Health After Release from Prison (HARP) cohort study

Project Details

""

The HARP study is the world’s largest prospective cohort study of adults released from prison. A total of 2,701 people were interviewed within 6 weeks of expected release from prisons in Queensland and Western Australia. Survey data were combined with data from prison medical records, a range of state and Commonwealth health data and correctional records, using retrospective and prospective data linkage. The cohort includes >500 women and 1000 Aboriginal and Torres Strait Islander people.

The overarching aims of the study are to:

  1. Provide a platform for describing the health-related trajectories of people who experience incarceration in Australia;
  2. Identify links between poor health outcomes and re-incarceration;
  3. Estimate the direct healthcare costs associated with poor health outcomes after release from prison.

Some of the specific research questions explored to date include:

  1. Identify barriers to, and facilitators of, access to appropriate community-based health care for Indigenous and non-Indigenous people released from prison;
  2. Explore the health consequences of the exclusion of people in custody from Medicare and Pharmaceutical Benefits Scheme (PBS) subsidies, both in custody and post-release;
  3. Identify pathways linking health care utilisation, physical and psychiatric morbidity, mortality and recidivism among Indigenous and non-Indigenous people released from prison;
  4. Explore the impact of mental illness on physical health, health service utilisation and reincarceration outcomes among Indigenous and non-Indigenous people released from prison.

Given the richness of the data and vast array of research questions that could be explored, opportunities exist for external researchers (including students) to work with HARP data, in collaboration with the Justice Health Unit. Interested parties should contact Prof Kinner in the first instance.

Researchers

The Justice Health Unit researchers involved with this project are:

Prof Stuart Kinner

Dr Jesse Young

A/Prof Rohan Borschmann

Anna Forsythe

Lindsay Pearce

Dr Lucas Calais Ferreira

Melissa Willoughby

Louise Southalan

Collaborators

Queensland Corrective Services

WA Department of Justice

University of Melbourne

University of Western Australia

Curtin University

The University of Queensland

Funding

NHMRC funded two grants totalling $3,283,795 comprising:

  1. $1,835,817
  2. $1,447,978

ARC funded a grant for Identifying novel, health-related predictors of recidivism: Informing evidence-based throughcare (2014-2016), $390,000

AIC funded a grant for Treating co-occurring substance use disorder and mental illness among Indigenous people released from prison will increase life expectancy, reduce incarceration, and contribute to Closing the Gap (awarded in 2022 for 2022-2024), $200,000

