Deaths in custody rightly receive significant attention in the media, but the far higher rate of deaths among ex-prisoners during their first year after release from prison is not widely reported. A high risk of death after release from custody seems counterintuitive, but the phenomenon has been reported in overseas literature. In this issue of the Journal (Kinner), we present the first Australian evidence.
The Australian prison population is about 30 000, a figure that had increased by 39% over the decade to 2009. Approximately 50 000 prisoners are released each year, and there are about 385 000 ex-prisoners living in the community (http://www.aihw.gov.au/publication-detail/?id=6442468371). This represents 1.8% of the Australian population, so ex-prisoner health has significant repercussions, and the load on our health services is likely to increase. It is now clear that this population is extremely vulnerable.
Sadly, a United States man with chronic health problems recently resorted to stealing $1 from his bank with the aim of being arrested to gain access to prison health services. If we are to look for answers overseas, there is probably more to be learnt from the German penal system, which aims to resocialise and rehabilitate prisoners. It endeavours to “normalise” living conditions so that they resemble life in the community (http://www.publications.parliament.uk/pa/cm200405/cmselect/cmhaff/193/19304.htm). Presumably, this makes the transition to freedom less stressful.
Better data are needed to understand what is happening to prisoners after release, but the results of the study by Kinner et al leave no doubt that the health care system must flag ex-prisoners as a high-risk group, and move to meet its needs.