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
- Publication Type:
- Thesis
- Issue Date:
- 2023
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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.
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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 โConnectionsโ 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.
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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.
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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 womenโs services, providing wraparound support for women in areas such as housing, income/employment, reunification of children, and domestic violence.
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