Epidemiology of physical-mental multimorbidity and its impact among Aboriginal and Torres Strait Islander in Australia: a cross-sectional analysis of a nationally representative sample.

OBJECTIVES: This study aimed to examine the differences in multimorbidity between Aboriginal and Torres Strait Islander people and non-Indigenous Australians, and the effect of multimorbidity on health service use and work productivity. SETTING: Cross-sectional sample of the Household, Income and Labour Dynamics in Australia wave 17. PARTICIPANTS: A nationally representative sample of 16 749 respondents aged 18 years and above. OUTCOME MEASURES: Multimorbidity prevalence and pattern, self-reported health, health service use and employment productivity by Indigenous status. RESULTS: Aboriginal respondents reported a higher prevalence of multimorbidity (24.2%) compared with non-Indigenous Australians (20.7%), and the prevalence of mental-physical multimorbidity was almost twice as high (16.1% vs 8.1%). Multimorbidity pattern varies significantly among the Aboriginal and non-Indigenous Australians. Multimorbidity was associated with higher health service use (any overnight admission: adjusted OR=1.52, 95% CI=1.46 to 1.58), reduced employment productivity (days of sick leave: coefficient=0.25, 95% CI=0.19 to 0.31) and lower perceived health status (SF6D score: coefficient=-0.04, 95% CI=-0.05 to -0.04). These associations were found to be comparable in both Aboriginal and non-Indigenous populations. CONCLUSIONS: Multimorbidity prevalence was significantly greater among Aboriginal and Torres Strait Islanders compared with the non-Indigenous population, especially mental-physical multimorbidity. Strategies are required for better prevention and management of multimorbidity for the aboriginal population to reduce health inequalities in Australia.

Social and emotional wellbeing among Indigenous Australian correctional officers.

The workplace challenges of correctional officers have been well documented. Yet little is known about how such stressors impact the wellbeing of correctional officers from minority cultural-subgroups. This study explored Indigenous Australian correctional officers' social and emotional wellbeing (SEWB) when managing workplace adversity. Specifically, the study sought to identify culturally-specific stressors, protective factors and associated response tendencies to gain a more robust understanding of the factors that impact Indigenous officers' wellbeing in the workplace. In total, 15 Indigenous Australian correctional officers from the Northern Territory participated in the study through focus groups or semi-structured interviews. Thematic analysis of participant data revealed that Indigenous correctional officers' SEWB is influenced by four broad categories: cultural connection, morale, social functioning and somatic health. Results are discussed in terms of common themes, future research and implications for assisting the SEWB of Indigenous officers.

The Personality Inventory for DSM-5-Brief Form: An Examination of Internal Consistency, Factor Structure, and Relationship to Aggression in an Incarcerated Offender Sample.

This study evaluated the internal consistency and factor structure of the Personality Inventory for DSM-5-Brief Form (PID-5-BF), and its relationship to aggression in 438 incarcerated Australian male offenders. Results provide support for the internal consistency and five-factor and bifactor structure of the PID-5-BF. The PID-5-BF total score, as well as the domains of Antagonism, Disinhibition, and Negative Affect (low), demonstrated significant relationships with aggression. These results provide preliminary support for the psychometric properties of the PID-5-BF within prison settings, and suggest that a PID-5-BF assessment may be useful within forensic settings to screen for broad maladaptive personality characteristics that are indicative of a greater propensity for aggressive behavior.

Closing the (incarceration) gap: assessing the socio-economic and clinical indicators of indigenous males by lifetime incarceration status.

