1

Punishing the vulnerable:

Women with Mental Health Disorders & Cognitive Disabilities in the NSW Criminal Justice System

Presenter: Eileen Baldry with Catriona McComish, Melissa Clarence

& Leanne Dowse, Phillip Snoyman University of New South Wales

2

A tale of 2 women Jen - a young Indigenous woman; raised in disadvantaged

suburb outer Sydney; out of home care; very poor education background - truanting / expelled; unstable housing; petty crime; juvenile justice; adult prison; problematic alcohol use; 25 convictions by age 30; 10 custodial episodes; theft, minor assault, breaching orders; 3 dependent children; has borderline ID, PTSD, Alcohol problem; has never had stable supported housing when released or met the criteria for appropriate rehabilitation programs.

Ann - a 35 year old non-Indigenous woman; has schizophrenia, some cognitive impairment (ABI?), PD and irregular drug use. History of childhood sexual and physical abuse. Whilst in psych unit 1 year ago threw coffee over a nurse; charged; 1st time in prison - remanded. Last 12 months in and out of prison 3 times; no service will take her; prison the only accommodation.

These pathways into prison show the institutional and social failures experienced by women like Jen & Ann

3

The Study Title:

People with Mental Health Disorders and Cognitive Disabilities in the Criminal Justice System in NSW

Objectives: Create criminal justice life course histories, highlighting

points of agency interactions, diversion and support Identify gaps in policy, protocols and service delivery and

areas of improvement for Criminal Justice and Human Service agencies

Describe individual and group experiences

4

The Study Method:

Nature of sample – purposive and not representative From Prisoner Health Survey & DCS SDS ID database

Detailed data set on the life-long CJ & HS involvement for cohort of prisoners using linked but de-identified extant administrative records from CJ & HS agencies - Police, Corrections, JH, Courts, JJ, Legal Aid, MH, DoCS, Disability, Housing, other Health services.

Pathway and multilevel analysis

5

Cohort - Summary Full Cohort N=2,731 Intellectual disability N=680 Borderline cognitive disability N=783 Mental health N=965 No MHCD diagnosis N=339 Substance abuse disorder = 1276 Women = 11% N = 313 (30% Indigenous) Indigenous Australians = 25% N = 676; Females N = 93 Not representative - purposive sample

6

Mental State of NSW prisoners

0

10

20

30

40

50

60

70

80

AOD iapp12 psychosis depression ipers anxiety(inclPTSD)

women men ABS

7

Cognitive disability in prison

•Est. between 2-12% have Intellectual disability (ID)

•High borderline ID - UK study (Hayes et al 2007) ~ 25%; av IQ was 85%

•High acquired brain injury

8

Study findings

Identifying factors linked to full-time incarceration for women with MHD&CD (sentenced & remand)

Convictions

Across the whole cohort:

9

ie. men and women in prison identified with cognitive disabilities and mental health disorders:• As can seen in this graph there are significantly higher convictions for those with dual or co-occurring disorders (complex needs) than for those with a single diagnosis or no diagnosis

• The other major finding is that Indigenous persons have a significantly higher number and rate of convictions than non Indigenous people

10

Further findings on convictions People with a history of substance use have a higher

proportion of convictions than those with no history

People with a borderline intellectual disability (BID) have a higher number of convictions than people without intellectual disability or those with an IQ < 70

There is a significant difference in overall rate of convictions with females having a higher rate of conviction than males

Indigenous women have significantly higher rates of convictions than non-Indigenous

11

Offence data: women with MHD&CD are predominantly convicted for …

Theft and related offences Road traffic & regulatory Deception (fraud) Justice (breaching orders) Public order

These offences are very low on the national severity scale and it is notable that within this cohort, across the different diagnostic groups, men commit offences with a more serious index rating than women.

