The leading voice in Indigenous drug and alcohol policy advice. AIJA INDIGENOUS JUSTICE CONFERENCE Thursday 18 July Friday 19 July, 2013

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1 The leading voice in Indigenous drug and alcohol policy advice AIJA INDIGENOUS JUSTICE CONFERENCE Thursday 18 July Friday 19 July, 2013 University of South Australia Presenter: Mr Scott Wilson, Deputy Chair of NIDAC

2 The National Indigenous Drug and Alcohol Committee (NIDAC) Established in 2004 by the Australian National Council on Drugs (ANCD) The ANCD is the principal advisory body on alcohol and drug policy to the Prime Minister and the Australian Government

3 Governance structure to support the National Drug Strategy Ministers Prime Minister Annual information meetings to discuss strategic issues as required Annual Reports Australian National Council on Drugs Annual stakeholder forum Intergovernmental Committee on Drugs Health Officials Law enforcement officials Of Substance Asia Pacific Drug Issues Committee National Indigenous Drug & Alcohol Committee Time limited working groups Standing Committees Research and Data Working Group Workforce Development Working Group Aboriginal & Torres Strait Islander Peoples Drug Strategy Working Group Stakeholder and expert representation Alcohol Tobacco Illicit Drugs Pharmaceutical drugs misuse

4 NIDAC s Key Roles and Responsibilities As the leading voice in Indigenous alcohol and other drug policy, NIDAC aims to identify and embrace opportunities to influence decisions to reduce alcohol and other drug problems and associated harms in Indigenous communities nationally It provides advice to the ANCD and Government based on this collective expertise and experience, as well as through ongoing consultation with those working in the field, various stakeholders and relevant experts

5 NIDAC Membership Membership consists of people who have a wide range of valuable expertise and knowledge on Indigenous alcohol and drug use that spans: Aboriginal Community Controlled Health Organisations Indigenous AOD and health promotion services providers working in government and nongovernment sectors Indigenous medical services; and Indigenous research sector

6 NIDAC Membership Executive Committee Members Associate Professor Ted Wilkes NIDAC Chair - Curtin University (WA) Mr Scott Wilson NIDAC Deputy Chair - Aboriginal Drug and Alcohol Council (SA) Ms Wendy Casey - Aboriginal Alcohol and Other Drugs, Drug and Alcohol Office (WA) Ms Donna Ah Chee CEO Central Australian Aboriginal Congress (NT)

7 Committee Members Mr Matthew Bonson - Central Aboriginal Alcohol Program Services (CAAPS) (NT) Ms Lisa Briggs - National Aboriginal Community Controlled Health Organisation (NACCHO) (ACT) Ms Viki Briggs National Centre for Excellence in Indigenous Tobacco Control (CEITC) (VIC) Mr Bradley Freeburn Aboriginal Medical Service, Redfern (NSW) Professor Dennis Gray National Drug Research Institute, Curtin University (WA) Ms Kristie Harrison Aboriginal Drug & Alcohol Network Leadership, Aboriginal Health & Medical Research Council (ADAN, AHMRC) (NSW) Dr John Herron Australian National Council On Drugs (ANCD) Chairman (QLD) Mr Romlie Mokak Australian Indigenous Doctors Association (AIDA) (ACT)

8 Young people People in the justice system Fetal and infant health Priority Areas for NIDAC Adequate and secure funding to build the capacity of Aboriginal and Torres Strait Islander community controlled health organisations and other culturally secure services to respond to ATOD use Workforce and organisational development

9 Indigenous Australians in the justice system NIDAC position paper - Bridges and Barriers: Addressing Indigenous Incarceration This paper highlights the high rates of incarceration of Indigenous people: 26% of prisoners are Indigenous Nationally, Indigenous people are 14 times more likely to be imprisoned than non Indigenous Increase of 343% for women in prison from time of the 1991 Royal Commission into Aboriginal Deaths in Custody 49% of people in juvenile corrective institutions in were Indigenous

10 Prison Related Health Risks Prison related health risks are much higher for all prisoners and include issues such as: Blood borne viruses high risk behaviours including injecting drug use, tattooing, physical violence, body piercing and unprotected sex Hep C virus is 30 times greater in prison than in general community (Butler et al, 2011b) Comorbidity common among offenders 43% of subjects had suffered from a mental health disorder within previous 12 mths 55% had a substance use disorder in previous 12 mths 29% prevalence of comorbidity (Butler et al, 2011a) Suicide and death from overdose (Hobbs et al, 2006)

11 Cost Benefit Analysis NIDAC was well aware of the heath benefits for Indigenous people being diverted away from prison but identified the need for the cost benefit to be determined NIDAC commissioned Deloitte Access Economics to undertake this analysis comparing the costs associated with prison vs residential treatment

