Implementing Harm Minimisation

Program Title

Implementing harm minimisation (HM) strategies in the South Australian prison system.

Needs Assessment.

According to Kettner, Moroney and Martin (2008 p. 67), the identification of at risk groups is fundamental to any needs assessment. Holmewood & Rae (2003 p. 854) identify prisons as an at risk group. They state that imprisonment rates in Australia have steadily increased over the past decade and that prisoners have high rates of substance use and dependence, self injuriousbehaviours and infectious disease.

According to Kettner, Moroney and Martin (2008 p. 59) there are 4 different perspectives on need, they are:

Normative.

This is a need that is defined as falling below a standard or criterion established by custom, authority, or general consensus. Since the early 1980s the Australian government has funded a needle exchange program (NSP) which has gained recognition around the world for helping to curb the spread of HIV and hepatitis C among injecting drug users. This has created a standard by which the community has come to expect. (Medical news today 2006). When this standard is compared to the prison community it comes up short in that the government and prison authorities have yet to implement an NSP in its prisons, thus creating a need. Hence this perspective is incorporated into the needs assessment for this program.

Perceived.

This is a need that is defined in terms of what people think their needs are or feel their needs to be. This perspective can also be used to formulate the needs assessment. For example, if a person comes into the prison system as an injecting drug user (IDU) and have an addiction to drugs, then they could be forced to use a needle that has already been used. This behaviour would then place the person at risk of contracting a Blood Borne Disease (BBD) thus this person’s perceived need would be the use of a clean needle giving rise to the need of an NSP.

Expressed.

This is where a need is defined in terms of the number of people who actually have sought help. This perspective would require a historical approach/search for past needs identified. For example, ideally records should have been maintained of previous requests made for clean needles or condoms etc. However unfortunately, in terms of a prison community, the number of records sourced may be scant as there is a longstanding culture amongst inmates to not expose themselves as drug users within a climate that historically and presently maintains a zero tolerance policy (Mogg & Levy 2009 p.3).

Relative.

This is a need that is measured by the gap between the level of services existing in one