Research Publications

  1. Snow K, Petrie D, Young JT, Preen DB, Heffernan E, Kinner SA (2022). Impact of dual diagnosis on healthcare and criminal justice costs after release from Queensland prisons: a prospective cohort study. Australian Journal of Primary Caredoi: 10.1071/PY21142. Epub ahead of print.
  2. Willoughby M, Keen C, Young J, Spittal M, Borschmann R, Janca E & Kinner SA (2022). Violence-related morbidity among people released from prison in Australia: A data linkage study. Drug and Alcohol Review, 41(2), 457-466.
  3. Borschmann R, de Andrade D, Kinner SA (2021). Health and welfare outcomes for adolescents following release from prison in Queensland, Australia: a prospective cohort study. Adolescents, 1(2), 175-185.
  4. Ryan N, Ackerman J, Ready J, Kinner SA (2020). Indigeneity, prisoner visitation, and reincarceration in Australia: The association between visits in prison and reincarceration for Indigenous and non-Indigenous people. British Journal of Criminology, 60(4), 1056-79. doi: 10.1093/bjc/azaa009.
  5. Borschmann R, dos Santos MM, Young JT, Andreoli SB, Love AD & Kinner SA (2020). Health, social and criminal justice factors associated with dual diagnosis among incarcerated adults in Brazil and Australia: a cross-national comparison. Social Psychiatry and Psychiatric Epidemiology, 55, 1355-1362.
  6. Young JT, Borschmann R, Heffernan E, Spittal MJ, Brophy L, Ogloff JRP, Moran P, Armstrong G, Preen D & Kinner SA (2020). Contact with mental health services after acute care for self-harm among adults released from prison: A prospective data linkage study. Suicide and Life-Threatening Behavior, 50(5), 990-1006.
  7. Keen C, Kinner S, Borschmann R & Young J (2020). Comparing the predictive capability of self-report and medically-verified non-fatal overdose in adults released from prison: a prospective data linkage study. Drug and Alcohol Dependence, 206, 107742.
  8. Keen C, Young JT, Borschmann R & Kinner SA (2020). Non-fatal drug overdose after release from prison: a prospective data linkage study. Drug and Alcohol Dependence, 206, 107707.
  9. Butler A, Love A, Young JT & Kinner SA (2020). Frequent attendance to the emergency department after release from prison: a prospective data linkage study. Journal of Behavioral Health Services & Research, 47(4), 544-559.
  10. Young JT, Borschmann R, Preen DB, Spittal MJ, Brophy L, Wang EA, Heffernan E & Kinner SA (2019). Age-specific incidence of injury-related hospital contact after release from prison: a prospective data-linkage study. Injury Prevention, doi: 10.1136/injuryprev-2018-043092.
  11. Winter RJ, Stoové M, Agius PA, Hellard ME & Kinner SA (2019). Injecting drug use is an independent risk factor for reincarceration after release from prison: a prospective cohort study. Drug and Alcohol Review, 38(3), 254-263.
  12. De Andrade D, Spittal MJ, Snow K, Taxman F, Crilly J & Kinner SA (2019). Emergency health service contact and reincarceration after release from prison: a prospective cohort study. Criminal Behaviour and Mental Health, 29(2), 85-93.
  13. Ryan N, Bond C, Ready J & Kinner SA (2019). Prison life and prior social experiences—understanding their importance for Indigenous peoples’ reentry outcomes. British Journal of Criminology, 59(1), 188-208.
  14. Young JT, Heffernan E, Borschmann R, Ogloff JRP, Spittal MJ, Kouyoumdjian FG, Preen DB, Butler A, Brophy L, Crilly J & Kinner SA (2018). Dual diagnosis and substance use disorder and injury in adults recently released from prison: A prospective cohort study. The Lancet Public Health, 3(5), PE237-E248.
  15. Forsyth S, Carroll M, Lennox N & Kinner SA (2018). Incidence and risk factors for mortality after release from prison in Australia: A prospective cohort study. Addiction, 113(5), 937-45. doi:10.1111/add.14106.
  16. Puljević C, de Andrade D, Carroll M, Spittal M & Kinner SA (2018). Use of prescribed smoking cessation pharmacotherapy following release from prison: A prospective data linkage study. Tobacco Control, 27, 474-78. doi:10.1136/tobaccocontrol-2017-053743.
  17. Cheng Q, Kinner SA, Snow K & Graves N (2018). Cost-utility analysis of low-intensity case management to increase contact with health services among ex-prisoners in Australia. BMJ Open, 8:e203282. doi: 10.1136/bmjopen-2018-023082.