12 Cost Benefit Analysis Comparison of 2 alternative pathways were examined (prison pathway and the residential rehabilitation pathway) Target population - Indigenous offenders who were post trial, pre sentence and faced possibility of going to prison, non violent with problematic substance use issues who may benefit from diversion Utilised ABS figures estimating the number of Indigenous Australians in prison system, data on the numbers entering prison for non violent offences and figures linking offending to AOD use Number of prisons and costs associated with running them and number of residential rehabs and their costs were also considered Outcomes such as recidivism, health outcomes (mental health service use, risk of contracting Hep C and drug relapse rates) were also considered and factored into the calculations Non financial benefits (improved mortality and quality of life) were also considered

13 Key findings from Deloitte s work $111,000 per year/offender cost saving by diverting non violent Indigenous offenders with substance use problems into Rx instead of prison Further $92,000/offender saving in the long term due to lower mortality and better health related quality of life outcomes In 2011 there were 115 correctional custodial facilities costing $3b/annum ( capital and recurrent) In there were 30 facilities providing residential drug and alcohol treatment services for Indigenous people Further detailed information on the findings can be accessed from the report, An economic analysis for Aboriginal and Torres Strait Islander Offenders: Prison vs Residential Treatment

14 Items Costs Cost of each alternative Benefits Financial benefits Net present value, $ NPV prison Column A NPV resi rehab Column B Difference Column B Column A Comment $114,832 $18,385 -$96,446 Use of residential rehabilitation represents a saving Recidivism $96,348 $84,888 -$11,461 Recidivism is lower with residential rehabilitation leading to savings in prison costs Mental health service usage Hepatitis C treatment costs $3,278 $0 -$3,278 Residential rehabilitation is not associated with the same adverse impacts on mental health as prison leading to savings in use of mental health services $1,993 $1,747 -$246 Residential rehabilitation is associated with lower rates of contraction of hepatitis C leading to savings in treatment costs Costs of drug use for those who relapse $164 $136 -$28 Residential rehabilitation is associated with lower rates of drug use relapse leading to savings in healthcare and productivity costs Subtotal financial $101,783 $86,771 -$15,012 Saving per offender resulting from Net financial benefit of residential rehabilitation Source: Deloitte Access Economics calculation use of residential rehabilitation -$111,458 Savings per offender resulting from use of residential rehabilitation

15 Net present value, $ (cont) Non-financial benefits (improved mortality and quality of life) Hepatitis C burden of disease Premature mortality Total nonfinancial $23,281 $92,543 $23,065 -$216 -$92,543 These figures represent the monetary value of improvements in mortality and quality of life, and $115,824 $23,065 -$92,759 represent benefits of using residential rehabilitation in addition to the financial benefits above

16 Time for a new approach The Deloitte s work shows: Considerable benefits associated with the diversion of Indigenous prisoners into community residential drug and alcohol rehabilitation services instead of incarceration Financial savings as well as improvements in health and mortality We know that imprisonment is not working for Indigenous people it is not able to address the underlying causes of offending Need to start spending government funds in a smarter way We know that diversion programs have huge benefits avoid negative labelling and stigma and reduce the number of people going back to prison Need to shift the investment from prisons to community based and controlled services ( Justice Reinvestment)

17 JUSTICE REINVESTMENT IS Justice Reinvestment involves a shift in spending NOT an increase in spending PRISON PREVENTION DON T SPEND MORE, SPEND SMARTER

18 JUSTICE REINVESTMENT IS Page Heading Data driven Place based Supported by centralised strategic body Targeted to increasing community safety Targeted to reducing offending & imprisonment Fiscally sound

19 Community Example of Justice Reinvestment Bourke community approached NSW Justice Reinvestment Campaign for Aboriginal Young People to develop a justice reinvestment implementation plan Bourke identified as having the highest number of breaches to bail conditions in NSW; no residential AOD treatment services and lack of AOD and MH services Looked at young Aboriginal people aged years (47 youth identified) Cost of incarceration for these youth estimated to be over $2million Funding could be used to establish programs such as youth diversion and family case management

20 What NIDAC and ANCD are seeking NIDAC and the ANCD are calling on a justice reinvestment approach which involves shifting part of the spending away from prisons towards community-based programs and services that address the factors that contribute to criminal behaviour An inclusion of information on incarceration rates for Indigenous men, women and young people in Closing the Gap: Prime Minister s Report, tabled annually in federal parliament

21 The leading voice in Indigenous drug and alcohol policy advice To obtain further information about NIDAC, to obtain copies of reports or to subscribe to NIDAC Weekly News visit our website at : NIDAC Secretariat can be contacted on: (02) or nidac@ancd.org.au