title: Comparison of social circumstances, substance use and substance-related harm in soon-to-be-released prisoners with and without intellectual disability.
abstract: BACKGROUND
  The transition out of prison is likely to be a challenging time for prisoners with intellectual disability (ID). However, little evidence exists to inform interventions for people with ID making this transition. In this study we aimed to describe social circumstances, patterns of substance use and substance-related harm in soon-to-be-released prisoners with ID. We compare this group with those without ID, to better understand how the health-related needs of this group compare with the 'mainstream' prison population.
  
  
  METHODS
  Data came from face-to-face, confidential interviews with 1325 adult prisoners in seven adult prisons in Queensland, Australia. Prisoners with ID were identified using the Hayes Ability Screening Index (HASI). We used cross-sectional data to examine (i) demographics and criminographics; (ii) social circumstances; and (iii) substance use and substance use related harm. We compared characteristics of those with and without ID using univariable logistic regression.
  
  
  RESULTS
  Prisoners with ID (n = 115) were more likely than their peers without ID to be male, to identify as Indigenous Australian, and to report low educational attainment (<10 years) and pre-incarceration unemployment. Those with ID reported a high prevalence of poly-drug use (28.0%), unsafe tattooing (51.1%), unsafe sex (91.0%) and HCV infection (55.6%), although differences with their peers were non-significant.
  
  
  CONCLUSIONS
  The health and social needs of prisoners with ID transitioning into the community are a significant concern for researchers, policy makers and practitioners. Our findings highlight the need for proactive, appropriate and targeted service responses from disability, health and justice sectors.
authors.affiliation: Queensland Centre for Intellectual and Developmental Disability, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia; School of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Bhandari
authors.forename: K
authors.initials: K
authors.lastname: van Dooren
authors.forename: G
authors.initials: G
authors.lastname: Eastgate
authors.forename: N
authors.initials: N
authors.lastname: Lennox
authors.forename: S A
authors.initials: SA
authors.lastname: Kinner
mesh_terms: D000328:Adult; D015897:Comorbidity; D005260:Female; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006801:Humans; D008607:Intellectual Disability / Q000453:epidemiology*; D008297:Male; D011329:Prisoners / Q000706:statistics & numerical data*; D012309:Risk-Taking; D019966:Substance-Related Disorders / Q000453:epidemiology*
keywords: intellectual disability; prisoner; risky behaviour; substance use