Predictors of Receiving Disability Support Services After Release From Prison in Adults With Intellectual Disability: A Population-Based Linkage Study From New South Wales, Australia

Background: Individuals with intellectual disability are often reported to be overrepresented in prison populations and to have higher recidivism rates compared to those without intellectual disability, although these patterns vary substantially between countries and jurisdictions. Receiving post-release disability support services have been associated with reduced recidivism, most likely through mechanisms such as improved housing stability, mental health and social integration. This study aimed to further this literature by exploring predictors of receiving disability support after release from prison in adults with intellectual disability. Methods: This retrospective cohort study analysed linked health and administrative data from New South Wales, Australia, to identify predictors of post-release disability support. Discrete-time survival analysis was used, incorporating variables such as age, gender, Aboriginal status and comorbid conditions. Insights from lived experience consultants with intellectual disability and incarceration histories were integrated to enhance our understanding of the findings and implications. Results: A total of 1868 individuals with intellectual disability were released from custody in New South Wales between 2005 and 2015 and included in this study. Of these, 49.1% received disability support services in the year following release. Older age, mental illness and substance use were associated with a lower likelihood of receiving support, whilst autism, history of self-harm and higher socio-economic status were linked to increased support. These findings are evident of ‘cycling’ (repeated incarceration), ‘complexity’ (overlapping needs), ‘acuteness’ (health service contact) and ‘resources’ (social and financial) effects in shaping access to post-release support. Conclusions: The findings reflect the challenge presented by the complex needs of those with intellectual disability who are justice-involved. The harmful and perpetuating nature of repeated incarceration for those with intellectual disability must be recognized and responded to. Targeted release planning is needed to improve disability support service receipt, particularly for those who have served long or repeated sentences and those with complex co-occurring mental health needs, with financial and social resource enhancement being ideal additional targets for intervention.