Australia’s incarceration rate is now at its highest since 1899, despite an overall fall in crime rates. There are now more than 40,000 people in prison in Australia. While tighter bail conditions and longer sentences are thought to account for around 75 percent of the increase, it is also known that people in prison have higher rates of mental health conditions. Previous research has found that people in prison are less likely to have sought or had access to clinical health services in the community.
According to an Australian Institute of Health and Welfare (AIHW) report on the health of Australia’s prisoners by the health of prisoners, almost half of prison entrants in 2015 reported that they had been diagnosed with a mental health disorder by a health professional and one in four received medication for mental health while in prison. Antidepressants or mood stabilisers accounted for 16 percent of medications dispensed, being the most common, and were prescribed at a higher rate than that of a comparable population in the community. Other medications dispensed at higher rates include antipsychotic medications, and opioid substitution therapy.
The health of Australia’s prisoners report 2018 two in three prison entrants used illicit drugs in the year prior to being incarcerated and that two in three women had a history of a mental health condition. One in three prisoner entrants had been diagnosed with a chronic health condition, and a similar rate had been homeless or in insecure accommodation in the month prior to entering prison. Over half of those being released from prison expected to be homeless after release. Around 40 percent of those discharged are expected to be back in prison within two years of their release. Some prisoners report breaking the law to get back into jail in order to have a roof over their head and regular meals.
Mental health improves during incarceration
While incarceration obviously can exacerbate mental health issues, especially initially, according to the AIHW report 41 percent of those about to leave prison said their mental health had improved since being in jail. Only 10 percent of men and four percent of women said that their mental health issues had become worse. However, studies have found that within a few months of release many people lose any healthy gains they have made. The barriers identified as causing this include lack of access to required medications or treatment, and access to accommodation and support services.
According to the Health of Australian Prisoners 2018 report, prison can provide opportunities for people to access treatment which is accessed less often in the community due to cost, work or family commitments, and alcohol or other drug issues. The 2018 report found that 30 percent of those being released from prison reported attending a medical appointment outside the prison during their incarceration. Half of prison dischargees had been given a referral or had an appointment to see a health professional after release, almost a third of those were to a medical practitioner.