triggered:
• at initial assessment
• during offending behaviour program screening and assessment
• during Case Management Review Committee meetings
• by a urine sample positive for AOD use.
A prisoner may also self-refer to AOD treatment.
329. Justice Health169 contracts an independent
provider, Caraniche170 to deliver AOD
programs in all Victorian public prisons. In private prisons these programs are delivered in-house at Fulham Correctional Centre and are sub-contracted to Uniting Care ReGen at Port Phillip Prison.
Remand prisoners
330. Prisoners on remand have access to a range of short-term AOD health programs, which focus on harm reduction and relapse prevention.
169 Justice Health is a business unit of the Department of Justice and Regulation and is responsible for delivering health services to people in Victoria’s prisons.
170 Caraniche is a company of psychologists, social workers and other health professionals.
331. Similar to offending behaviour programs, there have been limitations on the AOD programs that remandees can participate in. However, in response to my draft report, the department advised that ‘Justice Health has increased AOD delivery for remandees and has made 24-hour health [AOD] programs available to remandees’.
Sentenced prisoners
332. Sentenced prisoners have access to a broader range of AOD programs. These programs, delivered by Caraniche, are divided into two streams:
• health stream programs: aim to help prisoners understand the risk and harms of substance abuse, promote healthier lifestyles and prepare prisoners for returning to the community
• criminogenic programs: longer group- based programs that target the relationship between substance use and offending171.
333. Programs vary in intensity and duration. The longer, more intensive programs target prisoners with a higher risk of reoffending and more significant drug and alcohol issues.
334. In its submission to my investigation, Caraniche highlighted that:
Unlike sex offender and violent offender treatment programs in which the offending behaviour is the direct treatment target, criminogenic AOD treatment addresses a broad range of offending behaviours and the specific relationship between them and substance use172.
171 Caraniche, Submission to Ombudsman Discussion Paper, December 2014.
335. Program evaluation data from Caraniche shows that participants make significant gains from AOD treatment programs in mental health and wellbeing, addressing criminal thinking patterns and decision- making skills.
336. A range of programs are available in different locations including:
• a 130 hour intensive residential drug treatment program at Marngoneet Correctional Centre and Dame Phyllis Frost Centre
• individual counselling sessions • AOD programs targeted at prisoners
with both substance abuse and mental health problems, including depression, stress, anxiety and grief and loss
• AOD programs addressing substance abuse issues and women’s histories of trauma, violence, grief, relationships and children
• transitional programs to help prisoners prepare for release who have substance abuse issues.
Changing trends in drug use
337. Witnesses told my officers that AODprograms need to be regularly adapted to address changing trends in drug use. 338. Several submissions to my investigation
highlighted the challenges posed to the prison system by the increased use of methamphetamine, commonly known as ‘ice’, and the need for specific programs targeting the use of this drug.
339. Caraniche data shows that drug use patterns of prisoners participating in their programs are changing. In the last four years:
• heroin use has almost halved (32.7 per cent to 17.9 per cent)
• ice use has doubled (20 per cent to 40 per cent)
• violent offences committed by drug users have doubled (18.7 per cent to 36.7 per cent).
340. The data shows that in 2013-14:
• the most significant drug for male prisoners prior to their imprisonment was ice (49 per cent), followed by alcohol (23 per cent) and heroin (18 per cent)
• the most significant drug for women prisoners was heroin (45 per cent), followed by ice (33 per cent) and alcohol (12 per cent)173.
341. In August 2015 the Victorian Government announced174 a new pilot program aimed
at prisoners identified as having a high risk of reoffending and a history of ice use. The program, to be trialled at the Marngoneet and Hopkins prisons, involves 44 hours of intensive treatment, including cognitive behaviour therapy, specifically designed to reduce reoffending among ice users. The announcement also referred to two other pilots that have recently been introduced:
• 24-hour program aimed at increasing prisoners’ understanding of their ice use and the effect on their mental health • six-hour harm-minimisation education
program to help prisoners understand the effects of withdrawal and long-term use, as well as where to find support.
Marngoneet Correctional Centre
342. Marngoneet Correctional Centre was originally designed as the sole therapeutic and treatment focussed prison in Victoria, comprising three separate living areas (known as ‘neighbourhoods’), housing male prisoners convicted of sexual offences, violent offences, and those with significant substance abuse issues175. However, this
model has changed as a result of pressures across the system.
173 While heroin remains the most significant drug for women, Caraniche advised that ice use and violence are increasing. 174 The Hon Daniel Andrews MP, Premier, Media release – Ice-addict
prison treatment aims to break link with crime, 24 August 2015.
