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Thousands of prisoners suffering from drug and mental health
problems need help behind bars, not official bungling.
IN THE past 20 years Australia has almost doubled the
rate at which we put people in prison. As we go about our daily
business there are more than 25,000 fellow citizens living in a
prison. They are locked away each night behind the high walls and
razor wire in cities and towns around the country, out of our sight
and increasingly out of our thoughts for the future.
Most of these prisoners can be categorised as having committed
their offences while intoxicated with alcohol or some other drug,
being drug or alcohol-dependent or suffering from severe mental
health problems, if not all three at once.
Some would also have been physically and sexually abused as
children. Indigenous people will make up more than 22% of the
prison population. More than half will have been in prison before,
with some returning for many more visits, and their rate of
hepatitis C will far exceed the rate in the community.
In prison they can be expected to regularly see, if not
experience, acts of violence, sexual assault and intimidation, be
moved from prison to prison at a moment's notice and locked in
their cells for hours or days at a time. Not quite the holiday camp
some may have you believe.
Nonetheless, prisons have a role to play as they provide crime
deterrence and a secure environment to keep the community safe from
convicted murderers, sex offenders and other violent offenders.
However, for the mentally ill, sexually abused and drug dependent
there are much better options, such as getting people with problems
into treatment much earlier, whether this be in residential centres
that provide 24-hour services for people with serious drug and
alcohol problems, as well as mental health problems, or by
providing other forms of treatment.
In its review of Australian prisons and drug policies and
programs a couple of years ago, the Australian National Council on
Drugs found that many prisons failed to provide even the most basic
range of treatments for most of its prisoners. This was
particularly so for methadone, which is the most widely available
and effective treatment option in the community. This is the price
you can pay if heroin-dependent and in prison: the removal of the
most effective and efficient treatment we have. One of the results
of this policy is groups of prisoners regularly sharing used and
often blunt injecting equipment as needle exchange programs fail to
even gain a trial foothold in any prison in Australia.
The indisputable evidence for investment in these programs seems
to be overrun by a belief that the limited money available for drug
and alcohol services in prisons is better spent urine-testing
hundreds of prisoners each day to see who is using drugs, and then
punishing them if they have used a drug.
Given what we already know about the high levels of drug use by
people before they enter prison and the continuation of drug use
problems among many in prison, I wonder how we would react to
governments spending millions of dollars each year on the aged so
they could prove they were aged rather than help them with care and
treatment.
So what can we do? The first thing is to acknowledge that with
tens of thousands of people going through the prison system each
year, it is in our interests to have them leave prison with a
reduced likelihood of re-offending and a real chance to live with
respect and dignity. We need to increase the availability of
treatment in the community for people with severe problems to a
point where waiting lists are obsolete.
Thankfully some things are changing. The Council of Australian
Governments Illicit Drug Diversion Initiative is a genuine attempt
to provide alternatives for the drugdependent and is an initiative
that may well have contributed to the very recent stabilisation in
Australia's prison population. We hope it is a program the Federal
Government will commit to in the long term, and hopefully the
recent COAG initiative on mental health will lead to better access
in the community for people with mental illnesses. Of course, the
issue here will be ensuring that it goes to those that most need
it, as already highlighted by the Mental Health Council of
Australia.
The development of health-based diversion alternatives to prison
for mentally ill people as well as those with alcohol problems are
also ideas gaining a lot of currency in professional circles.
The alternative is to continue the current practice of often
releasing people more damaged and more violent into the community
as a result of their prison experiences.
We also need to rethink our prisons to see real changes occur.
If we accept that many prisoners are probably some of our most
damaged citizens, as a starting point we have to look at how we
staff and manage prisons. While prison staff often do a tremendous
job in trying environments, for us to expect that prison officers
predominantly trained in security are best placed to manage some of
most serious cases of substance use, mental illness and disability
is not in anyone's best interest.
Prisons cost a lot of money to run — close to $60,000 a
prisoner each year. It is unacceptable for public funds to be
poured into a system in which violence and intimidation are the
norm and the outcomes on re-offending are so poor. We would be
entitled to expect a lot better return on our investment if it was
spent more wisely.
Gino Vumbaca is executive director of the Australian
National Council on Drugs.
http://www.theage.com.au
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