Mandy Wilson

Barriers and enablers to the provision of alcohol treatment among Aboriginal Australians: A thematic review of five research projects

INTRODUCTION AND AIMS To review the results of five research projects commissioned to enhance alcohol treatment among Aboriginal Australians, and to highlight arising from them. DESIGN AND METHODS Drafts of the papers were workshopped by project representatives, final papers reviewed and results summarised. Lessons arising were identified and described. RESULTS While the impact of the projects varied, they highlight the feasibility of adapting mainstream interventions in Aboriginal Australian contexts. Outcomes include greater potential to: screen for those at risk; increase community awareness; build capacity and partnerships between organisations; and co-ordinate comprehensive referral networks and service provision. DISCUSSION Results show a small investment can produce sustainable change and positive outcomes. However, to optimise and maintain investment, cultural difference needs to be recognised in both planning and delivery of alcohol interventions; resources and funding must be responsive to and realistic about the capacities of organisations; partnerships need to be formed voluntarily based on respect, equality and trust; and practices and procedures within organisations need to be formalised. CONCLUSIONS There is no simple way to reduce alcohol-related harm in Aboriginal communities. However, the papers reviewed show that with Aboriginal control, modest investment and respectful collaboration, service enhancements and improved outcomes can be achieved. Mainstream interventions need to be adapted to Aboriginal settings, not simply transferred. The lessons outlined provide important reflections for future research.

'My Journey Map': Developing a qualitative approach to mapping young people's progress in residential rehabilitation

Young people with substance misuse issues are at risk of harm from significant negative health and life events. Contemporary research notes both a historical failure to recognize the unique needs of adolescents, and the ongoing need for dedicated adolescent treatment programs and outcome measures. It is concerning that there is so little literature assessing the quality, availability, and effectiveness of adolescent-focused treatment programs, and no adolescent-specific measurement tools centered on a young persons progress in residential treatment. This article reports on the process of developing a qualitative approach to mapping progress in treatment over time. The research seeks to develop an approach that captures, at three points in time and from multiple viewpoints, the progress of young people in four residential rehabilitation services located in New South Wales and Western Australia, across several dimensions of the personal and social aspects of life. Our aim is to develop an approach that is accessible to the alcohol and other drug workforce, and that informs the development of a psychometrically robust quantitative measure of progress that is meaningful and useful both to practitioners and to the young people themselves.

“I Lost Me Visits”: A Critical Examination of Prison Drug Policy and Its Effects on Connection to Family for Incarcerated Young Men With Histories of Injecting Drug Use

Utilizing Bacchi’s poststructuralist approach, “What’s the problem represented to be?,” we critically examine how the “problem” of drug use in prison is represented within a key initiative—the Identified Drug User program (IDUP)—of prison drug policy in one Australian jurisdiction. We use two data sources for our analysis: interview transcripts of recently incarcerated young men (aged 19–24) with histories of injecting drug use and selected prison drug policy and program documents. We examine how the “problem” of drug use in prison is problematized within the IDUP and question commonly accepted ways of thinking that underpin the program. We explore the discursive and subjectification effects of problem representations which produce young men as “rational” and “choosing” and, at the same time, as “untrustworthy” and “deserving of punishment.” We highlight how these effects have consequences for young men’s connections to family while incarcerated which can work against the very issues the IDUP is trying to address. We make two claims in particular: that the IDUP produces harmful effects for young men and their families and that the harmful effects produced are, paradoxically, those the IDUP aims to avoid. Our analysis offers insights into how drug use in prison could be thought about differently, including suggestions that might reduce at least some of its adverse effects.

Using narratives to understand progress in youth alcohol and other drug treatment

Purpose – This paper aims to illustrate how narrative research techniques can be employed to promote greater understanding of young peoples experiences of progress in residential alcohol and other drug treatment.Design/methodology/approach – Narrative inquiry is used to explore client understandings of what characterises progress in treatment for young people attending a residential detoxification and a residential rehabilitation service in Perth, Western Australia. This article focuses on stories of progress collected through in‐depth qualitative interviews, observation and participation with clients of the two services, over a five‐month period.Findings – Analysis of data revealed that young people were able to vividly describe their progress through treatment, and their drug taking trajectories can be conceptualised along five stages. The authors prepared narrative accounts to illustrate the features characteristic of each stage as identified by the young people. These composite narratives, written fr...

‘You’re a woman, a convenience, a cat, a poof, a thing, an idiot’: Transgender women negotiating sexual experiences in men’s prisons in Australia

We examine the lived experiences of transgender women in Australian men’s and women’s prisons. We draw on Alice Ristroph’s sexual punishments framework to discuss the diversity and ambiguities of sexual experiences reported by participants, and argue for a need to move beyond the dominant narrative of prison rape.

Violence in the lives of incarcerated aboriginal mothers in Western Australia

Drawing on in-depth interviews with incarcerated Aboriginal and Torres Strait Islander mothers in Western Australia, we report on the women’s use of violence in their relationships with others. Results reinforce that Aboriginal women are overwhelmingly victims of violence; however, many women report also using violence, primarily as a strategy to deal with their own high levels of victimization. The “normalization” of violence in their lives and communities places them at high risk of arrest and incarceration. This is compounded by a widespread distrust of the criminal justice system and associated agencies, and a lack of options for community support.

Narratives of Young Men With Injecting Drug Use Histories Leaving Adult Prison

This research focuses on an under-examined aspect of the post-release prison trajectory for a seldom-researched cohort. Narratives of the immediate days/weeks surrounding release were gathered from young men with histories of injecting drug use (IDU). Twenty-eight participants (aged 19-24) released from adult prisons in Victoria, Australia, participated in face-to-face in-depth qualitative interviews after release. Analysis of findings through the lens of a “risk environment” framework reveals how their experiences were compromised by risk factors embedded in the physical spaces and social situations they inhabited, as well as the multi-sectoral policy environments under which they were governed. A complex interplay between these factors, young men’s drug use and broader issues of structural vulnerability, including institutionalization and social disadvantage, combined to limit young men’s chances of “success”1 on the outside. Narratives provide evidence for interventions that transform risk environments into enabling environments, thereby promoting a more successful transition from prison to community for young men with IDU histories.