Justice Health and Forensic Mental Health Network (Justice Health NSW) is a state-wide service that provides healthcare to adults and young people in contact with the forensic mental health and criminal justice system in NSW. Research has shown that individuals in contact with the prison system make up one of society’s most vulnerable groups, experiencing higher rates of physical and mental health concerns than the general population. 1,2,3,4
Justice Health NSW provides multidisciplinary services across public goals belonging to Corrective Services New South Wales (CSNSW) which include primary care, drug and alcohol, mental health, population health, women’s health and midwifery care, oral health, Aboriginal health, youth health and a range of allied health services. These services collectively contribute to the Justice Health NSW strategic goal of returning healthier patients to their communities. Justice Health NSW provides healthcare services to patients in these highly secure settings in cooperation with CSNSW, whose principal remit is to reduce the risk of re-offending, provide safe, secure and humane management of offenders and encourage community support and successful re-integrations.
The complexities of working in a highly secure environment are many and revolve around an existing culture of prioritising privacy and security; often the immediate family is the victim of the patient’s crime and staff are wary of media attention concerning high-profile patients. Justice Health NSW has no clear structure to enable engagement and collaboration of family and carers to share health information and participate in health goal setting for patients.
Facilitating meaningful partnerships and centering patient dignity
This project aims to facilitate collaboration and enable meaningful partnerships between Justice Health NSW and the families and carers of patients in custodial care. In establishing a collaborative and transparent approach to healthcare decision-making that respects the dignity our patients, we hope to empower their families and carers to actively engage in their care. We also aim to increase family and carers experience and reduce complaints by March 2024, whilst also improving staff self-reported experience of the new processes. The project team identified key issues by using an evidence-informed and collaborative approach guided by Justice Health NSW clinicians, families and carers of patients in custody and CSNSW. The key issues identified were:
- limited family and carer involvement in decision-making
- families and carers cannot easily contact treating health teams
- staff in custodial environments do not actively engage with families of patients.
Based on these issues, several solution workshops were facilitated, which led to the identification of the following solutions:
- develop a standardised process that supports staff engagement with families and carers in consultation with CSNSW
- develop a dedicated families and carers health inquiry line
- develop a training package to build Justice Health NSW staff capability to support family and carers.
To date, we have successfully provided education to clinical staff across the state regarding how they receive information from families effectively. The team has begun developing resources for media, as well as resources for families and carers. Over the next few months, the project team will commence the development of a dedicated inquiry line.
View this project's poster from the Centre for Healthcare Redesign graduation December 2023.
References
- Australian Institute of Health and Welfare (AIHW). The Health of Australia’s Prisoners 2018. Canberra: AIHW; 2019. Report No.: Cat. no. PHE 246.
- Fazel S, Baillargeon J. The health of prisoners. Lancet. 2011;377(9769):956–65. doi: 10.1016/ S0140-6736(10)61053-7
- Fazel S, Hayes AJ, Bartellas K, Clerici M, Trestman R. Mental health of prisoners: Prevalence, adverse outcomes, and interventions. Lancet Psychiatry. 2016;3(9):871–81. doi:10.1016/S2215- 0366(16)30142-0
- Rose A, Trounson JS, Louise S, Shepherd S, Ogloff JRP. Mental health, psychological distress, and coping in Australian cross-cultural prison populations. J Trauma Stress. 2020;33(5):794–803. doi: 10.1002/jts.22515
