MHDCD Project

1. Introduction

Aboriginal and Torres Strait Islander peoples with mental health disorders and cognitive disability (MHDCD) are significantly over-represented in Australian criminal justice systems. Despite this, there has been a lack of critically informed evidence, analysis and co-ordinated policy and service response on this most pressing human rights issue. The Indigenous Australians with Mental Health Disorders and Cognitive Disability in the Criminal Justice System (IAMHDCD) Project[1] brings an innovative Indigenous-informed mixed method research approach that provides, for the first time, a critical analysis of systems interactions and responses to the complex needs of Indigenous people with disability in criminal justice. The project used data from the mental health disorder and cognitive disability (MHDCD) Dataset as well as gathering qualitative information. The MHDCD Dataset contains lifelong administrative information on a cohort of 2,731 persons who have been in prison in NSW and whose MHDCD diagnoses are known. All NSW criminal justice agencies (Corrective Services, Police, Juvenile Justice, Courts, Legal Aid) and human service agencies (Housing, Ageing Disability and Home Care, Community Services, Justice Health and Health NSW) have provided data relating to these individuals, including residential addresses. A quarter (676) of the cohort is Indigenous: 583 Indigenous men (21% of the whole cohort and 86% of the Indigenous sub-cohort) and 93 Indigenous women (3% of the whole cohort and 14% of the Indigenous sub-cohort). Ethics permissions for the Dataset compilation were given by the UNSW Human Research Ethics Committee (HREC), Aboriginal Health and Medical Research Council of NSW and each agency’s data custodian or ethics committee.[2]

The first phase of the project involved a quantitative analysis of the pathways Aboriginal and Torres Strait Islander people with MHDCD take into, around and through the human service and criminal justice systems. The second phase of the project was a qualitative investigation of the experiences of Aboriginal people with mental and cognitive disabilities in the criminal justice system, as well as specialist Aboriginal agencies and Aboriginal communities regarding these pathways and how system, policy and program dynamics impact on Indigenous people and their communities. The third phase of the project has been the in-depth analysis of the interconnections between the qualitative and quantitative data, drawing on the project’s critical methodological approach. This project has developed an in-depth picture of the interactions of diagnoses, vulnerabilities, complex support needs and intensive interventions and how these coalesce for Aboriginal people with mental and cognitive disabilities in the criminal justice system.

The project has developed new understandings of the interactions amongst criminal justice and social, health, disability and other human services for Indigenous Australians with MHDCD in two Australian criminal justice systems (NSW and NT). This report presents quantitative analysis of data for 676 Indigenous people who have been incarcerated in NSW, 15 case studies drawn from this group’s administrative data, the outcomes of qualitative interviews investigating the experiences of Indigenous women and men who have MHDCD and who have been in the criminal justice system, and of the views of Indigenous community members and service providers in four communities in NSW and one community in the NT regarding systemic and social challenges, service failures, positive program interventions, and culturally appropriate approaches and remedies. This project provides innovative theoretical and applied knowledge that can assist in the reduction of the unacceptably high level of Indigenous persons with MHDCD in Australian criminal justice systems.


[1] ‘Indigenous’ is the primary term used in this report to refer to Aboriginal and Torres Strait Islander people in Australia, for reasons of consistency with government data. Where people use ‘Aboriginal’ or other terms of self or community identification, those are used in context.

[2] UNSW HREC Ethics No. 06214, AH&MRC Ethics No. 569/06.

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