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Health after release from prison

  • Background and aims

    The HARP study is the world’s largest prospective cohort study of adults released from prison across two states (Queensland and Western Australia). A total of 2,701 people were interviewed within 6 weeks of expected release from prison; survey data were combined with data from prison medical records and, through retrospective and prospective data linkage, with a range of state and Commonwealth health data, and correctional records. The cohort includes >500 women and >1000 Indigenous Australians; more than one in four participants was aged <25 years at baseline.

    The overarching aim of the study is to:

    1. Provide a platform for describing the health-related trajectories of people who experience incarceration in Australia
    2. Identifying links between poor health outcomes and re-incarceration
    3. Calculating the direct healthcare costs associated with poor health outcomes after release from prison.

    The project goals are as follows:

    1. Compare the health-related experiences of Indigenous and non-Indigenous ex-prisoners in two Australian states, during the first two years post-release;
    2. Identify barriers to, and facilitators of, access to appropriate community-based health care for Indigenous and non-Indigenous ex-prisoners;
    3. Explore the health consequences of prisoners’ exclusion from Medicare and the Pharmaceutical Benefits Scheme (PBS), both in custody and post-release;
    4. Identify pathways linking health care utilisation, physical and psychiatric morbidity, mortality and recidivism among Indigenous and non-Indigenous ex-prisoners;
    5. Explore the impact of mental illness on physical health, health service utilisation and offending outcomes among Indigenous and non-Indigenous ex-prisoners.

    Collaborators

    Queensland Corrective Services 

    WA Department of Justice 

    University of Melbourne 

    University of Queensland 

    University of Western Australia

    Funders

    NHMRC 

    ARC

    Key papers

    Young, J. T., Heffernan, E., Borschmann, R., Ogloff, J. R., Spittal, M. J., Kouyoumdjian, F. G., ... & Kinner, S. A. (2018). Dual diagnosis of mental illness and substance use disorder and injury in adults recently released from prison: a prospective cohort study. The Lancet Public Health3(5), e237-e248. DOI: https://doi.org/10.1016/S2468-2667(18)30052-5

    Borschmann, R., Thomas, E., Moran, P., Carroll, M., Heffernan, E., Spittal, M. J., ... & Kinner, S. A. (2017). Self-harm following release from prison: a prospective data linkage study. Australian & New Zealand Journal of Psychiatry51(3), 250-259. DOI: https://doi.org/10.1177/0004867416640090

    Winter, R. J., Young, J. T., Stoové, M., Agius, P. A., Hellard, M. E., & Kinner, S. A. (2016). Resumption of injecting drug use following release from prison in Australia. Drug and alcohol dependence168, 104-111. DOI: https://doi.org/10.1016/j.drugalcdep.2016.08.640

    Key contact

    Chief investigator, Professor Stuart Kinner.