A group of volunteer inmates in the Red Cross’s Sisters for Change program is helping to transform the mental health and well-being of prisoners in Townsville Women’s Correctional Centre.
Cathleen* entered the Townsville Women’s Correctional Centre after having experience in youth justice and child protection systems.
Eager to make a difference, Cathleen joined the Australian Red Cross’s Sisters for Change program to become a community health volunteer and change-maker within the prison.
As part of her training, Cathleen embraced the opportunity to complete Mental Health First Aid, harm reduction, and behavioural change modules. She displayed a natural aptitude for the Aboriginal and Torres Strait Islander Mental Health First Aid® (MHFA™) program, which became an integral part of her journey.
Equipped with the skills to provide practical support to her peers, Cathleen actively participated in group workshops, prisoner-led projects and initiatives to foster cultural well-being, bringing positive change into the lives of the women around her.
After she was discharged, Cathleen relocated to outback Queensland where she found work in the mining services industry and continued applying her skills as a Mental Health First Aider™. Beyond providing on-the-spot support and care to colleagues during this time, the mental health first aid skills Cathleen learnt in Townsville proved invaluable. It was when Cathleen approached a suicidal peer that she realised the incredible power that these skills could have in saving the life of someone she cared for.
Cathleen is now a proud ambassador for mental health. Her commitment to providing support remains an integral part of her life, serving as a role model for her siblings, extended family and friends and as she continues her volunteer journey with the Australian Red Cross.
Cathleen shares her inspiring story – occasionally on a public stage – advocating for mental health and emphasising the positive impact of the Sisters for Change program and MHFA training on the women in Townsville’s Correctional Centre, recalling first-hand the power a mental health first aid conversation can have in helping to save a life.
Peer support: an answer to increased mental health risks and challenges
Many people in custodial settings grapple with mental health problems and illnesses, with prisons often bringing together people with complex trauma histories. Separated from family, children and their support systems in community, prisoners can face elevated mental health risks while in incarceration – which, for many, can be the lowest point in their lives.
People entering these custodial settings are already at a higher mental health risk, with two in five Australian prisoners reporting on entry that they had previously been told they had a mental health disorder (AIHW 2022).
Despite these increased risk factors, prisoners often face an array of challenges when trying to access mental health support. Rachel Montgomery, Team Leader of Community Justice and Partnerships at the Australian Red Cross, understands that the unique challenges in custodial settings can hinder efforts to access help.
“There are few support services available inside, with very few counselling or therapeutic services, no Indigenous health workers, little mental health promotion or information, and little access to health workers generally.”
“With no Medicare coverage or NDIS system operating inside, the prison health service is often under pressure and in high demand, and can be challenging to navigate.”
This is where the Sisters for Change program steps in, offering peer support networks as a supplementary approach to raising awareness of health and mental health issues and connecting people with professional support services.
Part of the International Federation of Red Cross’s flagship health promotion initiative Community-Based Health and First Aid (CBHFA), the Sisters for Change program empowers incarcerated women to advocate for health promotion and harm reduction. Known as ‘Sisters for Change’, these volunteers dedicate their time in incarceration to supporting others around them.
On entry into the program, the volunteers undertake a comprehensive suite of training courses to focus on self-development and equip them with the skills to make a real difference in the prison community. Amongst these courses is the Aboriginal and Torres Strait Islander Mental Health First Aid® training that aims to improve mental health support for the prison’s First Nations population.
There are currently 24 Sisters for Change in the Townsville Women’s Correctional Centre, who are helping to transform the lives of and drive positive change for their population of 250 prisoners.
“It was essential to look at how the courses might need to be adapted to a centre with a significant over-representation of First Nations women. It was essential that the training modules and implementation approach was engaging and accessible for First Nations participants and had cultural perspectives embedded throughout all the core competencies.”
Rachel Montgomery, Team Leader of Community Justice and Partnerships, Australian Red Cross
Developing a culturally informed and impactful training program
In 2019, the local program implementation team for the Townsville Women’s Correctional Centre reviewed its program to ensure it reflected the unique needs of its population, which has an over-representation of Aboriginal and Torres Strait Islander women.
Across the country, Aboriginal and Torres Strait Islander people represent 3.8 per cent of the Australian population, yet account for 32 per cent of all prisoners. This disproportionate representation increases significantly in the Townsville Women’s Correctional Centre, where 60 per cent of inmates are Aboriginal and Torres Strait Islander women.
