Mental health services use and post-sentence mortality in a whole-population cohort of first-time adult offenders in Western Australia

Nita Sodhi

Research output: ThesisDoctoral Thesis

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Almost 30 million people are estimated to transit through prisons internationally every

year, with about 50,000 prison releases in Australia. Despite the high prevalence of

mental illness in prisoners, understanding of their use of mental health services (MHSs)

either before or after incarceration is lacking. Also, in spite of the reduced life

expectancy associated with mental illness, the influence of MHS use on ex-prisoners’

mortality is not known. Furthermore, although offenders serving community-based

(non-custodial) sentences constitute a much larger group than prisoners, and are known

to have a higher risk of death than prisoners and the general population, relatively little

published research exists on this vulnerable offender group.


The overarching aim of this thesis was to determine the predictors of MHS use and

death in adult offenders after completion of their first-ever sentence, informed by their

baseline use of MHSs prior to first sentence commencement.


This thesis drew on the resources of the world-renowned Western Australian Data

Linkage System which allowed reliable and confidential linkages between

administrative records maintained by the Department of Corrective Services and the

Department of Health (including hospitalisations, MHS use and deaths). The study

cohort consisted of all adult (≥18 years) offenders who began their first-ever criminal

sentence in Western Australia from 1985-1994 (n=25,637) and were followed until

2008. A gender and age matched comparison group consisting of non-offending adults

from the general population (n=23,854) was selected through the Western Australian

Electoral Roll during the same period. In addition, offender sub-groups were identified

for internal comparisons. These consisted of prisoners and non-custodial offenders,

violent and non-violent offenders, offenders younger or older than 45 years of age, and

specific demographic categories including Indigenous females, non-Indigenous females,

Indigenous males and non-Indigenous males.

Original languageEnglish
QualificationDoctor of Philosophy
Publication statusUnpublished - 2014


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