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88 Unfinished business: Koori women and the justice system
When things get bad on the outside,
jail is a better option. Jail provides
security.
521
[In prison] you know where you are
going and this is like home.
522
Psychological impacts
Research demonstrates that the majority of Koori
women in prison have multiple and complex
needs, including mental health, drug and alcohol
issues and experience of sexual abuse and family
violence. Many of the women we spoke to told
us about the deep and persistent trauma that the
cycle of poverty, violence, homelessness, ill health
and family breakdown creates across generations.
Many women described how these health impacts
were exacerbated by incarceration and persisted
on leaving prison.
Leaving prison is very overwhelming.
[I] have suffered from panic attacks
and have ended up reoffending, as [I]
can't cope with the outside world.
523
Recent Victorian research has found that Koori
women in prison have experienced high rates
of mental disorder and poor rates of social and
emotional wellbeing.
524
This reflects similar findings
in NSW, where the 2009 NSW inmate health survey
found that prisoners in general are more likely to
report both mental and physical health problems.
525
As noted in the Koori Prisoner Mental Health and
Cognitive study, Koori prisoners require culturally
appropriate mental health assessment upon
reception into prison as well as adequate aftercare
once released from prison.
526
Studies have shown
that demand for mental health and drug and alcohol
services increases after time spent in prison.
527
The Koori women we spoke to were also clear
about the need for holistic health services.
521
Focus group participant, 17 January 2013.
522
Focus group participant, 17 January 2013.
523
Focus group participant, 14 December 2013.
524

James Ogloff et al, `Koori Prisoner Mental Health',
above n 134, 17-18.
525

Devon Indig et al, 2009 NSW Inmate Health Survey:
Key Findings Report
(New South Wales Justice Health,
2010) 51, 135.
526

James Ogloff et al, `Koori Prisoner Mental Health',
above n 134, 17-18.
527

Hobbs et al (2006) cited in National Indigenous
Drug and Alcohol Committee, above n 487, 41. Note:
Admissions to general hospitals also increase after
imprisonment.
[We] need ongoing sessions for
women around their health and sexual
health. It can't just be a one-off
program.
528
[We] need medical services that are
culturally appropriate. Years ago, there
was a Koori nurse provided through
the gathering place.
529
Health services are critical for women
[leaving] prison. Many women have
drug and alcohol issues and need to
be able to access programs. Some
women also have mental health issues
and so need case management or
counselling to assist to treat these
issues. Counselling is also important
as many women have suffered varying
degrees of trauma. Based on past
experiences, many women are unable
to trust others. It is also important to
start to build up their self esteem, their
sense of self worth and purpose.
530
Some key informants identified barriers to services
or questioned the quality of available health
services, within and outside prison.
The prison system is not well equipped
to support people with disabilities or
the elderly.
531
Health care is an area of huge concern
within the women's correctional
framework. It has long been
recognised that women's health issues
are greater, more complex and occur
at a higher rate than those of men.
532
Health impacts
We also know that mortality rates amongst ex-
prisoners are "alarmingly high, particularly within the
first few weeks of release" and that the mental health
and substance misuse risks contribute to this.
533
528

Focus group participant, 14 December 2013.
529
Focus group participant, 6 March 2013.
530
Focus group interview, 17 January 2013.
531

Key Informant interview, Aboriginal Outcomes Unit,
Department of Human Services, 30 November 2012.
532
Case study 5.
533

Kinner et al (2010) cited in National Indigenous Drug
and Alcohol Committee, above n 487, 41.