175 Deakin University, Evaluation of the Marngoneet Correctional
343. A number of witnesses raised concerns about the current operation of the residential drug program at Marngoneet. The Managing Director of Caraniche advised:
Whilst we run the residential program at Marngoneet and it’s an intensive program, it doesn’t follow the principles of ideal practice that we know are what’s required to get best treatment outcomes. So it’s a very compromised treatment approach that we have significant concerns about. It’s not operating any way near in optimal conditions.
344. During my investigation it became clear that overcrowding has influenced the current operation of the residential drug program. The Forensic Services Manager at Caraniche advised:
When they developed Marngoneet, it was about building a state of the art programs prison based on a Therapeutic Community philosophy and operating model, a 300 bed prison with three neighbourhoods, violence, sex and drug and alcohol. But the issue was that the system had grown substantially and the moment that SMU’s [Sentence Management Unit’s] decisions about placement became security focused and stopped considering all of the other responsivity factors that are required to make an assessment about whether someone should go there (into a treatment prison), then the beginning of the culture starts to get eroded and then over time, other decisions have been made and Marngoneet is not operating like a TC [therapeutic community] at all, it’s operating just like another prison really. 345. The Director of Justice Health also
commented on changes at Marngoneet, telling my officers that due to
overcrowding, prisoners had been placed in the residential drug treatment unit who were not undertaking the intensive drug treatment program, resulting in a change to the profile of the unit.
346. Similar concerns were noted in a 2013 evaluation report of Marngoneet,
commissioned by Corrections Victoria. The report noted:
It is … evident that the Marngoneet model has experienced considerable change since it was first implemented, with concerns expressed by some stakeholders (but by no means all) that this has
undermined both the quality and integrity of the rehabilitation services that are offered. For some, the prison is evolving into a mainstream medium security prison in which programs are delivered, but in which the social therapy model has limited relevance176.
347. Corrections Victoria has acknowledged Marngoneet’s changing role in the Victorian prison system, noting that the original clinical service model was implemented prior to the department’s decision to regionalise clinical services, which has meant access to treatment and programs has been expanded to a number of prisons177.
Resourcing
348. Witnesses and submissions to my investigation spoke of there being a high demand and long waiting lists for AOD programs, as a result of the increase in prisoner numbers. This is reflected in the large volume of complaints received by my office from prisoners about delays in accessing AOD programs, which are often required for parole eligibility.
176 ibid, page 152.
177 Corrections Victoria, Strategic Policy and Planning Branch,
Key recommendations from the 2013 final report by Deakin University on the evaluation of Marngoneet, prepared for the
349. My officers were unable to determine the full extent of the waiting lists for these programs. In response to a request for details of the waiting lists for AOD programs Corrections Victoria stated: Justice Health is unable to provide wait list data. Justice Health does not routinely collect wait list data, and understands wait list data maintained by its AOD service provider is not reliable as an indicator of demand. Wait list protocols vary from site to site owing to local operational imperatives, and would need to be interpreted differently for each site. For example, some sites capture certain prisoners on their wait lists, and not others, some sites have multiple lists in which the same prisoner may appear multiple times, and do not indicate whether a prisoner is in fact suitable for AOD program participation, some waiting lists are a living record rather than a snapshot in time, etc.178
350. To address the increased demand, funding for AOD programs has considerably increased in the last three years. At interview the Director, Justice Health advised that full-time equivalent staff for the delivery of AOD programs in public prisons has increased by 16, and funding will have increased by about $3 million per annum since July 2012.
351. In addition, Justice Health has established an AOD quality framework, which aims to provide greater consistency of AOD services provided in both public and private prisons179.
352. At interview the Director, Justice Health said that work is also currently underway to incorporate AOD program completion data into CVIMS. This should enable better data and analysis on the completion and impact of AOD programs. The Director anticipated that this will be operational by the end of 2015.
178 Corrections Victoria, email response to Victorian Ombudsman enquiries, 14 April 2015.
179 Justice Health, Quality Framework 2014, Alcohol and Other
Drug Services, August 2014.
353. Other new approaches being developed by Justice Health and Caraniche include:
• a ‘maintenance’ program for prisoners who have completed an AOD
criminogenic program
• an intensive criminogenic program, for prisoners housed at locations other than Marngoneet (where an intensive 130 hour program is available).
354. Historically, criminogenic AOD programs have only been delivered at medium and maximum security prisons, not minimum security locations, as these are intended to house prisoners towards the end of their sentence. Caraniche told my officers that these demographics are changing, with an increasing number of prisoners serving a significant portion of their sentence at minimum security prisons, particularly those on short sentences. As a result, criminogenic AOD programs were introduced at Langi Kal Kal Prison in July 2014, and at Beechworth and Dhurringile prisons in July 2015.