  18. Dias S, Waghorn G, Kinner SA, Ware R & Heffernan E (2018). Identifying rehabilitation priorities among ex-prisoners vulnerable to mental illnesses and substance abuse. Journal of Rehabilitation, 84(3), 46-56.
  19. Love A, Kinner SA & Young JT (2017). Social environment and hospitalisation after release from prison: a prospective cohort study. International Journal of Environmental Research and Public Health, 14, 1406; doi: 10.3390/ijerph14111406.
  20. Borschmann R, Young JT, Moran P, Spittal J, Snow K. Mok K & Kinner SA (2017). The accuracy and predictive value of incarcerated adults’ accounts of their self-harm histories: findings from an Australian data linkage study. CMAJ Open, 5(3), E694-E701; doi:10.9778/cmajo.20170058.
  21. Borschmann R, Young JT, Moran P, Carroll M, Heffernan E, Spittal M, Mok K & Kinner SA(2017). Ambulance attendances resulting from self-harm after release from prison: a prospective data linkage study. Social Psychiatry and Psychiatric Epidemiology, 52(10), 1295-1305.
  22. Young JT, Cumming C, van Dooren K, Lennox NG, Alati R, Spittal MJ, Brophy L, Preen DB & Kinner SA (2017). Intellectual disability and patient activation after release from prison: a prospective cohort study. Journal of Intellectual Disability Research, 61(10), 939-956. doi: 10.1111/jir.12349.
  23. Snow KJ, Richards A & Kinner SA(2017). Use of multiple data sources to estimate hepatitis C seroprevalence among prisoners: a retrospective cohort study. PLoS ONE, 12(7): E0180646.
  24. Carroll M, Spittal MJ, Kemp-Casey A, Lennox N, Preen DB, Sutherland G & Kinner SA (2017). High rates of general practice attendance following release from prison: A prospective cohort study. Medical Journal of Australia, 207(2), 75-80.
  25. Borschmann R, Thomas E, Moran P, Carroll M, Heffernan E, Spittal MJ, Sutherland G, Alati R & KinnerSA (2017). Self-harm following release from prison: A prospective data linkage study. Australian and New Zealand Journal of Psychiatry, 51(3), 250-259.
  26. Carroll M, Sutherland G, Kemp-Casey A & Kinner SA (2016). Agreement between self-reported healthcare service use and administrative records in a longitudinal study of adults recently released from prison. Health & Justice, 4:11; DOI: 10.1186/s40352-016-0042-x.
  27. Winter R, Young J, Stoové M, Agius P, Hellard M & Kinner SA (2016). Resumption of injecting drug use following release from prison in Australia. Drug and Alcohol Dependence, 168, 104-111.
  28. Kinner SA, Alati R, Longo M, Spittal M, Boyle F, Williams GN & Lennox N (2016). Low-intensity service brokerage increases contact with health care in recently released prisoners: A single-blinded, multi-site randomised controlled trial. Journal of Epidemiology & Community Health, 70, 683-688.
  29. Thomas EG, Spittal MJ, Heffernan EB, Taxman FS, Alati R & Kinner SA (2016). Trajectories of psychological distress after prison release: implications for mental health service need in ex-prisoners. Psychological Medicine, 46(3), 611-621.
  30. Kinner SA, Young JT & Carroll M (2015). The pivotal role of primary care in meeting the health needs of people recently released from prison. Australasian Psychiatry, 23(6), 650-653.
  31. Winter R, Stoové M, Degenhardt L, Hellard ME, Jenkinson R, McCarthy DR & Kinner SA (2015). Incidence and predictors of non-fatal drug overdose after release from prison among people who inject drugs in Queensland, Australia. Drug and Alcohol Dependence, 153, 43-49.
  32. Young JT, Arnold-Reed D, Preen D, Bulsara M, Lennox N & Kinner SA (2015). Early primary care physician contact and health service utilisation in a large sample of recently released ex-prisoners in Australia: prospective cohort study. BMJ Open, 5(e6), DOI: 10.1136/bmjopen-2015-008021.
  33. Young J, van Dooren K, Lennox N, Butler T & Kinner SA (2015). Inter-rater reliability of the Hayes Ability Screening Index in a population of Australian prisoners. Journal of Intellectual Disability Research, 59(11), 1055-1060.
  34. Thomas E, Spittal M, Taxman F & Kinner SA (2015). Health-related factors predict return to custody in a large cohort of ex-prisoners: New approaches to predicting reincarceration. Health & Justice, 3:10.DOI 10.1186/s40352-015-0222-6.
