Ted Wilkes

1. Alcohol and Drugs and Justice reinvestment in Indigenous Australia Reintegration Conference Auckland New Zealand September 2013 Ted Wilkes

2. Kaya Nguny Djurapin

3. Wadjuk Nyungar Budja • Wadjuk Nyungar………All the people of the clans that are ancestral to the people from the Derbarl Yerrigan (Swan River). • Budja ………land • Wargul…….. creator

4. The leading voice in Indigenous drug and alcohol policy advice

6. Impact of white colonization on Aboriginal health today COLONISATION Cultural genocide Stolen children Loss of hunter-gatherer Lifestyle, loss of culture Fixed settlements Fringe camps Urban ghettoes Marginalization from white society, poor communication and discrimination Poor nutrition Poor housing, Poor hygiene, Overcrowding and Infectious disease Unemployment, Poverty, Poor education Alcohol and Substance abuse Respiratory disease, Ear disease, Rheumatic heart dis. Renal disease Low birth weight, Diabetes mellitus Hypertension Cardiovascular. disease Domestic violence, Accidents, deaths in custody From Matthews 1997

7. Personal achievement, social competence and emotional resilience Pathways to Resilience(Silburn, 2003) Opportunities for achievement and recognition of accomplishments Sense of self-efficacy & self-worth Sense of social connected-ness Healthy beliefs and clear standards Academicsuccess & other achievements Responsive Parenting (i.e. appropriate care stimulation and monitoring) Positive interaction with peers Reduced exposure to harmful drugs Effective learning, communication & problem solving skills Positive interaction with adults Optimal brain development in utero and early childhood Genetic factors Effective self regulation of emotion, attention & social interaction Availability of +ve adult role models & engaging community activities Healthy pregnancy,reduced maternal smoking, alcohol & drug misuse Social and economic environments supportive to child rearing – especially absence of poverty and exposure to violence Time Healthy nutrition in utero & throughout childhood & adolescence

8. Pathways to Vulnerability(Silburn, 2001) Crime & violence Suicidal behaviour Absence of employment Availability of harmful drugs Harmful drug & alcohol use Depression Affiliation with deviant peers Low self-esteem Increasing psychosocial difficulties Acute stress significant loss School & learning difficulties Peer problems Negative thinking patterns Adverse parenting & exposure to violence Self-regulation of emotion, attention & social interaction Poor problem solving skills Genetic factors Early neurological (brain) development Low SES, maternal infections, drug use & exposure to neurotoxins Diet & nutrition Time

9. The National Indigenous Drug and Alcohol Committee (NIDAC) • Established in 2004 by the Australian National Council on Drugs (ANCD) • The ANCD is the principal advisory body on alcohol and drug policy to the Prime Minister and the Australian Government

10. NIDAC’s Key Roles and Responsibilities • As the leading voice in Indigenous alcohol and other drug policy, NIDAC aims to identify and embrace opportunities to influence decisions to reduce alcohol and other drug problems and associated harms in Indigenous communities nationally • It provides advice to the ANCD and Government based on this collective expertise and experience, as well as through ongoing consultation with those working in the field, various stakeholders and relevant experts

11. NIDAC Membership 2011 - 2014 Executive Committee Members Associate Professor Ted Wilkes – NIDAC Chair - Curtin University (WA) Mr Scott Wilson – NIDAC Deputy Chair - Aboriginal Drug and Alcohol Council (SA) Ms Wendy Casey - Aboriginal Alcohol and Other Drugs, Drug and Alcohol Office (WA) Ms Donna Ah Chee – CEO Central Australian Aboriginal Congress (NT)

12. Committee Members Mr Matthew Bonson - Central Aboriginal Alcohol Program Services (CAAPS) (NT) Ms Lisa Briggs - National Aboriginal Community Controlled Health Organisation (NACCHO) (ACT) Ms Viki Briggs – National Centre for Excellence in Indigenous Tobacco Control (CEITC) (VIC) Mr Bradley Freeburn – Aboriginal Medical Service , Redfern (NSW) Professor Dennis Gray – National Drug Research Institute, Curtin University (WA)Ms Kristie Harrison – Aboriginal Drug & Alcohol Network Leadership, Aboriginal Health & Medical Research Council (ADAN , AHMRC) (NSW)Dr John Herron – Australian National Council On Drugs (ANCD) Chairman (QLD)Mr Romlie Mokak – Australian Indigenous Doctors’ Association (AIDA) (ACT)

