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systematic literature review with inclusion method

systematic literature review with inclusion method


Aboriginal  and Torres Strait Islanders deaths in custody is a social and political issue in Australia, this is the research question of this study. According to Dickson et al. (2019), the circumstances of female deaths are different than those of male deaths and the custody of good order crime is high in the case of indigenous women. Even the rate of indigenous population deaths in custody was 8 times high than that of the population those were not indigenous. The indigenous population was at high death risks and many factors like clinical and socio-historical posed a high risk for their deaths. However, injuries, behavioral disorders, parasitic diseases, and few more were the key reasons for their hospitalization that might result in their deaths in severe cases (Dickson et al., 2019).

The methodology used in this study is systematic literature review with inclusion method. The various keywords that have been used for the given study are as follows:

  death in custody, Aboriginal and Torres Strait Islander, death in Australia in custody

The articles are critically appraised using the CASP checklist and then selected for the literature review part mentioned below to review the literature about the indigenous custodial death in Australia. The critically appraising skills help us to assess the relevance, creditworthiness, and findings of published papers. The few of the Boolean operators that have been employed are OR, NOR, AND, for the selection of the below-mentioned literature review part. The literature review is important to the research question as it provide the evidence of indigenous population deaths in custody.


Literature review

According to the study of Walsh & Counter (2019), a documentary analysis was conducted on the reports on custodial death from 1991 to 2016. They performed a qualitative analysis of the reports that have information like causes of death, features of dead people, place territory of their death, and custodial forms or types. They did a content analysis on each report and the coding categories were refined. They found Australian states differ in their practices of reporting, and details on custody deaths were difficult to get access to. The limitation was using the information provided in coroners’ reports only and this manner of collecting data might miss the useful data that could be obtained from other resources. The strength of this study was, the authors developed a coding dictionary with limited possible values for variables to get precise and reliable data.

According to Willis et al., (2016), the study aimed at identifying all types of female deaths during the custody period. The objective was to have a specified focus on the characteristics and circumstances of female deaths in Australia from 1980-2000. The paper did a statistical analysis of male and females case studies that died under custody in Australia including the manner and cause of death. The authors found that the circumstances of female deaths are different than those of male deaths and the custody of good order crime was high in the case of indigenous women. The limitation of this study was the small sample sizes. The strength of this study was analyzing 5 extra case studies of Indigenous and non Indigenous population to get more comparative insight into the custodial deaths.

According to Austin et al. (2017), the study aimed at identifying the reasons for death in custody in SA to decrease the characteristics of such cases. The authors did an electronic and manual search of pathology files and conducted statistical analyses. The authors found that more deaths occurred just after the arrest, during the time of sentencing periods, and 8 times more deaths occur in prison in SA than in the general Australian community. The strength was only those cases were considered that showed statically significant values. The limitation was the use of GraphPad prism for analysis that resulted in an unbalanced design that cannot handle missing values during statistical analysis.

According to Favril et al. (2017), the study aimed at estimating suicide attempts among aboriginal prisoners. They conducted a telephone survey with a cross-sectional design and the selection of participants was random. The authors found that aboriginal prisoners committed more suicides than non-aboriginal prisoners and the suicidal ideation included depression, violent offending, and few more. The use of large sample sizes with random selection reduces the chances of bias studies and this came out as strength for this study. The limitation was the use of telephonic interviews instead of face to face interviews.

According to Shepherd et al. (2018), their study aimed at correlating the suicidal behavior for indigenous males under Australian custody. An interview was conducted to obtain data on environmental stressors, suicidal behaviors, and socio-demographic information. They found that the indigenous population was at high death risks and many factors like clinical and socio-historical posed a high risk for their deaths. Voluntary participation and statistical analysis were the strengths of the study to get reliable and unbiased data. The limitation included - lifetime suicidal ideation had no significant predictors because additional predictors were not allowed due to the sample size.

According to Armstrong et al. (2017), the study aimed at examining the extent of any discrepancy between non-indigenous and indigenous male prisoners, and the objective was to compare the generality of thoughts of suicide and attempts between non-indigenous males and indigenous male prisoners in Australia. The authors did a statistical analysis using chi-square tests for the sample. They found that the indigenous community with adulthood population was at high death risks. The strength and limitations included the large sample size and a major focus on gender-based data collection respectively.

According to Klippmark & Crawley (2017), the study focused to recognize the factors related to indigenous children's suicides. The authors performed statistical analysis of data collected in IBM SPSS Statistics 21. They found that the rate of indigenous population deaths in custody was 8 times high than that of the population that were not indigenous. The strengths and limitations include- the study also focuses on mental and socio-behavioral factors and the causes of the population in the data from ABS Census9 were chosen where ethnicity was not stated respectively.

 According to Stewart et al. (2018), the study aim at identifying the chances of suicide attempts in prisoners. They surveyed baseline interviews for data collection with quantitative analysis. Their findings were that prisoners aged 30 - 39 years had more chances to have a history of NSSI as compared to prisoners with the age of 40. The strength was the use of cross-sectional analysis to reduce biased results. The limitation was that the authors were not able to establish temporality between outcomes and correlates.

According to Lloyd et al. (2017), this study aimed to identify non-Aboriginal and Aboriginal ex-prisoners’ risk of rehospitalization and hospitalization. The authors conducted the multivariate and univariate analysis for dependent variables. They found that injuries, behavioral disorders, parasitic diseases, and few more were the key reasons for their hospitalization that might result in their deaths in severe cases. The strengths were linked data analysis, in-depth interviews, and systematic reviews to get more insights for the study. This study had a limitation that the cognitive disability rates were more in the indigenous population than the general former prisoner population.

