Support and service provision for women with substance use issues exiting prison in Australia: findings from a 10-year retrospective cohort analysis

Purpose The purpose of this study is to inform gender-responsive policy and practice by investigating services and supports that women with substance use issues need when exiting prison. Design/methodology/approach This is a retrospective cohort study of women (n = 989 / 18%) and men (n = 4609 / 82%) exiting prison who engaged with the prison health program “Connections” in Australia between 2008 and 2018. Using pre-release assessment data, six re-entry variables were computed: substance use, mental health, housing, employment, social support and parenting. These variables represent areas of support/service provision that might be needed on release. Descriptive statistics were calculated. Associations between “re-entry support needs” and sex were estimated by multiple logistic regression, adjusting for potential confounders. Findings “Re-entry support need” was higher for women in housing (52% vs 46%), employment (88% vs 79%) and parenting (68% vs 60%) compared to men. Multivariate analysis found women also had increased odds of “re-entry support need” in these areas. Similar proportions of women and men were sentenced for substance-related offences (74.4% vs 75.3%), yet, twice the proportion of women were incarcerated for the first time (20.4% vs 8.6%), and double were sentenced to ≤6 months compared to men (44.3% and 22.9%). Originality/value This is a large-scale study of women’s re-entry needs on exiting prison, which is rare. The findings of this study indicate that gender-responsive policy/practice must account for women having higher level of need in housing, employment and parenting and ceasing the use of punitive short-term sentences. Gender-responsiveness requires addressing women’s social determinants of health and incarceration via policy, service provision and practice that will support women and address broader gender inequity taking an intersectional approach.