13. Indigenous Australians in the justice system • NIDAC position paper - ‘Bridges and Barriers: Addressing Indigenous Incarceration” • This paper highlights the high rates of incarceration of Indigenous people: • 26% of prisoners are Indigenous • Nationally, Indigenous people are 14 times more likely to be imprisoned than non Indigenous • Increase of 343% for women in prison from time of the 1991 Royal Commission into Aboriginal Deaths in Custody • 49% of people in juvenile corrective institutions in 2010 -11 were Indigenous

14. Prison Related Health Risks Prison related health risks are much higher for all prisoners and include issues such as: • Blood borne viruses – high risk behaviours including injecting drug use, tattooing, physical violence, body piercing and unprotected sex • Hep C virus is 30 times greater in prison than in general community (Butler et al, 2011b) • Comorbidity – common among offenders • 43% of subjects had suffered from a mental health disorder within previous 12 mths • 55% had a substance use disorder in previous 12 mths • 29% prevalence of comorbidity(Butler et al, 2011a) • Suicide and death from overdose (Hobbs et al, 2006)

15. Cost Benefit Analysis • NIDAC was well aware of the heath benefits for Indigenous people being diverted away from prison but identified the need for the cost benefit to be determined • NIDAC commissioned Deloitte Access Economics to undertake this analysis comparing the costs associated with prison vs residential treatment

16. Cost Benefit Analysis • Comparison of 2 alternative pathways were examined (prison pathway and the residential rehabilitation pathway) • Target population - Indigenous offenders who were post trial, pre sentence and faced possibility of going to prison, non violent with problematic substance use issues who may benefit from diversion • Utilised ABS figures estimating the number of Indigenous Australians in prison system, data on the numbers entering prison for non violent offences and figures linking offending to AOD use • Number of prisons and costs associated with running them and number of residential rehabs and their costs were also considered • Outcomes such as recidivism, health outcomes (mental health service use, risk of contracting Hep C and drug relapse rates) were also considered and factored into the calculations • Non financial benefits (improved mortality and quality of life) were also considered

17. Key findings from Deloitte’s work • $111,000 per year/offender cost saving by diverting non violent Indigenous offenders with substance use problems into Rx instead of prison • Further $92,000/offender saving in the long term due to lower mortality and better health related quality of life outcomes • In 2011 there were 115 correctional custodial facilities costing $3b/annum (2010 -11 -capital and recurrent) • In 2009 – 10 there were 30 facilities providing residential drug and alcohol treatment services for Indigenous people Further detailed information on the findings can be accessed from the report, An economic analysis for Aboriginal and Torres Strait Islander Offenders: Prison vs Residential Treatment

18. Time for a new approach • The Deloitte’s work shows: • Considerable benefits associated with the diversion of Indigenous prisoners into community residential drug and alcohol rehabilitation services instead of incarceration • Financial savings as well as improvements in health and mortality • We know that imprisonment is not working for Indigenous people – it is not able to address the underlying causes of offending • Need to start spending government funds in a smarter way • We know that diversion programs have huge benefits – avoid negative labelling and stigma and reduce the number of people going back to prison • Need to shift the investment from prisons to community based and controlled services ( Justice Reinvestment)

19. JUSTICE REINVESTMENT IS Justice Reinvestment involves a shift in spending NOT an increase in spending PRISON PREVENTION DON’T SPEND MORE, SPEND SMARTER

20. JUSTICE REINVESTMENT IS Page Heading Supported by centralised strategic body Place based Data driven Targeted to increasing community safety Targeted to reducing offending & imprisonment Fiscally sound

21. Community Example of Justice Reinvestment • Bourke community approached NSW Justice Reinvestment Campaign for Aboriginal Young People to develop a justice reinvestment implementation plan • Bourke identified as having the highest number of breaches to bail conditions in NSW; no residential AOD treatment services and lack of AOD and MH services • Looked at young Aboriginal people aged 10 – 24 years (47 youth identified) • Cost of incarceration for these youth estimated to be over $2million • Funding could be used to establish programs such as youth diversion and family case management

22. What NIDAC is seeking • NIDAC is calling on a justice reinvestment approach which involves shifting part of the spending away from prisons towards community-based programs and services that address the factors that contribute to criminal behaviour • An inclusion of information on incarceration rates for Indigenous men, women and young people in Closing the Gap: Prime Minister’s Report, tabled annually in federal parliament

23. The leading voice in Indigenous drug and alcohol policy advice To obtain further information about NIDAC, to obtain copies of reports or to subscribe to NIDAC Weekly News visit our website at :www.nidac.org.au NIDAC Secretariat can be contacted on: (02) 6166 9600 or nidac@ancd.org.au