Curtin University of Technology

SCREAM is a NHMRC funded project with a New South Wales and Western Australia hub. The project is led by the National Perinatal Epidemiology and Statistics Unit  and the purpose of the study is to: 1. Describe the health of Aboriginal mothers in prison and in transition from prison to the community and improve health outcomes for these women. 2. Identify gaps in service delivery and make recommendations to improve integrative service delivery that targets the unique physical and social and emotional wellbeing needs of Aboriginal mothers 3. Promote culturally safe models of health care for Aboriginal women in prison and in transition from prison to the community

Rationale

Indigenous women are the fastest growing group within the Australian prison population. At June 2010, female Indigenous prisoners comprised 30% of the full-time adult female prison population. The imprisonment rate for adult Indigenous women was 394 per 100000 (a 14% rise from 2006) compared with 25 per 100000 for the non-Indigenous female prison population. Indigenous women are therefore 16 times more likely to be imprisoned than non-Indigenous women. By way of contrast, Indigenous men are 14 times more likely to be imprisoned than non-Indigenous men (ABS 2010).   

Indigenous women have been, and continue to be, the main carers and providers in their extended families. The increasing imprisonment of Aboriginal women is therefore a major public health issue for Aboriginal families, communities and society as a whole. One way in which the burden of disease and cycle of incarceration within families can be addressed is by improving health outcomes for Aboriginal mothers and Aboriginal women in prison and in the post-release period.

International and Australian research has demonstrated that ‘as compared with males, female offenders under supervision seem to have a higher prevalence of needs in the personal and emotional area, in marital and family relations, and in academic and vocational skills’ (Porporino and Fabiano 2005). Despite this, a low priority is placed on gender-specific rehabilitation services for women that address physical and sexual abuse, psychological wellbeing, children and families (Bartels 2010; Sorbello et al 2002; Wilmoth 2005).  In addition, Aboriginal women prisoners suffer multiple disadvantages and face race, gender and health discrimination (Armstrong et al 2005).

The health and treatment needs of these women have been overlooked in research with Aboriginal communities.  Further, research on Aboriginal women in prison has not included health and justice agencies as participants. This is despite evidence that Aboriginal women being released from prison are at the highest risk of social exclusion, homelessness, domestic violence victimisation and re-incarceration (Baldry et al 2006). 

An integrated approach is required. This research involves Aboriginal mothers, Aboriginal women, and a broad range of other stakeholders in identifying practical steps to reduce health inequalities between Aboriginal mothers and Aboriginal women in contact with the criminal justice system and those in the community. In doing so, it will address the burden of disease and cycle of incarceration within families by informing culturally safe health care policy and practice. 

This study has been initiated by and will be carried out by Aboriginal women. Two of the CIs are Aboriginal female academics that have participated in an advisory group for a NHMRC project grant on the impact of imprisonment on women whilst pregnant. This group was unanimous in the view that the consequences of imprisonment for Aboriginal mothers, women, children and communities are unique to Aboriginal peoples and a systematic investigation must be conducted and properly resourced if any practical benefit is to be derived from the research.

Aims

1. Involve a broad range of stakeholders throughout the research process

2. Describe the health of Aboriginal mothers in prison with a focus on social and emotional wellbeing

3. Investigate the equity of access to culturally safe health care in prison for Aboriginal women 

4. Identify the key attributes of culturally safe models of health care for Aboriginal women in prison

5. Identify pathways for the transition of culturally safe health care into the community so that health gains are maximised on release from prison

6. Build capacity among Aboriginal researchers, Aboriginal community controlled health services and relevant community organisations

Design & Method

This is a study of Aboriginal women in prison and their institutional and external stakeholders. The study design uses a mixed methods approach, including the application of nationally developed standardised measures of Aboriginal social and emotional wellbeing, medical record audit, narrative interviews triangulated with an analysis of policy and procedural documents relating to standards of health care, and focus group interviews with a range of stakeholders. The principle of involving stakeholders in defining and answering research questions and identifying actions to beimplemented draws upon participatory action research.

Progress/Update

The research has two phases. Phase One focuses on consultation with a broad range of stakeholders. The purpose of Phase One is to establish the study design in each state in a way that is responsive to the knowledge of stakeholders and that facilitates Aboriginal community control throughout Phase Two of the research.  This consultation work will continue throughout Phase Two via communication with Advisory Groups established during Phase One. Phase Two is the operational phase of the research incorporating the recruitment of participants, collection and analysis of data and the dissemination of findings.  The research is currently in the final stage of phase one.  The NSW and WA Advisory Groups have been established and the study design is in the process of being finalised.  The questionnaire that will be used in WA is currently being piloted at Boronia Pre-Release Centre for women.

Benefits

The high level of incarceration of Aboriginal women represents a health risk. However, culturally safe, high quality health care in this environment and successful integration with community-based services has the potential to reduce the health, social and economic burden of Aboriginal maternal imprisonment on society as well as the individual. The immediate outcomes of the research will include specific recommendations for models of care for Aboriginal women in the prison context, prepared with the involvement of women themselves, health and correctional services, and community organisations; increased capacity among Aboriginal female researchers in the field of public health and justice health; and recommendations for professional development and skills training among health and correctional workers in Australian prisons. In the medium- to long-term, it is hoped that the study will generate improved understanding of the needs of Aboriginal women in Australian prisons, with particular regard to the impact of this rising imprisonment on children and families as a whole. Opportunities for prevention and early intervention will be identified with the research providing a platform for policy and practice change in this area.

Output

The outcomes of the research will include specific recommendations for models of care for Aboriginal women in prison; increased capacity among Aboriginal female researchers in the field of public health and prison health; and recommendations for professional development and skills training among health and correctional workers in Australian prisons. Opportunities for early intervention to prevent fragmentation and disintegration of the family; grief; stigma; financial hardship; and the psychological trauma which leads to offending behaviour in children will be identified, with the research providing a platform for policy and practice change.

Other Investigators

Chief Investigators

Professor Elizabeth Sullivan, Director of the National Perinatal Epidemiology and Statistics Unit, School of Women’s and Children’s Health, University of New South Wales, NSW

Professor Juanita Sherwood, Professor of Australian Indigenous Education, Faculty of Arts and Social Sciences, University of Technology Sydney, NSW

Ms Jocelyn Jones, Research Fellow, National Drug Research Institute, Curtin University, WA

Professor Eileen Baldry, School of Social Sciences, University of New South Wales, NSW

Professor Tony Butler, Kirby Institute, University of New South Wales, NSW

Associate Professor Marisa Gilles, Rural & Remote Medical Practice, Combined Universities Centre for Rural Health, Geraldton WA

Professor Michael Levy, Director ACT Justice Health Service, Australian National University Medical School, Canberra ACT

 

Associate Investigators

Dr Mandy Wilson, Research Fellow, National Drug Research Institute, Curtin University, WA

Dr Sacha Kendall, Research Fellow, National Perinatal Epidemiology and Statistics Unit, School of Women’s and Children’s Health, University of New South Wales, NSW

Project Members
image - 1338431618 Tony Butler
Professor Tony Butler
Professor and Program Head

Project Contacts

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