Co-Design Case Study: 'I Can Do It - co-design to take control of ice use in jail'

The problem:

Did you know that Australia has the highest per capita methamphetamine use in the world? And illicit drug use causes significant harm in jail. In 2024, 54% of NSW prisoners used drugs in the 4 weeks before they entered custody. Drugs in prisons create a whole scope of issues – from racking up debt to violence and unsafe injecting.

In 2018 the Special Commission of Inquiry into the Drug Ice was created to investigate and advise on how best to tackle the growing Ice issue. The NSW Ice Inquiry highlighted an urgent need for better drug and alcohol services in prisons.

Our approach:

As a result of the Ice Inquiry, Justice Health NSW and the Ministry of Health’s Centre for Alcohol and Other Drugs (CAOD) engaged House of Kitch to update and create new content for the online Drug and Alcohol portal to provide improved resources for prisoners.

Clinical Consultation:

We conducted extensive consultations with clinicians who work directly with drug users in prisons to discover their pain points, mine their knowledge and identify gaps for the prisoners.

House of Kitch team members [LTR] Leigh Goldberg, Samara Kitchener and Victoria Mackinlay onsite during stakeholder consultations

To ensure everybody could attend and contribute, we used the online platform ‘IdeaFlip’ to collect every piece of input on virtual sticky notes for later analysis.

At this early stage, we also visited a maximum-security facility guided by the Nurse Unit Manager to gain real insights into the unique prison environment and challenges it presents.

Research:

House of Kitch conducted extensive research on global and local programs and expertise to tackle problematic drug and alcohol use. We dug deep into clinical and behavioural science, reviewed CBT resources and activities and listened to case studies to inform our approach.

Prisoner Consultation:

A lot of the most useful feedback and insights we received came from the multiple consultations we carried out with prisoners. We visited a variety of prison sites to ensure we could get input and feedback from a varied spread of demographics (male/female/Indigenous/non-Indigenous) and experiences.

Insights from prisoner focus groups

The prisoners provided excellent feedback and were very articulate in what they wanted and didn’t want and what would work and wouldn’t work. For example, in a first iteration of the workbook, we had included prisoner artwork from the Boomgate Gallery which featured realistic prison scenes. The prisoners expressed that they were in prison, and didn’t want to be reminded that they were in prison and would prefer to see escapist, natural images of landscapes and animals. We updated all the imagery in future iterations.

The prisoners also fed-back on which activities were useful and which weren’t so that we could add/remove content.

No mobile phones or devices are allowed in jails, but we were able to obtain special permission to bring in a dictaphone to record the consultations so that the feedback was reported accurately and could be actioned in all of the resources.

Creation of Online Content:

UX mapping of tablet content

Prisoners in NSW have tablets in their cells where they can access internal webpages only. The existing ‘Drug and Alcohol’ portal, which sits under the ‘Health’ section, had limited content and was written to a high literacy level with a lot of medical terminology.

We conducted a full review of the content and, through consultation, identified critical gaps in the information (for example information on drug withdrawal).

We restructured the site map to follow the user journey (so that prisoners in jail weren’t given Drug and Alcohol information and resources that are only applicable for when they are released).

Re-imagined tablet content

We then re-wrote the entire content to a literacy level of year 8, given the low literacy levels in prison. We used prisoner vernacular and slang, especially for drug names (e.g. we called Depot Buprenorphine, ‘Bupe’) so that the content could be easily read and understood.

Because of low literacy levels, and informed by prisoner feedback, we incorporated imagery, infographics and diagrams to present information in a visual way wherever possible.

Creation of Printed Workbook:

During the consultation process, House of Kitch identified a need for a self-paced printed resource to expand the reach of the BIG Program.

Prisoners valued having their voices and opinions heard and resources that authentically reflect their perspectives. In order for this resource to be well received and valued by some of the most vulnerable members of our society, from the outset, House of Kitch wanted to create a beautiful resource created with care and detail.

The written content was created to a literacy level of below year 8 and word count was severely limited to make the content easy to digest and not overwhelming.

We incorporated prisoner artwork from the Boomgate Gallery and had the workbook printed at the CSI prisoner printers so the prisoners were integrated into the creation of the workbook.

One of the main pieces of feedback received during prisoner consultations was that they wanted to hear from other prisoners and hear success stories from people who had overcome problematic substance use in jail. Throughout the book we weaved prisoner quotes and case studies to inspire and encourage reflection.

Content Review:

All created content was reviewed by clinicians and current and former prisoners to assess for clinical accuracy and language level. Multiple rounds of feedback were provided and content was updated each time to get it right.

Results:

House of Kitch re-wrote all existing pages of the Drug and Alcohol portal and created 45 pages of new online psychosocial and clinical based content and a complementary workbook based on CBT and behavioural science.

Prisoners commented on the high quality of the printed workbook and were very happy to see their feedback and quotes incorporated.

"I have done a lot of drug and alcohol courses. There has been nothing on this scale. This looks a lot more helpful. It's a lot more realistic too. It can show how you have progressed.” Prisoner at Dillwynia