Custodial Episodes by Personal Experience

Individuals with complex needs have significantly higher number of custodial orders than those without complex needs

Women have a higher rate of custodial episodes per year than men

Women with complex needs higher number and rate of custodial episodes than men

Indigenous women have thehighest number & rate

12

Custodial Episodes By Gender

0

2

4

6

8

10

12

14

MH_ID MH_BID MH_AOD ID_AOD BID_AOD ID BID MH PD/AOD NoDiagnosis

Study Group

Avg

Num

ber o

f Cus

todi

al

Epis

odes

0.0

0.5

1.0

1.5

2.0

2.5

3.0

Rat

e Of C

usto

dial

Epi

sode

s Pe

r Ye

ar

Average Custodial Episodes Female Average Custodial Episodes MaleRate Custodial Episodes * Female Rate Custodial Episodes * Male

Average Time Spent In Custody

Men across the cohort categories spend a significantly greater number of days in custody than females in the cohort

So although women have more custodial episodes these are shorter in duration - greater rate of cycling in and out of prison for women with complex needs

13

Average Days Per Episode In Custody

Average Custodial Length Of Stay By Gender

0

50

100

150

200

250

300

350

400

450

500

MH_ID MH_BID MH_AOD* ID_AOD BID_AOD ID BID MH PD/AOD No Diagnosis

Study Group

Day

s in C

usto

dy

Avg Episode Length Per Person Avg Episode Length Per Female Avg Episode Length Per Male

Those with complex needs spend a significantly shorter time on each custodial episode than those with a single or no diagnosis

Although they have more episodes in prison, the av. length of stay for Indigenous women is sig. shorter than for non-Indigenous suggesting these may be remand episodes

14

15

Remand Episodes by Gender

0

10

20

30

40

50

60

70

80

90

100

MH_ID MH_BID MH_AOD ID_AOD BID_AOD ID BID MH PD/AOD Control

Study Group

Avg

Day

s Pe

r Epi

sode

0

2

4

6

8

10

12

14

Avg

Rem

ands

Per

Per

son

Avg Remand LOS Per Episode Avg Remand LOS Per Episode _ Female Avg Remands Avg Remand Episodes _ Female

Average Days On Remand By GenderWomen with complex needs spend less time in remand but have higher number of remand episodes per person than the av in the cohort and than those with single or no diagnosis

16

Which groups of women have the higher rates of incarceration? Complex needs – cognitive disability together

with a mental health &/or AOD disorder – rather than single diagnosis

Interim analysis is suggesting that being an Indigenous woman may not be associated with higher rates of custody

17

Human services

75% of these women reliant on social housing

1/3rd of these women been through juvenile justice

Only 7% of those women with cognitive disability supported by Disability Department

18

What does all this mean? No safe place for disadvantaged girls and women with MHD &/or

CD &/or AOD issues. Their self destructive, difficult and anti social behaviour leads to homelessness and social exclusion.

Frequently assessed as high risk because of their behaviour though their ‘offending’ is rarely serious

This is a social exclusionary and systemic response based upon risk management funneling them into the criminal justice system

Starts a normalising cycle around a marginalised prison-community existence & space; no suitable post-release support; CJS repositioned as the ‘therapeutic’ punishing institution

Although acknowledged to have high health and social support needs but a low risk to others, usually treated as a high security risk and isolated……. exacerbates mental health problems

19

Further conclusions.. … Although Indigenous women with MHD&CD have the

highest rate of custodial episodes, it may not be their Aboriginality that explains this – the critical variable appears to be their complex needs. This keeps them in the cycle.

But these Indigenous women’s position of disadvantage and trauma in the first place IS due to their Aboriginality - colonial patriarchy dispossessed, stole, institutionalised and raped Indigenous girls and women and is ongoing.

20

Response Outrage that prison the new therapeutic agencyPrevent De-colonise human service and criminal justice agencies Support for vulnerable families & childrenDecarcerate Resource a variety of long-term, healing & culturally

safe community wrap around support housing for women with complex needs (& their children where appropriate)