Prevalence of mental disorders among Australian females: Comparison according to motherhood status using Australian birth cohort data.

PURPOSE: Studies examining mental disorders among women have primarily focused on either depression, anxiety, or substance use disorders and not included the broader spectrum of mental disorders. Mixed evidence exists on the prevalence rates of mental disorders among mothers. This study compares the prevalence of different mental disorders and mental comorbidities between mothers and non-mothers and assesses correlates of mental disorders among mothers. METHODS: A population-based birth cohort design was adopted, consisting of 40,416 females born in Queensland, Australia, in 1983/84. Linked administrative data from hospital admissions were used to identify mental disorders. Cumulative incidence curves of different mental disorders were created separately for mothers and non-mothers. RESULTS: Mental disorder prevalence among females by age 29-31 years was 7.8% (11.0% for mothers and 5.2% for non-mothers). Mothers were overrepresented in almost all categories of mental disorders, with overrepresentation becoming more pronounced with age. Mothers with a mental disorder were more likely to be unmarried, Indigenous, young at birth of first child, have greater disadvantage, and have a single child, compared to mothers without a mental disorder. Nearly half of the mothers (46.9%) had received a mental disorder diagnosis before having their first child. CONCLUSIONS: Mothers, particularly unmarried, Indigenous, having greater disadvantage, and younger at birth of first child, represent a unique group with high vulnerability to mental disorders, that begins in childhood and is amplified with age. Presence of significant mental disorder comorbidities among females highlights the critical importance of a comprehensive, integrated approach to prevent and address multiple comorbidities.

Child Sexual Abuse Victimization Amongst Detained Adolescents and Incarcerated Young Adults: Findings from an Australian Population-Based Birth Cohort Study.

To guide prevention and intervention efforts, the prevalence and impact of child sexual abuse (CSA) victimization among detained and incarcerated populations requires further examination, particularly with consideration of multi-type maltreatment experiences and sex-based variations. This longitudinal population-based study explores these relationships in an Australian birth cohort comprising all individuals born in Queensland in 1983 and 1984 (n = 82,409; 48.68% female). Data include all notified and substantiated harm(s) from child protection services (0 to 17 years), and sentences to youth detention and/or adult incarceration between ages 10 and 30. Findings indicate greater prevalence of CSA amongst detained/incarcerated individuals compared to the general population but emphasize the impact of cooccurring maltreatment (particularly neglect) on the likelihood of custodial outcomes. Important sex-based differences were noted in the intersection of CSA victimization and detention/incarceration. Findings reinforce the need for trauma-informed practices when working with custodial populations, particularly females, and highlight opportunities for prevention of detention/incarceration in at-risk populations, in line with a broader public health approach to child protection.

Psychiatric illness and the risk of reoffending: recurrent event analysis for an Australian birth cohort.

BACKGROUND: Psychiatric illness is a well-established risk factor for criminal justice system involvement, but less is known about the relationships between specific psychiatric illnesses and reoffending. Research typically examines reoffending as a single discrete event. We examined the relationship between different psychiatric disorders and types of reoffending while accounting for multiple reoffending events over time. METHODS: Data were drawn from a population cohort of 83,039 individuals born in Queensland, Australia, in 1983 and 1984 and followed to age 29-31 years. Psychiatric diagnoses were drawn from inpatient health records and offending information was drawn from court records. Descriptive and recurrent event survival analyses were conducted to examine the association between psychiatric disorders and reoffending. RESULTS: The cohort included 26,651 individuals with at least one proven offence, with 3,580 (13.4%) of these individuals also having a psychiatric disorder. Individuals with any psychiatric disorder were more likely to reoffend compared to those without a disorder (73.1% vs. 56.0%). Associations between psychiatric disorders and reoffending varied across age. Individuals with a psychiatric disorder only started to accumulate more reoffending events from ~ 27 years, which accelerated up to age 31 years. There were both specificity and common effects in the associations between different psychiatric disorders and types of reoffending. CONCLUSIONS: Findings demonstrate the complexity and temporal dependency of the relationship between psychiatric illness and reoffending. These results reveal the heterogeneity present among individuals who experience psychiatric illness and contact with the justice system, with implications for intervention delivery, particularly for those with substance use disorders.

Psychiatric disorders and offending in an Australian birth cohort: Overrepresentation in the health and criminal justice systems for Indigenous Australians.

