Academic journal article The Journal of Rehabilitation

Identifying Rehabilitation Priorities among Ex-Prisoners Vulnerable to Mental Llnesses and Substance Abuse

Academic journal article The Journal of Rehabilitation

Identifying Rehabilitation Priorities among Ex-Prisoners Vulnerable to Mental Llnesses and Substance Abuse

Article excerpt

A substantial proportion of the overall cost of prisons in developed countries can be attributed to ex-prisoners returnrig to prison after release. Internationally, reincarceration estimates are as high as 55% within five years of release (Durose, Cooper & Snyder, 2014; Fazel & Wolf, 2015). In Australia, a national adult prison census on 30 June 2016 found that 56.2% of 38,845 prisoners had prior incarcerations (ABS, 2016). The same national census reported that 64% of Queensland prisoners had prior incarcerations, 91% were male, and 32% were indigenous (Aboriginal or Torres Strait Islanders) (ABS, 2016). Reincarceration remains challenging in Australia and in other developed countries, because decades of research and substantial investment in prison-based programs, transition programs, and post-release supervision, do not appear to have reduced reincarceration rates.

Community rehabilitation, which involves identifying the most at risk subgroups and designing tailored interventions to facilitate more successful transitions, is one potential strategy for reducing reincarceration. The aims of this study support the goals of community rehabilitation by exploring whether post-release employment reduces the risk of reincarceration after controlling for known predictors of reincarceration, including mental health vulnerability, substance abuse risk, gender, age, indigenous status, and prior imprisonment.

In a meta-analysis of 131 studies of the predictors of recidivism, Gendreau, Little and Goggin (1996) found that: younger age, being male, past criminal activity, having criminal associates, antisocial personality, prior substance abuse, and low social achievement, were each associated with recidivism. This was defined as any post-release arrest, conviction, reincarceration, parole violation, or a combination of those. In an Australian study of ex-prisoners (n=238), unstable accommodation, being homeless, and not being employed after release were each negatively associated with staying out of prison (Baldry, McDonnell, Maplestone & Peeters, 2004). These results are consistent with a large community study in Norway where Skardhamar and Telle (2012) found that post-release employment significantly reduced the risk of reoffending, for all categories of principal offence, among a national cohort consisting of every person released from prison in 2003.

Other researchers have found that various attributes of criminal history increase the risk of both general recidivism and violent re-offending. However, the relative importance of clinical characteristics such as mental health diagnosis and substance abuse risk as predictors of recidivism remains unclear. An international meta-analysis of longitudinal studies published between 1959 and 1995 (Bonta, Law, & Hanson, 1998) examined 35 predictors of general recidivism among ex-prisoners, including those with a history of mental disorder. The authors found that the strongest positive predictors were: adult criminal history, juvenile delinquency, anti-social personality, and non-violent criminal history; and these applied to both those with and without mental disorders. Other significant predictors but with weaker associations were younger age, poor institutional adjustment, past psychiatric hospital admissions, male gender, substance abuse, and family problems. Psychosis, mental health treatment history, and having any mental disorder, protected against general recidivism. Interestingly, socio-economic status, race, education level, and previous problems with employment, were not found to be associated with general recidivism.

A more recent systematic review and meta-analysis of 27 studies produced different findings with respect to the association between mental disorders and recidivism. Fazel and Yu (2011) found an increased risk of repeat offending among those with psychotic disorders, compared to individuals without any psychiatric disorder. …

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