7.3 The SPRINT Project – Primary health care better meeting the needs of Aboriginal Australians released from prison

Dr Jane Lloyd is an NHMRC Postdoctoral Research Fellow at the UNSW Centre for Primary Health Care and Equity who drew on the MHDCD Dataset to investigate the primary health care needs of Indigenous Australians transitioning from prison back to the community. The aim of the SPRINT Project was to develop culturally specific understandings of how primary health care services can better meet the health care and social support coordination needs of Aboriginal Australians after release from custody to the community, with a view to reducing ill-health and re-imprisonment and improving quality of life and wellbeing. The study found that there was inadequate continuity of comprehensive health care in the context of Aboriginal inmates’ complex needs and significant emotional distress and anxiety. While the health and social support needs of Aboriginal inmates released from custody are high, post release support is not universally or immediately available to all former inmates and no one agency is responsible for post release care. In terms of health, the study found that Aboriginal people are not accessing timely and appropriate primary health care in the community and often delay seeking treatment until hospitalisation is required and that more needs to be done to support Aboriginal people released from custody to access primary health care immediately and over a longer period post-release.

During transition from custody to the community, Aboriginal former inmates were found to experience high vulnerability, trauma and emotional distress, have high medical and mental health and wellbeing needs, high risk of illness and injury, and increased risk of relapse to substance misuse and risky behaviours post release. They also have a strong need to reconnect with family, community and culture. While access to post-release care for Aboriginal Australians was found to be especially important, so too what happens in the five years post release and the extent to which institutions such as hospitals and mainstream primary health care services meet the specific needs of Aboriginal Australians was identified. Transitional support after release from prison was found to be critically important to Aboriginal people’s adjustment to community life and therefore requires specific attention. The lack of transitional support was found to leave Aboriginal peoples and family members unsupported, prevent access to timely and appropriate primary health care and increase the risk of reincareration. All of this contributes to the higher risk of injury and illness experienced by Aboriginal peoples post-release, and to the institutionalisation of Aboriginal peoples within and outside the criminal justice system. The report outlined that transitional support must be: coordinated and intensive; immediate; of longer duration; comprehensive and multi-faceted; systematically available to all; and culturally informed and appropriate, involving family, Aboriginal Elders and community members.