![handle is hein.journals/hlthjs1 and id is 1 raw text is: van Dooren et al. Health and Justice 2013, 1:1
http-//www.healthandjustice.com/content/1 /1/1
Health & Justice
RE A R ARTCL Acs
Complex health-related needs among young,
soon-to-be-released prisoners
Kate van Dooren, Alun Richards2, Nick Lennox] and Stuart A Kinner3,4,5'6
Abstract
Background: To estimate the prevalence and co-occurrence of health-related needs among young people aged 18
to 24 years transitioning out of adult prisons.
Methods: Data came from face-to-face, confidential interviews with adult prisoners aged 18-24 years in seven adult
prisons in Queensland, Australia. We identified the prevalence and co-occurrence of overlapping health-related needs
using an Australian health performance framework with four domains: physical health, mental health, risky substance use
and socioeconomic disadvantage.
Results: Most young prisoners experience multiple and complex health problems prior to their release: 98% of young
prisoners reported at least one indicator of poor health, and 30% reported at least one indicator of poor health in all four
evaluated domains.
Conclusions: Young people in adult prisons report a high prevalence of health problems across multiple domains. Addressing
these complex needs will require coordinated service delivery across health-related sectors both in custody and after release.
Keywords: Prisoners; Young adult; Risk taking; Morbidity; Illicit drugs
Background
The transition out of prison is challenging, with most indi-
viduals re-entering the community with entrenched and
overlapping health and social needs (Hammett et al. 2001;
Kinner 2006; Kinner and Cogger 2007; Mallik-Kane
and Visher 2008). Post-release, risk of death from drug
overdose and suicide is high and morbidity is greatly ele-
vated compared with the general population (Bird and
Hutchinson 2003; Kariminia et al. 2007; Merrell et al.
2010). A substantial proportional of individuals reoffend
and are reincarcerated within a relatively short period
(Gendreau et al. 1996; Baldry et al. 2004; Holland et al.
2007; Wilson and Zozula 2012). Many of the individual
and structural factors that influence post-release health-
related outcomes are also relevant from a criminal justice
perspective: those who experience homelessness, un-
employment, alcohol and drug misuse and lack of social
connectedness are likely to experience poor health out-
comes and are also more likely to re-offend (Borzycki and
Baldry 2003; Baldry et al. 2004). Therefore, interventions
*Correspondence: k.vandooren@uq.edu.au
Queens and Centre or nte ectua and Developmental Disability, School of
Medicine, The University of Queensland, Brisbane, Australia
Full list of author information is available at the end of the article
1Ei Springer
that successfully target these factors during and after the
transition from custody have the potential to simultan-
eously improve health outcomes and reduce recidivism. A
prerequisite for the development of such interventions is a
detailed understanding of the unaddressed health needs of
soon-to-be-released prisoners (Ahalt et al. 2012).
In response to long-standing gaps in knowledge about
the health of prisoners, Australia's national agency for
health and welfare statistics established a set of national
prisoner health indicators (NPHI) that are now collected in
prisons nationally and reported annually (Belcher and Al
Yaman 2007; Australian Institute of Health and Welfare
2011a). The NPHI are used to inform service delivery
in prisons and provide a benchmark for measuring
changes in health status and service delivery over time.
However, from a re-entry perspective, the NPHI are limited
in two important ways. First, the focus of the NPHI is pris-
oner health and prison health services, based primarily on
a census of prison receptions, such that the collection is
likely to be a poor reflection of the health status of soon-to-
be released prisoners. Second, reports based on the NPHI
consider each health indicator separately, failing to identify
or characterise overlapping health needs. Consequently, we
© 2013 van Dooren et al., licensee Springer. This is an Open Access artide distributed under the terms of the Creative
Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and
reproduction in any medium, provided the original work is properly cited.](ViewImageLocal?handle=hein.journals/hlthjs1&div=1&collection=&method=preview&ext=.png&size=3)
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