BACKGROUND: Approximately 1 in 5 to 1 in 6 Indigenous Australian males are currently imprisoned or have previously been imprisoned. Recent work has also pointed to a widening socio-economic gap within the Indigenous population. Given the myriad social, wellbeing and environmental risk factors associated with justice-involvement, it is conceivable that incarceration may contribute to the increasing disparities found within the Indigenous population. This study aimed to explore the presence and extent of an 'incarceration gap' within the Indigenous population and to uncover which social factors characterise the disparity. METHODS: The study utilised data from the 2014-5 National Aboriginal and Torres Strait Islander Social Survey (NATSISS). A number of socio-economic, environmental and clinical factors were compared by life-time incarceration status. Chi-square tests were used to examine the association between incarceration status and each of the comparison variables. RESULTS: Disparities were observed within the Indigenous Australian population across a number of important health and socio-economic markers by incarceration status - the most pronounced being for educational obtainment - year 10 completion (Never incarcerated 73%, Ever incarcerated 50%), labour force participation (Never incarcerated 56%, Ever incarcerated 26%) and drug/alcohol problems (Never incarcerated 7%, Ever incarcerated 29%). Never-incarcerated Indigenous males yielded aggregate proportions across numerous variables that approximated or matched general Australian population estimates. CONCLUSIONS: There appears to be evidence for a substantial 'incarceration gap' within the Indigenous Australian population.

Mental Health, Psychological Distress, and Coping in Australian Cross-Cultural Prison Populations.

The rates of mental illness are significantly higher in prison populations compared to the general community; however, little research has examined the rates of mental illness for cross-cultural groups of prisoners in Australia. This omission is concerning given the increasingly diverse nature of the Australian prison population. To address this gap in knowledge, the present study aimed to identify rates of key mental health factors and associated psychological processes in a cohort of 191 men from culturally and linguistically diverse, Indigenous Australian and English-speaking backgrounds who were incarcerated at a maximum-security prison in Victoria, Australia. We also explored differences in both psychological distress levels and predictors of psychological distress. Although no significant mental health differences were identified cross-culturally, the results revealed that several mental health factors predicted psychological distress for all prisoners, F(11, 147) = 33.23, p < .001, R2 = .71. The experiences of anxiety and sleep disturbance-related symptoms, ß = .34; depressive symptoms, ß = .19; posttraumatic stress disorder symptoms, ß = .25; and the use of psychological processes, such as avoidance coping, ß = .16; and engagement in cognitive fusion, ß = .15, all predicted psychological distress. The use of positive thinking as a coping strategy was found to predict a reduced level of psychological distress for prisoners, ß = -.13. The findings indicated that the mental health profiles of cross-cultural groups of prisoners are similar in nature, suggesting that justice involvement may be a more useful predictor than cultural differences concerning psychological health.

Psychological wellbeing, distress and coping in Australian Indigenous and multicultural prisoners: a mixed methods analysis.

The Australian prison population is growing and becoming increasingly diverse. Yet very little research has investigated mental health concerns for multi-cultural prisoners. This mixed methods study aimed to identify the prevalence of mental health factors (wellbeing, distress and coping) in a cohort of 530 prisoners from Indigenous, culturally and linguistically diverse (CALD) and English-speaking backgrounds (ESB) at a maximum-security prison in Victoria, Australia. Focus group interviews were also conducted with an additional 40 prisoners. It was found that Indigenous prisoners had significantly higher levels of distress and more symptoms of anxiety and depression than CALD and ESB prisoners. CALD prisoners had a greater sense of 'feeling in control' in prison than ESB prisoners. The focus group interviews also identified several factors that contributed to mental health differences between the groups. Findings reinforce the need for a more individualised approach in addressing mental health issues for prisoners cross-culturally.

Correctional Officers and Workplace Adversity: Identifying Interpersonal, Cognitive, and Behavioral Response Tendencies.

This study explored correctional officers' response tendencies (i.e., cognitive, interpersonal, and behavioral response patterns they engage in) when managing workplace adversity. In total, 53 Australian correctional officers participated in the study. Eight exploratory focus group discussions ( n = 42) were conducted to identify a set of officer-endorsed response tendencies. Thematic analysis of group data revealed that correctional officers engage in a range of response tendencies when facing workplace adversity and that these tendencies may be categorized as interpersonally, cognitively, or behaviorally based. Semistructured interviews ( n = 11) were then conducted to provide further depth of information regarding officer response tendency usage. Results are discussed in terms of common themes, future research, and implications for developing training programs designed to ameliorate the effects of workplace adversity.