In identifying the right training programs for the centre, Rachel says it was integral that targeted, culturally informed support was made available to these women.
“It was essential to look at how the courses might need to be adapted to a centre with a significant over-representation of First Nations women. It was essential that the training modules and implementation approach was engaging and accessible for First Nations participants and had cultural perspectives embedded throughout all the core competencies.”
As the implementation team introduced stronger requirements for a culturally informed and safe training program, they updated their health and well-being framework to ensure initiatives would consider culture, family, community, Country and spirituality from an Aboriginal and Torres Strait Islander perspective.
The implementation team turned to Mental Health First Aid Australia, recognising that its targeted Aboriginal and Torres Strait Islander MHFA course would support the demographic profile of the correctional centre.
“Importantly, it delivered all of the content through the lens of culture, embedding First Nations stories and perspectives and using images of Indigenous artworks within the material,” Rachel reflects.
In addition to the culturally informed material, the course would comprehensively cover a range of mental health problems experienced by people both in custody and community. Participants would learn to recognise and respond to mental health illnesses such as depression, anxiety, suicide, self-harm, psychosis, and alcohol and other drug problems, as well as referring their peers to formal and informal supports and encouraging positive action and awareness.
The program’s focus on peer support aligns perfectly with the Mental Health First Aid Australia ethos of community-led care, making the volunteer inmates ideal candidates to become Mental Health First Aiders equipped with the skills, knowledge and confidence to recognise and respond to mental health problems within the centre in a culturally safe and inclusive way.
Peer support model drives change for prisoners
Within the first year of introducing the Aboriginal and Torres Strait Islander MHFA course into the Sisters for Change program in 2019, 24 incarcerated volunteers became trained MHFAiders. Participant feedback was so positive that the program quickly expanded to include custodial officers at the recommendation of the original participants. More than 60 women have now become Aboriginal and Torres Strait Islander MHFAiders providing peer support to women in the centre and taking increased knowledge and skills back into their families and communities, post-release.
“Training people living and working in custodial settings in Aboriginal and Torres Strait Islander Mental Health First Aid provides immense benefits to inmates, staff and the centre.
“Volunteers develop so much insight and understanding into mental health and can now better understand how mental health issues have affected them, their families, the people around them, and society in general.”
Having the course delivered by an experienced and knowledgeable Aboriginal Instructor with roots in North Queensland made the material more relatable and de-stigmatising. The Instructor shared stories, experiences and connection to the local community, driving home many of the themes explored in the training.
Rachel says the Sisters for Change report being better equipped to respond to mental health problems and crises, feeling more confident in how they respond, and being more tolerant and understanding of those around them. The course handbook is now stocked in the prison library for others to reference the content and find cultural and professional supports.
Participant feedback has indicated just how valuable the knowledge and skills learnt in MHFA training can be.
“This course has equipped us with skills that we had never thought of, nor realised we needed,” says one participant. “The components have practical use in everyday life, and we have been able to use our learnt skills in many different scenarios in a prison setting where Indigenous people are overrepresented.”
Other Sisters for Change volunteers shared how the course expanded their understanding of their own mental health and well-being.
“Even though I had been in and out of mental health facilities in the 1990s and had my own understanding of mental health, this program taught me so much more – not just as a sufferer but also as a caregiver and support person. I am now equipped to help those around me to the best of my abilities.”
Mobilising an untapped resource in prisons
As culturally informed and accredited MHFAiders, the Sisters for Change meet regularly, and provide ongoing support to women in low-, medium- and high-security centres, as well as those in solitary confinement. Highly valued and respected by nurses, officers and their peers, the MHFAiders help fellow inmates cope during what is a difficult time in their lives and provide pathways to professional support.
Stories like Cathleen’s are showing how the Aboriginal and Torres Strait Islander MHFA training undertaken through the Sisters for Change program is helping the volunteers to not only change lives, but to save lives as well.
“This course has helped mobilise a great untapped resource in prisons – the prisoners themselves – to help drive change from the ground upwards,” Rachel comments.
“Without a doubt, embedding Aboriginal and Torres Strait Islander MHFA as part of the core module training has saved lives behind bars and in community.”
*Name has been changed to maintain confidentiality.