According to Heffernan et al. (2016), the study aim at describing the mental health correlates of substance use disorders in incarcerated Indigenous Australians. They conducted a cross-sectional survey with face to face interviews to collect data and the assessments were made via a diagnostic instrument and questionnaire. The authors found that the chances of suicide attempts were more in the indigenous population while they were in custody. The strength was the use of face to face interviews to collect data instead of telephonic interviews. The limitation was using CIDI this resulted in bias for the culturally-based measurement.

According to Larney et al. (2015), the study aimed at describing the deaths in prison in opioid-dependent prisoners. The design of this study was a retrospective cohort study and statistical analysis was performed. The authors found that the death rate of opioid-dependent prisoners was low after the receipt of OST because opioid substitution therapy (OST) decreases death risks in custody inside the prison. The strength was a large sample size that results in less biased or no business with reliable findings and the use of statistical analyses provided reliable results. The limitation was - the cohort members were selected on a biased selection not randomly.

According to Stoliker et al. (2020), the study aimed to estimate the generality of attempts of suicide and suicidal ideation among aboriginal prisoners. For this study cross-sectional design was used. The sample was selected randomly who completed a telephonic survey. They found that women aboriginal prisoners had more chances to have suicide attempts and suicidal ideas in comparison to aboriginal men. This was because the women were more exposed to trauma, anxiety, and stress than men in custody. The limitation was the use of telephonic interview that might result in the less-depth study and biased results. It is considered that if the authors chose telephonic methods for data collection then in that way they save their time but at the risk of effective outcomes of their study.

According to Dickson et al. (2019), the study aimed at investigating the generality of suicide ideation and suicide attempts among Aboriginal and Torres Strait Islanders in Australia. The data was collected from online databases. The findings were risks for self-harm, suicide attempts, and deaths were more in indigenous Australian prisoners than the non-indigenous prisoners. The limitation was the exclusion of qualitative analysis that would have helped in providing more knowledge about the factors that lead to prisoners died in custody. The strength was the use of the narrative synthesis tool to reduce the risk of biases in the study.

According to Gaggioli & Elger (2016), the article aimed at the causes of death in custody. The study performed retrospective collection and the collected data of deaths in police and custody was analyzed. The authors found that most of the deaths were because of the disease of respiratory or circulatory systems and self-harmful behavior. The strength of this study was the comparative analysis of death in males and females along with their reasons for death. The study used a retrospective method that has limitations of being more prone to give biased results and provide inferior levels of pieces of evidence.

According to Lloyd et al. (2015), the study aimed at considering the pieces of evidence for the mental health status of indigenous prisoners. The authors did a systematic review of various articles and analyzed them for relevant abstracts. The authors found that the indigenous population had very high rates of incarceration and they also showed a high rate for mental illness. The limitation was the study included limited data on types of mental health issues on the indigenous population in custody.

According to Radford et al. (2015), the study examined the issues of health care provided to Aboriginal and Torres Strait islanders population in custody. The study collected data from already published articles. The authors found that old age health issues like dementia leads to deaths of old age population in custody. The limitation was limited sources were chosen by the authors because they faced difficulty in access to the published articles and selecting the relevant ones.

According to Wilson et al. (2017), the study aimed at the use of violence against aboriginal women in Australian prisons. The data was collected by using face to face interviews taken by 3 female interviewers. These face to face interviews enabled the authors to have a comprehensive understanding of the topic and study and get in-depth data collection. The authors found that women had been exposed to violence at high rates. Moreover, the facial expressions and body language can also be briefly examined. The limitation was the selection of only those women who were exposed to violence thereby making it a biased study.

According to Le Grande et al. (2019), the authors aimed at cardiovascular risk factors among male smoking prisoners. They involved only male prisoners from different prisons and the data collected were statistically analyzed. The authors found that the aboriginal population in prisons is more at risk of developing cardiovascular diseases than those of non-aboriginal populations. The limitation was the study did not include the other risk factors for cholesterol, blood pressure, or diabetes. The advantage of using statistical analysis was that it enabled the authors to identify trends and the results obtained are more reliable.

According to Thomas et al. (2015), the study focused to recognize the health-related factors that were forecasters of re-incarceration in the aboriginal population. The authors collected data by selecting participants that were prisoners and conducted a written questionnaire with them. The findings included obesity, sedentary behavior, and chronic disease that were found to be associated with health risk factors for prisoners. The limitation of this study was the reliability of self-report measures by the authors that made this study a biased one. In self-reported answers, the participants might not reveal out the information as they might feel embarrassed and the answers can be exaggerated, but the advantage of such reports is they are easy to obtain. 

According to Rogerson et al. (2015), the study's goal was to compare the smoking and alcohol characteristics of aboriginal and non-aboriginals prisoners. The study was a descriptive one with a cross-sectional analysis of data collected by self-report instruments. The findings included that aboriginal prisoners are more exposed to smoking posing a threat to health. The strength was it was a volunteer prisoner’s recruitment during data collection. The limitation was reliability on self-reports that made the study imprecise one, this is because self-reported answers can be exaggerated, the participants might not reveal out the exact information as they might feel embarrassed.





The research gap between the literature reviewed and the research question was the custodial death of indigenous population was studied more in Australia inside prison, but death also occur in rest of the part of the world outside custody/prison, that needed to be researched more. Moreover, these population also face discrimaination resulting in their deaths in general life that needed to be researched. It was also found that the indigenous population is more chances of deaths or suicides than the non-indigenous population (Le Grande et al., 2019). All this detailed information obtained through collecting data from various articles provided with various reasons and factors that lead to custodial deaths and also tells us about the points to keep in mind while carrying out any study to avoid limitations or biases and strengthen our study. Moreover, for this research 25 articles were viewed but as past 5 years old were chosen, so out of 25, only 20 got selected from reliable resources.


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