  35. Sutherland G, Carroll M, Lennox N & Kinner SA (2015). Prescribed contraceptive use in women after release from prison. Health and Justice, 3:8. DOI 10.1186/s40352-015-0019-1.
  36. Snow K, Young J, Preen D & Kinner SA (2014). Incidence and correlates of hepatitis C virus infection in a large cohort of prisoners who have injected drugs. BMC Public Health, 14, 380.
  37. Bhandari A, van Dooren K, Eastgate G, Lennox N & Kinner SA (2014). Comparison of social circumstances, substance use and substance-related harm in soon-to-be-released prisoners with and without intellectual disability. Journal of Intellectual Disability Research, 59(6), 571-579.
  38. Cutcher, Z., Degenhardt, L., Alati, R., & Kinner, S. A. (2014). Poor health and social outcomes for ex-prisoners with a history of mental disorder: A longitudinal study. Australian and New Zealand Journal of Public Health, 38(5), 424-429.
  39. van Dooren, K., Kinner, S. A. & Hellard, M. (2014). A comparison of risk factors for hepatitis C among young and older adult prisoners. Journal of Correctional Health Care, 20(4), 280-291.
  40. Kinner, S. A., van Dooren, K., Boyle, F., Longo, M., & Lennox, N. (2014). Development of an intervention to increase health service utilisation in ex-prisoners. Health and Justice, 2:4.
  41. Carroll, M., Heffernan, E. & Kinner, S. A. (2014). Medication use and knowledge in a large sample of Indigenous and non-Indigenous prisoners. Australian and New Zealand Journal of PublicHealth, 38(2), 142-146.
  42. Thomas, E., Degenhardt, L., Alati, R., & Kinner, S. A. (2013). Predictive validity of the AUDIT for hazardous alcohol consumption in recently released prisoners. Drug and Alcohol Dependence, 134, 322-329.
  43. Kinner, S. A., Lennox, N., Williams, G.W., Carroll, M., Quinn, B., Boyle, F. & Alati, R. (2013). Randomised controlled trial of a service brokerage intervention for ex-prisoners in Australia. Contemporary Clinical Trials, 36, 198-206.
  44. van Dooren, K., Kinner, S. A. & Richards, A. (2013). Complex health-related needs among young, soon-to-be released prisoners. Health and Justice, 1:1.
  45. Moore, E., Winter, R., Indig, D., Greenberg, D., & Kinner, S. A. (2013). Non-fatal overdose among adult prisoners with a history of injecting drug use in two Australian states. Drug and Alcohol Dependence, 133, 45-51.
  46. Dias, S., Ware, R.S., Lennox, N.G. & Kinner, S.A. (2013). Co-occurring mental disorder and intellectual disability in a large sample of Australian prisoners. Australian and New Zealand Journal of Psychiatry, 47(10), 938-944.
  47. Kinner, S. A., Moore, E., Spittal, M.J. & Indig, D. (2013). Opiate substitution treatment to reduce in-prison drug injection: A natural experiment. International Journal of Drug Policy, 24, 460-463.
  48. David, M., Alati, R., Ware, R.S. & Kinner, S.A. (2013). Attrition in a longitudinal study with hard-to-reach participants was reduced by ongoing contact. Journal of Clinical Epidemiology, 66(5), 575-581.
  49. Dias, S., Ware, R. S., Kinner, S. A., & Lennox, N. (2012). Physical health outcomes in prisoners with intellectual disability: a cross-sectional study. Journal of Intellectual Disability Research, 57(12), 1191-1196.
  50. Kinner, S. A., Jenkinson, R., Gouilou, M. & Milloy, M-J. (2012). High-risk drug-use practices among a large sample of Australian prisoners. Drug and Alcohol Dependence, 126(1-2), 156-160.
  51. Kinner, S.A., Dietze, P.M., Gouilloiu, M. & Alati, R. (2012). Prevalence and correlates of alcohol dependence in adult prisoners vary according to Indigenous status. Australian and New Zealand Journal of Public Health, 36(4), 329-334.
  52. Kinner, S. A., Lennox, N. G., & Taylor, M. (2009). Randomised controlled trial of a post-release intervention for prisoners with and without an intellectual disability. Journal on Developmental Disabilities, 15(2), 72-76.
  53. Kinner, S. A. (2008). Passports to advantage: Health and capacity building as a basis for social integration. Flinders Journal of Law Reform, 10(3), 581-589.

Research Group




Key Contact

For further information about this research, please contact the research group leader.

Department / Centre

Centre for Health Equity

MDHS Research library
Explore by researcher, school, project or topic.