OBJECTIVE: Most studies that examine psychiatric illness in people who offend have focused on incarcerated samples, with little known about the larger population of individuals with criminal justice system contact. We examine the overlap between proven offences and psychiatric diagnoses with an emphasis on experiences for Indigenous Australians. METHODS: In a population-based birth cohort of 45,141 individuals born in Queensland, Australia, in 1990 (6.3% Indigenous), psychiatric diagnoses were identified from hospital admissions between ages 4/5 and 23/24 years and proven offences were identified from court records (spanning ages 10-24 years). Prevalence rates for offending, psychiatric diagnoses and their overlap were examined for Indigenous and non-Indigenous individuals. Associations between specific psychiatric diagnoses and types of offending were examined using logistic regressions. RESULTS: There were 11,134 (24.7%) individuals with a finalised court appearance, 2937 (6.5%) with a diagnosed psychiatric disorder and 1556 (3.4%) with a proven offence and diagnosed psychiatric disorder, with Indigenous Australians significantly overrepresented across all outcomes. Compared with non-Indigenous Australians, Indigenous Australians were younger at their first court finalisation (Cohen's d = -0.62, 95% confidence interval = [-0.67, -0.57]), experienced a higher number of finalisations (d = 0.94, 95% confidence interval = [0.89, 1.00]) and offences (d = 0.64, 95% confidence interval = [0.59, 0.69]) and were more likely to receive custodial (d = 0.41, 95% confidence interval = [0.36, 0.46]) or supervised (d = 0.55, 95% confidence interval = [0.50, 0.60]) sentences. The overlap between offending and psychiatric illness was more pronounced for Indigenous Australians compared with non-Indigenous Australians (14.8% vs 2.7%). Substance use disorders were the most prevalent psychiatric diagnosis among individuals with a court finalisation (9.2%). CONCLUSIONS: Indigenous Australians were significantly overrepresented in court finalisations and psychiatric diagnoses. Indigenous Australians with a psychiatric diagnosis were at highest risk of experiencing a court appearance, emphasising the importance of culturally appropriate mental health responses being embedded into the criminal justice system.

Assessing the Effectiveness of a Specialized, Field-Based Treatment Program for Youth Who Have Committed Sexual Offenses in an Australian Jurisdiction.

This study provides an evaluation of recidivism outcomes for a specialized, field-based treatment program for youth who perpetrate sexual offenses in an Australian jurisdiction. Using survival analyses, recidivism outcomes for the treatment group (n = 200), who were followed for an average of 5.07 years (SD = 3.13), were contrasted with a sample of sexually offending youth who were either referred but not accepted or not referred to the program (n = 295). Rates of sexual recidivism were low and not significantly different between the groups (9.5% for treated and 10.8% for untreated). Unadjusted Cox regression results indicated that the treated group were less likely to violently recidivate compared to the untreated group (HR = 1.41, 95% CI [1.01, 1.96]), but this effect became nonsignificant when controlling for offense history covariates (HR = 1.22, 95% CI [0.87, 1.72]). Both groups exhibited high rates of nonsexual offending during the follow-up period, and treatment factors including clinician-rated success, were found to be associated with a lower frequency of reoffending after treatment. Findings highlight important considerations for both practice and research. First, findings suggest the need for specialized programs to ensure factors associated with general recidivism are also addressed in treatment; second, findings reinforce potential utility for clinician-rated and structured assessments to inform treatment planning and outcomes. Finally, the findings raise the importance of appropriate comparison groups when designing evaluation studies, to accurately inform policy and practice.

Reliability and Predictive Validity of the Juvenile Sex Offender Assessment Protocol-II in an Australian Context.

This study investigated the reliability and predictive validity of the Juvenile Sex Offender Assessment Protocol-II (J-SOAP-II), in an Australian context, and for Australian Indigenous and non-Indigenous youth. Participants were 123 (n = 91 non-Indigenous; n = 32 Indigenous) youth assessed using the J-SOAP-II and followed up over an average period of 4 years. The reliability of the J-SOAP-II was assessed using measures of internal consistency (Cronbach's alphas and inter-item correlations). Receiver operating characteristic (ROC) analyses were conducted to assess the J-SOAP-II's validity in predicting sexual and non-sexual (violent and non-violent) recidivism. Overall, the J-SOAP-II demonstrated moderate to high levels of reliability and weak to moderate levels of validity for predicting sexual and non-sexual (violent and non-violent) recidivism for the whole sample. While the J-SOAP-II total score was significantly associated with non-sexual (violent and non-violent) recidivism for non-Indigenous youth, it was not significantly associated with any of the outcome variables for Indigenous youth. Across all analyses, the dynamic scales of the J-SOAP-II predicted recidivism with greater accuracy than the static scales. However, the static scales had greater accuracy in predicting the risk of sexual recidivism for Indigenous youth. While a reliable measure, these preliminary findings raise questions about the validity of the J-SOAP-II for predicting sexual recidivism for Indigenous and non-Indigenous youth in an Australian context, and warrant further investigation.

Dual-system Involvement: Exploring the Overlap Between Domestic and Family Violence and Child Maltreatment Perpetration.

