Innovation in custodial health: How Indigenous businesses boldly go where others can’t
Professor Kerry Arabena
Managing Director
Introduction
Designing health care in prisons is never straightforward. Services have to meet the needs of individuals while dealing with the dynamics of the whole prison community. Mainstream providers tend to fall back on risk management and control, which leaves little room for new thinking. Indigenous businesses approach it differently. They bring cultural authority, lived experience, and holistic perspectives that open up space for new models of care.
At Margoneet Prison in Victoria, Karabena Consulting worked with VACCHO, VAHS, corrections staff, and Aboriginal men in custody to explore what an Integrated Aboriginal Justice Health Model (IAJHM) could look like.
Key innovations explored
Family at the centre
One of the strongest ideas was to treat family, not just the individual prisoner, as the unit of care. Aboriginal men described how the wellbeing of their partners, children, and Elders shaped their own health and behaviour inside.
The draft model built protocols to strengthen family connection: support around visits, more flexibility for cultural responsibilities, and recognition of how stress at home carried into the prison environment. Staff noticed that when family contact was supported, men were calmer and less volatile, particularly after visits.
Continuity of care beyond the gates
Release is one of the most vulnerable points in the prison journey. Health care and support often end the moment someone steps outside the gate. The Margoneet design work tested a different approach, one that connected men with Aboriginal community-controlled health services before release so medical care, mental health support, housing, and cultural programs could continue without interruption.
This planning reframed release as preparation for reintegration rather than a bureaucratic checklist. Men said knowing they had an appointment with a community health worker or Elder after release reduced the fear of “going back out there with nothing.”
Lived experience peer support
Some of the most powerful changes came from men inside taking on structured peer support roles. Aboriginal men acted as mentors and peer workers, running sessions throughout the week:
Mondays: debriefing after weekends, when tensions were often highest
Tuesdays: sessions on social and emotional wellbeing
Fridays: preparing for family visits and managing weekend pressures
These sessions gave Aboriginal men responsibility for shaping the climate of their units. Staff saw the difference with a reduced number of incidents, family visits going more smoothly, and officers recognising that peer workers can often set the tone more effectively than they can.
Why Indigenous businesses are critical
Karabena Consulting had the legitimacy to hold this work. As an Indigenous business, it could convene diverse groups, translate lived experience into structured models, and ensure Aboriginal authority stayed central.
The Margoneet process showed that Aboriginal-led design moves beyond critique. It generated a concrete model that others could test and refine. The Integrated Aboriginal Justice Health Model wasn’t implemented, but it gave ACCOs and corrections staff a practical framework to argue for change.
Conclusion
Innovation in custodial health is about reshaping systems, not just tweaking programs. Indigenous businesses bring cultural authority, credibility, and agility to spaces where mainstream providers struggle to gain traction. The Integrated Aboriginal Justice Health Model points to what’s possible: integrated, family-centred, and peer-led approaches that can transform health care inside the justice system.