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      Identifying the prevalence and predictors of suicidal behaviours for indigenous males in custody

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          Abstract

          Background

          High rates of suicidal behaviours among Indigenous Australians have been documented. Justice-involved individuals are also at a higher risk for engaging in suicidal behaviours. This study sought to ascertain the prevalence and correlates of suicidal behaviours for 107 Indigenous adult males in custody in Victoria, Australia.

          Methods

          Participants undertook a structured interview comprising a psychiatric assessment. Information on suicidal behaviours (ideation and attempts), socio-demographics, environmental stressors, negative life events and mental health was obtained.

          Results

          A high proportion of Indigenous males in custody experienced lifetime suicidal ideation (63.7%) and over one-half had attempted suicide (54.5%). A smaller, yet significant number of participants experienced ideation over the past 12 months (27.9%). Having a loved one pass away within the past 12 months predicted recent ideation; lifetime ideation and a diagnosis of Post-Traumatic Stress Disorder predicted a lifetime suicide attempt.

          Conclusions

          The prevalence of suicidal behaviours among Indigenous people in custody is remarkably high. Correlates of suicidal behaviours for Indigenous people in custody in this study likely manifest in the community, denoting an urgent public health response. Prevention must begin in communities at-risk for suicidal behaviours. The development of low intensity mental health service infrastructure in communities to promote awareness and provide accessible, least restrictive support and treatment is necessary. Correctional institutions must also continue to improve custodial suicide prevention and management initiatives.

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          Most cited references42

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          Substance abuse and dependence in prisoners: a systematic review.

          To review studies of the prevalence of substance abuse and dependence in prisoners on reception into custody. A systematic review of studies measuring the prevalence of drug and alcohol abuse and dependence in male and female prisoners on reception into prison was conducted. Only studies using standardized diagnostic criteria were included. Relevant information, such as mean age, gender and type of prisoner, was recorded for eligible studies. The prevalence estimates were compared with those from large cross-sectional studies of prevalence in prison populations. Thirteen studies with a total of 7563 prisoners met the review criteria. There was substantial heterogeneity among the studies. The estimates of prevalence for alcohol abuse and dependence in male prisoners ranged from 18 to 30% and 10 to 24% in female prisoners. The prevalence estimates of drug abuse and dependence varied from 10 to 48% in male prisoners and 30 to 60% in female prisoners. The prevalence of substance abuse and dependence, although highly variable, is typically many orders of magnitude higher in prisoners than the general population, particularly for women with drug problems. This highlights the need for screening for substance abuse and dependence at reception into prison, effective treatment while in custody, and follow-up on release. Specialist addiction services for prisoners have the potential to make a considerable impact.
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            Colonisation, racism and indigenous health

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              Colonisation – It’s bad for your health: The context of Aboriginal health

              Australia's history is not often considered to be an indicator of any person's health status. However, as health professionals we are taught the importance of taking and listening to our client's detailed history to assist us in our comprehension of the issues impacting upon their lives. This skill base is an important one in that it makes available valuable information that assists the health professional to be discerning of intimate and specific circumstances that could contribute to health related problems not previously diagnosed. It is a vital screening tool. I would like to advocate that history taking, that being Australia's colonial, political, social and economic histories be a course of action undertaken by all health professionals working with Aboriginal and Torres Strait Islander peoples. Health researchers of recent years have been able to clearly illustrate that there is a powerful relationship between health status and individuals or collectives; social, political and economic circumstances (Marmot, 2011; Marmot & Wilkinson, 2001; Saggers & Gray, 2007). This way of knowing how health can be affected through such social health determinants is an important health competency (Anderson, 2007; Marmot, 2011). As such this paper delivers a timeline of specific historical and political events, contributing to current social health determinants that are undermining Indigenous Australians health and well-being. This has been undertaken because most Australians including Indigenous Australians have not benefited from a balanced and well informed historical account of the past 200 and something years. The implication of this lack of knowing unfortunately has left its effect on the way health service providers have delivered health to Indigenous children, mothers, fathers, and their communities. Indigenous Australians view the way forward in improving health outcomes, as active partners in their health service delivery. This partnership requires health professionals to listen to their clients, with respect and a decolonising gaze.
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                Author and article information

                Contributors
                sshepherd@swin.edu.au
                bspivak@swin.edu.au
                Kerry.arabena@unimelb.edu.au
                yin.paradies@deakin.edu.au
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                4 October 2018
                4 October 2018
                2018
                : 18
                : 1159
                Affiliations
                [1 ]ISNI 0000 0004 0409 2862, GRID grid.1027.4, Centre for Forensic Behavioural Science, , Swinburne University of Technology, ; 505 Hoddle Street, Clifton Hill 3068, Melbourne, VIC 9947 2600 Australia
                [2 ]ISNI 0000 0004 1936 834X, GRID grid.1013.3, National Centre for Cultural Competence, , University of Sydney, ; Sydney, Australia
                [3 ]ISNI 0000 0001 2179 088X, GRID grid.1008.9, Indigenous Health Equity Unit, Melbourne School of Population Health, , University of Melbourne, ; Melbourne, Australia
                [4 ]ISNI 0000 0001 0526 7079, GRID grid.1021.2, Alfred Deakin Research Institute for Citizenship and Globalisation, , Deakin University, ; Geelong, Australia
                Article
                6074
                10.1186/s12889-018-6074-5
                6172717
                30286743
                c9a8ed44-2c03-4b6c-ad57-027fcf2e5833
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 27 June 2018
                : 26 September 2018
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2018

                Public health
                indigenous population,suicide,prison,mental illness,aboriginal and torres strait islander health

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