This longitudinal population-based study aimed to understand the dual-system involvement of males who engage in domestic and family violence (DFV) and child maltreatment perpetration. Specifically, this study investigates the prevalence of male perpetration of DFV, child maltreatment, and dual-system involvement, and compares the frequency and nature of perpetration by males with single-system contact and males with dual-system contact. The effect of race (Indigenous Australian/non-Indigenous Australian) and parental status on dual-system involvement is also examined. This study utilizes data from the Queensland Cross-sector Research Collaboration repository. These data contain each contact an individual male born in 1983 or 1984 had with the Queensland civil court system as a respondent to a domestic violence order (DVO) and the Queensland statutory child protection system, where, after an investigation, they were identified as the person responsible for substantiated harm to a child. The results from the study show a high level of overlap between males who perpetrate DFV and child maltreatment. Of males identified as being responsible for substantiated harm to a child, 58% have also been a respondent of a DVO, and approximately 16% of male DVO respondents were identified as being responsible for substantiated harm to a child. Differences were found in the frequency and nature of perpetration by males with dual-system involvement compared to those with single-system contact for either DFV or child maltreatment. Our results also show differences for Indigenous status, parental status, number of maltreatment events, harm type, number of DVOs, and number of breaches of a DVO. The implications of this study for both policy and practice are discussed.

Exploring dual-system involvement for domestic violence victimisation and child maltreatment perpetration: An exploration by gender and race/ethnicity.

BACKGROUND: There is an historical separation between system responses to domestic violence (DV) and child maltreatment. Concerns have been noted that DV victims may be over-represented as parents responsible for harm to children in the child protection system. Although there is a growing acknowledgement of the high overlap between DV and child maltreatment within families, little empirical research has been conducted on this relationship. OBJECTIVE: This study aims to longitudinally examine the overlap of being a victim of DV and a perpetrator of child maltreatment, along with the impact of dual-system involvement on the nature and frequency of the violence experienced. METHODS: The data are linked longitudinal administrative data from the Queensland Cross-sector Research Collaboration (QCRC) repository. These data contain each contact every individual born in Queensland in 1983 or 1984 had with the Queensland DV civil court system and the Queensland statutory child protection system. RESULTS: Of individuals identified as a perpetrator of child maltreatment, 45% have also been a victim of DV and approximately 22% of DV victims were identified as a perpetrator of child maltreatment. Our results also show differences based on Indigenous status, gender, parental status, number of substantiations, frequency of violence, harm type, and number of domestic violence orders. CONCLUSIONS: There is considerable overlap between individuals who are victims of DV and individuals who perpetrate child maltreatment. This overlap was influenced by both gender and race/ethnicity. The implications of this study for both policy and practice are discussed.

Prevalence of psychiatric disorders for Indigenous Australians: a population-based birth cohort study.

AIMS: Limited information exists about the prevalence of psychiatric illness for Indigenous Australians. This study examines the prevalence of diagnosed psychiatric disorders in Indigenous Australians and compares this to non-Indigenous Australians. The aims were to: (1) determine prevalence rates for psychiatric diagnoses for Indigenous Australians admitted to hospital; and (2) examine whether the profile of psychiatric diagnoses for Indigenous Australians was different compared with non-Indigenous Australians. METHODS: A birth cohort design was adopted, with the population consisting of 45 141 individuals born in the Australian State of Queensland in 1990 (6.3% Indigenous). Linked administrative data from Queensland Health hospital admissions were used to identify psychiatric diagnoses from age 4/5 to 23/24 years. Crude lifetime prevalence rates of psychiatric diagnoses for Indigenous and non-Indigenous individuals were derived from the hospital admissions data. The cumulative incidence of psychiatric diagnoses was modelled separately for Indigenous and non-Indigenous individuals. Logistic regression was used to model differences between Indigenous and non-Indigenous psychiatric presentations while controlling for sociodemographic characteristics. RESULTS: There were 2783 (6.2%) individuals in the cohort with a diagnosed psychiatric disorder from a hospital admission. The prevalence of any psychiatric diagnosis at age 23/24 years was 17.2% (491) for Indigenous Australians compared with 5.4% (2292) for non-Indigenous Australians. Indigenous individuals were diagnosed earlier, with overrepresentation in psychiatric illness becoming more pronounced with age. Indigenous individuals were overrepresented in almost all categories of psychiatric disorder and this was most pronounced for substance use disorders (SUDs) (12.2 v. 2.6% of Indigenous and non-Indigenous individuals, respectively). Differences between Indigenous and non-Indigenous Australians in the likelihood of psychiatric disorders were not statistically significant after controlling for sociodemographic characteristics, except for SUDs. CONCLUSIONS: There is significant inequality in psychiatric morbidity between Indigenous and non-Indigenous Australians across most forms of psychiatric illness that is evident from an early age and becomes more pronounced with age. SUDs are particularly prevalent, highlighting the importance of appropriate interventions to prevent and address these problems. Inequalities in mental health may be driven by socioeconomic disadvantage experienced by Indigenous individuals.

Women's Health in Queensland Prisons.

Internationally, best practice for prison health care recommends transferring health service provision from corrections to health authorities. Although it is expected that this change will result in improved health care, there is little evidence of evaluation. This article used qualitative interviews with health service providers to gain insight into the health needs of women's prisons in Queensland, Australia, both prior to and after the transition in health care service provision. We found that service providers identified that problems persisted regardless of service provider and that improvement required increased resources and more fundamental structural changes within prison environments.