Abstract
[Truncated]
Background
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.
Aim
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.
Methods
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 language | English |
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Qualification | Doctor of Philosophy |
Publication status | Unpublished - 2014 |