Care in custody

Editorial and photography: Jesse Wray-McCann

After a nursing career in war-torn South Sudan, rugged outback mining towns and a hospital emergency department in Scotland, Katelouise Howard was more than prepared for work in Victoria’s custody system.

The Custodial Health Service (CHS) nurse has always been drawn to caring for people at their most vulnerable, and even at their most hostile.

When Ms Howard was just a few days into a general nursing stint at a medical outpost in outback Western Australia, an Aboriginal man arrived for help but became aggressive and ended up pointing a bone at her, a practice that is said to mark the victim with a death curse.

“I just told him, ‘That doesn’t work with me. Do you want help or not?,” Ms Howard said.

So these days, when Ms Howard is dressing wounds or administering medication to people awaiting their court cases in the cells below Melbourne Magistrates’ Court, she knows how to handle people in an agitated state.

“It’s a conflict environment that we work in, because they’ve just been arrested and don’t know what their lives could look like after their court case,” she said.

“And I’m used to that kind of conflict, because I’ve always treated vulnerable people.”

But Ms Howard maintains that working with offenders and defendants in CHS is safer than working in hospital emergency departments.

“It’s a different environment but it’s not as scary as I thought it would be,” she said.

“We’re really well supported and there are always two guards with you.”

Made up of four doctors and 20 nurses, CHS is Victoria Police’s round-the-clock health support service responsible for the health and human rights of people detained in police custody.

A/Insp Guin Cleminson, Custodial Health Service nurse Katelouise Howard and custody officer Abdul Mohamed.

Ms Howard and her colleagues provide direct help with general medical conditions, mental health conditions and drug and alcohol issues to people in custody, while also giving expert health advice to police officers and Police Custody Officers managing cells around the state.

Ms Howard said by treating people in custody and managing the stresses that influence their behaviour, she is also helping the court system function effectively and getting better outcomes for the community at large.

“We don’t know their legal situation and we don’t need to know,” Ms Howard said.

“When they see that someone is caring for them and listening to them, it goes a long way to getting a better result for everyone.”

CHS’s Acting Chief Custodial Health Officer Dr Michael Wong said Ms Howard was an asset to CHS and Victoria Police.

“Our team is not judgemental, never holding back on caring for someone because they’re in custody,” Dr Wong said.

“We can sometimes deal with some really difficult people and potentially dangerous situations, but our team never loses sight of that care focus.”