The Australian Centre for Public and Population Health Research, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia.
Sydney School of Education and Social Work, Faculty of Arts and Social Sciences, The University of Sydney, Sydney, New South Wales, Australia.
Health Soc Care Community. 2022 Nov;30(6):e4735-e4744. doi: 10.1111/hsc.13880. Epub 2022 Jun 28.
Incarcerated young people (aged 18-24) with a history of problematic substance use are a particularly vulnerable group, with a higher risk of mortality and return to custody compared to their older counterparts. Yet, there is limited research investigating service accessibility for this population. This study aimed to address this gap by investigating the characteristics of young people exiting prison on the 'Connections Program' (Connections) and their access to support services. Connections is a transitional program with a remit to link people with problematic substance use exiting prison in New South Wales, Australia, to health and social services in the community. We used an explanatory sequential mixed methods approach including (1) a retrospective cohort study of young people on Connections (n = 359), utilising self-reported data collected in a routine pre-release questionnaire from January 2008 to February 2015 and (2) a qualitative survey with Connections caseworkers (n = 10). In stage one, descriptive statistics were calculated to produce a profile of sociodemographic and health characteristics of young people with problematic substance use exiting prison. In stage two, qualitative data were thematically analysed to explore the accessibility of services to meet young people's needs from the perspective of caseworkers. The study found young people experienced substantially poorer mental health than the general population, and the vast majority had received treatment for a mental health issue (96.5%). Illicit substance use prior to incarceration was common (91.5%). Caseworkers reported substantial barriers to service accessibility in the community related to intersecting social disadvantage and co-occurring mental distress and substance use. Caseworkers have front-line knowledge of how gaps and barriers in services impact transition from prison and identified longer-term case coordination, inter-agency collaboration and holistic care as vital strategies to support young people in transition from prison to community.
有问题物质使用史的被监禁年轻人（18-24 岁）是一个特别脆弱的群体，与年龄较大的同龄人相比，他们的死亡率和返回监禁的风险更高。然而，对于这一人群，研究服务的可及性的研究有限。本研究旨在通过调查从澳大利亚新南威尔士州监狱出狱的年轻人的特征和他们获得支持服务的机会来解决这一差距。Connections 是一个过渡性项目，旨在将有问题物质使用的人出狱后与社区中的健康和社会服务联系起来。我们使用了一种解释性顺序混合方法，包括：（1）对 Connections 上的年轻人（n=359）进行回顾性队列研究，利用 2008 年 1 月至 2015 年 2 月期间从常规出狱前问卷中收集的自我报告数据；（2）对 Connections 案件工作者进行定性调查（n=10）。在第一阶段，计算描述性统计数据，以生成有问题物质使用的年轻人出狱后的社会人口统计学和健康特征概况。在第二阶段，从案件工作者的角度对定性数据进行主题分析，以探讨服务的可及性，以满足年轻人的需求。研究发现，年轻人的心理健康状况明显比一般人群差，绝大多数人曾因心理健康问题接受过治疗（96.5%）。入狱前滥用非法药物的情况很常见（91.5%）。案件工作者报告说，社区中服务可及性存在很大障碍，涉及交叉社会劣势和同时存在的精神困扰和物质使用。案件工作者具有从监狱过渡到社区过程中服务差距和障碍的一线知识，并确定长期案件协调、机构间合作和整体护理是支持年轻人从监狱过渡到社区的重要策略。
