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Background Studies of the representation of people with intellectual disability (ID) in custody report widely inconsistent findings that reflect variation in how ID is defined and the methods employed for identification. Using linked administrative data may be of utility in studies of the representation of people with ID in custody. However, this approach requires an understanding of the purpose of and factors influencing identification in disparate administrative datasets. Methods This study uses linked administrative data encompassing disability, health and corrections data for the year 2014 to estimate the prevalence of ID in adult custody and explore how ID representation within administrative data impacts prevalence estimates and what patterns of identification reveal about support service access for this group. Results This study finds that 4.3% of the New South Wales adult custody population had an identified ID. Prisoners with ID were younger, more likely to have had a previous custodial episode and more likely to be Indigenous than the general prison population. Identification of ID across linked administrative datasets is uneven, which, if used in isolation, would result in variation in prevalence estimates according to source data. Conclusions The utilisation of linkage data from a broad range of health and support services including custody offers a comprehensive identification methodology. Inconsistency in the identification of ID across datasets indicates a potential disjuncture between prisoners with ID and support services, which may have relevance for efforts to reduce reincarceration of those in this population.

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Prisoners with an intellectual disability (ID) are an over-represented group in custody, with studies indicating this group is more likely to reoffend and be reincarcerated than the general prison population. While prisoners with ID share many of the same risk factors for recidivism as the general prison population, the lack of adequate disability support has been argued to be an additional key driver of recidivism for this group. This study aims to investigate reincarceration and factors associated with reincarceration after a first adult custody episode, including the impact of provision of general and specialist disability supports. The study used linked disability support services and custody data to identify a cohort of 1,129 prisoners with ID who were released from a first adult custodial episode in New South Wales (NSW) between 2005 and 2015. Over the follow-up period, the linked custody data showed that 72% (813) of those identified with an ID and released from a first adult custodial episode returned to prison, of which 76% (617) received no post-release disability support. This study found that 27% (308) of the study cohort had received a disability support service post-release from adult custody. Receipt of disability support was associated with a lower risk of reincarceration, while younger age and shorter duration of the custodial episode were associated with higher risk of reincarceration. The potential for disability support to lower risk of reincarceration highlights the importance of funding programmes that connect prisoners with ID to appropriate post-release disability supports.

Background Prisoners with an intellectual disability are overrepresented in custody and more likely to reoffend and be reincarcerated compared with the general prison population. Although prisoners with intellectual disability have many of the same risk factors for recidivism as the general prison population, the high rates of mental illness experienced by this group are key drivers of recidivism. Aims We aimed to assess the impact of provision of post-release disability and community mental health support on rates of reincarceration in a cohort with identified intellectual disability and serious mental illness diagnosis. Method We conducted a historical cohort study using linked administrative data-sets, including data on hospital admissions, community mental health, disability support and corrections custody in New South Wales, Australia (n = 484). To assess the time to return to adult custody, we used survival analysis on multiple failure-time data. Results Over the median follow-up period of 7.4 years, 73.7% (357) received community mental health support, 19.8% (96) received disability support and 18.6% (85) received a combination of supports during a post-release period from prison. Lower hazards of reincarceration in a post-release period were associated with receipt of community mental health support (hazard ratio [HR] = 0.58, CI 0.49–0.69, P < 0.001), or a combination of community mental health and disability support (HR = 0.46, CI 0.34–0.61, P < 0.001). Conclusions High rates of reincarceration for prisoners with intellectual disability and history of serious mental illness may be modifiable by provision of appropriate mental health and disability supports.