“For a young man with a co-occurring psychotic illness and substance use disorder, the experience of coming out of prison is almost as if it were structured for reoffending,” Dr Denton said.
“We are not talking about a small section of the prison population – young men with co-occurring conditions and multiple short term incarceration times are typical of prisoners with a mental illness.”
Previously manager of the Queensland Forensic Mental Health Service for 14 years, Dr Denton has more than two decades experience working with marginalised sections of the community.
While she emphasises that mental health treatment in Queensland prisons has improved markedly since 2000, her thesis Hoping against hope outlines areas where action is still needed.
“Situations that could lead to a return to jail include parole violations such as missing appointments, changing address without notice or not taking medication…basically being disorganised,” she said.
“And we have been told by previous studies that prisoners, post-release, are 17 times more likely to die in their first few months out of jail than others of a similar age and sex. The two major causes of death in that scenario are overdose and suicide.
“We need to look at better policy and treatment solutions that ensure not only better outcomes for these prisoners and their families, but also has better outcomes for society through less reoffending and less judicial cost.”
From an initial sample of 100 prisoners, Dr Denton staged in-depth interviews with 18 male prisoners aged 18-40, all suffering a psychotic illness and a substance abuse problem.
These were held within one month prior to release, one to two weeks after release, and three months post-release.
Although all the men interviewed had been diagnosed with psychiatric issues, the main reason they identified for reoffending was substance abuse, and not their mental health condition.
Dr Denton said only two of the 18 men accessed meaningful drug or alcohol treatment programs.
The 18 men had an average of seven incarcerations each, characterised by short-term, but frequent periods in jail.
A lack of suitable accommodation was another common factor in their transitioning phase making it more difficult for them to adhere to their parole conditions and remain in mental health treatment.