Megan Krakouer and Gerry Georgatos work extensively in the suicide prevention and trauma recovery spaces. Here they share their views on health inequality in the justice system.


There have been three unnatural deaths in one WA prison in the last year, two by suicide. All three of them were First Nations people—one aged 40, one aged 30 and one aged 19.

WA has 15 adult prisons and the worst custodial deaths record in the nation.

Since the Royal Commission into Aboriginal Deaths in Custody in 1991, 236 people have died in the State’s prisons. Of these deaths, 188 have gone through a coronial inquest and determinations and findings have been made.

Of the 188 deaths, 84 have been deemed unnatural—mostly suicides. This horrific unnatural death rate should have long ago brought about systemic improvements and protections. It’s as if a prisoner’s life does not matter.

Of the 236 people who have died in WA prisons since 1991, 74 have been First Nations. Non-Indigenous prisoner deaths are disproportionately higher but they do not account for the majority of unnatural deaths.

We must always ensure we disaggregate data in order to not discriminate by masking data. The younger a death, the more likely it was a First Nations life.

Jail should not breed health inequality and discrimination, but it does.

As soon as someone is jailed, they lose access to Medicare, the Pharmaceutical Benefit Scheme (PBS) and the National Disability Insurance Scheme (NDIS).

The loss of these health rights is killing people and maiming more. We must remind ourselves that the majority of the nation’s incarcerated are among our most vulnerable citizens.

According to the Australian Bureau of Statistics, eight out of ten prisoners have not completed secondary schooling and nearly 100 percent live below the Henderson Poverty Line.

It is a well-established fact that low income citizens have a higher likelihood of chronic and acute illnesses and comorbidities.

The custodial toll of unnatural deaths remains disturbingly high. The median age of unnatural deaths is less than 30-years-old.

In a civil society which argues for universal healthcare, denying prisoners access to healthcare is a human rights abuse. It is cruel.

It will take only minor amendments to the federal act to ensure all prisoners and detainees are protected with Medicare and the PBS as well as entitled to the NDIS.

Amending the Health Insurance Act 1973 will save lives by dramatically reducing health inequalities. Jail is punitive, it need not be a death sentence.

If Australia continues to deny quality healthcare to the incarcerated, it sends a message that the lives of the incarcerated do not matter.

Repairing the Health Insurance Act 1973 can be the simplest effort.

If you or anyone you know is struggling with mental ill-health, call or visit the online resources below:

By Megan Krakouer and Gerry Georgatos


Megan Krakouer is a Mineng Noongar woman from Mt Barker in Western Australia’s southwest. Presently, Megan is the Director of the National Suicide Prevention and Trauma Recovery (NSPTRP) and also works as a human rights legal practitioner for the National Justice Project.

Gerry Georgatos, the son of CALD migrants, is a suicide prevention and poverty researcher with an experiential focus. He has a Masters in Human Rights Education and a Masters in Social Justice Advocacy & Civil Rights Arbitration. He is the National Coordinator of the NSPTRP.