Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia.
Justice Health and Forensic Mental Health Network, NSW, Australia.
Aust N Z J Psychiatry. 2023 Jun;57(6):904-913. doi: 10.1177/00048674231151594. Epub 2023 Feb 14.
It is well established that First Nations Peoples in Australia are overrepresented within the criminal justice system. However, First Nations Peoples appear to be comparatively underrepresented in the forensic mental health system, and little is known about their outcomes once released from secure care.
To compare the characteristics and rates of repeat criminal justice contact for a criminal charge of First Nations and non-First Nations forensic patients in New South Wales.
Data on the sample were extracted from the New South Wales Mental Health Review Tribunal paper and electronic files matched to the Bureau of Crime Statistics and Research Reoffending Database. Characteristics of First Nations and non-First Nations patients were compared using univariate logistic regression analysis. Univariate and multivariate Cox proportional hazard regression was used to determine predictors of post-release criminal charges.
Key differences in the sociodemographic, clinical and forensic characteristics of First Nations compared with non-First Nations forensic patients were identified. The time to first criminal justice contact following release was significantly shorter for First Nations forensic patients ( < 0.01).
The findings of this study confirm that First Nations forensic patients have distinct and complex needs that are apparent at entry to the forensic mental health system and that their poorer criminal justice contact rates following release from secure care indicate that these needs are not being adequately met either during treatment or once in the community. Responses to these study findings must consider the complex and continuing impact of colonisation on First Nations Peoples, as well as the need for solutions to be culturally safe.
众所周知，澳大利亚原住民在刑事司法系统中的比例过高。然而，原住民在法医心理健康系统中的比例似乎相对较低，而且对于他们从安全护理中释放后的结果知之甚少。
比较新南威尔士州有犯罪指控的原住民和非原住民法医患者再次受到刑事司法接触的特征和比率。
从新南威尔士州心理健康审查法庭的纸质和电子文件中提取样本数据，并与犯罪统计和再犯罪研究局的数据库相匹配。使用单变量逻辑回归分析比较原住民和非原住民患者的特征。使用单变量和多变量 Cox 比例风险回归来确定释放后刑事指控的预测因素。
确定了原住民和非原住民法医患者在社会人口统计学、临床和法医特征方面的关键差异。与非原住民法医患者相比，原住民法医患者的首次刑事司法接触时间明显缩短（<0.01）。
本研究的结果证实，原住民法医患者有明显和复杂的需求，这些需求在进入法医心理健康系统时就很明显，而且他们在从安全护理中释放后的刑事司法接触率较低表明，这些需求在治疗期间或在社区中都没有得到充分满足。对这些研究结果的回应必须考虑到殖民化对原住民的复杂和持续影响，以及需要制定文化安全的解决方案。
