Looking beyond recidivism : a comprehensive exploration of the social determinants of reimprisonment of women with histories of substance-use to inform gender-responsive service provision

𝗕𝗮𝗰𝗸𝗴𝗿𝗼𝘂𝗻𝗱 Most women who enter prison report a history of substance-use. However, there is limited evidence on effective strategies supporting community re-entry and reducing recidivism among women. This thesis aimed to provide a comprehensive exploration of the re-entry needs and factors driving the reimprisonment of women with histories of substance-use in Australia to inform gender-responsive service provision. 𝗠𝗲𝘁𝗵𝗼𝗱𝘀 This thesis consisted of three interrelated studies. Study 1: a systematic review evaluating the efficacy of post-release programs aimed at reducing recidivism for women with substance-use disorders (SUDs). Studies 2 and 3 involved two retrospective cohort analyses using routinely collected data for the transitional support program ‘Connections’ in New South Wales, between 2008 and 2018. Study 2 compared the results of a comprehensive pre-release assessment between women and men engaged with Connections to inform what should be prioritised in gender-responsive frameworks. In Study 3, the relationship between social determinants of health (SDOH), mental health, substance-use and recidivism were investigated among women who completed Connections, to explore possible pathways to reimprisonment. 𝗥𝗲𝘀𝘂𝗹𝘁𝘀 Study 1 revealed a paucity of empirical research that evaluates the effectiveness of post-release programs for women with SUDs. However, programs that demonstrated reductions in recidivism were those that provided pre- and post-release support, and were described as gender-responsive, that included case management, targeting co-occurring substance-use and mental health issues. Study 2 findings revealed differences between women and men in sociodemographic characteristics, incarceration history, current sentenced offence, and time imprisoned, underscoring the necessity for gender-responsive programming. In addition, upon release women identified for greater need for support with housing, employment, self-harm, and parenting compared to men. In Study 3, substance-use increased the odds of recidivism. Poor mental health in tandem with ongoing social support, child-custody, financial, and housing needs were associated with increased odds of substance-use. Furthermore, mediation analysis showed that the relationship between ongoing housing, financial, child-custody, domestic violence, and social support needs, and substance-use were mediated by poor mental health. 𝗖𝗼𝗻𝗰𝗹𝘂𝘀𝗶𝗼𝗻 This thesis goes beyond recidivism to underscore the pivotal role of substance-use, potentially triggered by SDOH and mental health, in the pathways leading back to prison among women in Australia. To support survival in the community, gender-responsive programs must address the social determinants of substance-use. This requires targeted allocation of resources to community-based mental health, social welfare, and women’s services, providing wraparound support for women in areas such as housing, income/employment, reunification of children, and domestic violence.

Author dc:creator

• Edwards, Layla Maree Aranci

Statement dc:rights

• info:eu-repo/semantics/openAccess
• The author owns the copyright in this thesis including all reproduction and reuse rights for the work. The work may not be altered without the permission of the copyright owner. Attribution is essential when quoting or paraphrasing from this thesis.
• © 2023 Layla Maree Aranci Edwards
• au.edu.uts.lib/cph

Language dc:language.iso

en_US

Handle dc:identifier.uri

http://hdl.handle.net/10453/184988

OAI identifier oai:identifier

oai:opus.lib.uts.edu.au:10453/184988