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Targeted Call for Research - public call for research priorities in Aboriginal and Torres Strait Islander health

This submission reflects the views of
Organisation Name: 
Menzies School of Health Research
Personal Details
Specific Questions
1. What is the research priority (a significant research knowledge gap or unmet need) you are nominating? How would a TCR in this area greatly advance our understanding of this issue? (200 word maximum): 
Reducing incarceration rates of Aboriginal and Torres Strait Islander peoples Indigenous Australians are the most imprisoned people in the world (Blagg 2008). Although Indigenous Australians comprise 3% of the Australian population, in 2015 they represented 27% of the imprisoned population (4517.0 Prisoners in Australia 2015). Incarcerated Indigenous people have complex health and social needs; around 20% have high levels of psychological distress, 26% have intentionally self-harmed, 74% have a disability or limiting long term health condition, 74% smoked on entrance and 60% had used illicit drugs in the last year. On discharge 38% are expected to be homeless and 85% expect to go on Centrelink payments. Blagg describes the high rates of incarceration as `…a reflection of multiple-layered patterns of disadvantage and extreme forms of marginalisation experienced by Aboriginal people’. He strongly advocated for decolonising strategies. For example, communities which have experienced extreme forms of violence have called for community restoration rather than incarceration to deal with the violence (Douglas & Corrin 2010). Offending behaviour, incarceration and social determinants of health are closely linked. Targeted research is required to work with communities on how to address social determinants of health and criminogenic factors to develop and evaluate community-led solutions.
2. What are the relevant Australian Government Priorities, and/or Ministerially-agreed State and Territory health research priorities linked to your nominated priority? (200 word maximum): 
The overarching objectives of the justice sector are: i) safe communities, and ii) a fair, equitable and accessible system of justice. Reduce over-representation of Indigenous offenders, defendants and victims in the criminal justice system is one of the five goals of the National Indigenous Law and Justice Framework (2009-2015). The growing incarceration rate of Indigenous Australians is a major concern. Modeling for the Northern Territory (NT) demonstrated that the growth of Indigenous incarceration in the NT is far outstripping population growth (Payer, Taylor, Barnes: Research Brief 2015). The Social Justice Commissioner has pointed out that reducing the rates of incarceration of Aboriginal and Torres Strait Islander people should be a target for Closing the Gap in Indigenous disadvantage. Furthermore, the Redfern Statement recently released by the Aboriginal and Torres Strait Islander Peak Organisations, calls for prioritising of the outstanding recommendations for the Royal Commission in Aboriginal Deaths in Custody handed down in 1991 (2016). In the statement it was noted that the rates of incarceration of Indigenous people had increased substantially since 1991. South Australia has identified the need to transform their criminal justice system and are consulting with the public to consider alternatives to imprisonment (Transforming Criminal Justice 2015).
3. How would a TCR in this area contribute to Aboriginal and Torres Strait Islander health and improve health outcomes for the individual and/or community? (200 word maximum): 
Incarceration and offending behaviours are health issues, both at a community and individual level which are entwined in complex and mutually reinforcing ways. In addition to structural and systemic issues such as inadequate access to diversionary programs, discrimination, inadequate resourcing of Aboriginal Legal Services and genuinely higher levels of offending by Indigenous juveniles (Indigenous Justice Clearinghouse Brief 10, March 2011), other contributing issues include mental health issues, disabilities such as fetal alcohol spectrum disorders, and acquired brain injury and hearing loss and the intergenerational effects of incarceration. An understanding of the ongoing and compounding effects of a justice system that is based on a colonial model on the Indigenous populations is critical. Central to identifying and implementing effective solutions is a community-centered approach. The health of prisoners is a major concern, and a better understanding of the health and social support required to prevent Indigenous people entering into prison such as mental health services, services required in prison and the ongoing services and support required on discharge. Fundamental to the success of research projects in this area is Indigenous leadership, authentic community engagement, and involvement of stakeholders from concept development through to knowledge translation.
4. How will the TCR reduce the burden of disease on the health system and Australian economy? (200 word maximum): 
The Productivity Commission reported that Australia spent $192 million on government services in the 2014-15 financial year. Of this, $15.3 billion dollars was spent on the Justice System (Police services 66% and corrective services 24%). In Western Australia and the NT, over 30% of their justice expenditure was on corrective services. Research in the NT highlighted the magnitude of the high incarceration rates of Indigenous people, and reported that this has the potential to create severe dysfunction in terms of population structures, and social and economic impacts on affected communities. The international literature highlights a range of negative impacts that might be expected for small and remote communities, from the incarceration of residents including a loss of social capital, and the loss of income through employment. Reducing the number of Indigenous people incarcerated would reduce the expenditure on corrective services.
5. Are there any reports or findings that support your nomination for the suggested topic? (200 word maximum): 
The United Nations outlined a framework for research and data collection, for member states to eliminate violence against children in the field of crime prevention and criminal justice. This includes developing indicators for monitoring, reporting and evaluating the effectiveness of the justice system in meeting the needs of children and preventing such violence. Twenty five years after the Royal Commission into Aboriginal Deaths in Custody, a Royal Commission into juvenile detention in the NT has recently been announced. Although, there are many primary, secondary and tertiary prevention programs existing in Indigenous communities throughout Australia, only a small number of evaluations of such policies and programs have been conducted. A theme in the literature is the need for evidence-based intervention that are community centered.

Page reviewed: 30 August, 2018