More than 30 years on from the Royal Commission into Aboriginal Deaths in Custody (RCIADIC), the Federal Government’s continued failure to fully implement the Final Report’s 339 recommendations has led to further preventable First Nations deaths.
The Royal Commission into Aboriginal Deaths in Custody (RCIADIC) 1987-1991 was established in response to growing public concerns that Aboriginal and Torres Strait Islander deaths in custody were far too common and poorly explained. The Commission examined 99 deaths that occurred in custody between January 1980 and May 1989. The manner and circumstances of each death were investigated and reported on, as well as broader investigations into the social, cultural and legal factors that may have contributed to the deaths.
The Final Report, released in April 1991, concluded that First Nations peoples had a higher chance of dying in custody simply because they had a higher chance of being in custody. A central finding was that continuing conditions of over-representation of First Nations peoples in prisons had their ‘origins in structural, systemic injustice to a disadvantaged minority rather than in a propensity in this group to increased criminality’. In other words, what differs is not the behaviour of First Nations peoples compared to non-Indigenous people, but the discriminatory and violent ways in which they are treated.
The report’s 339 recommendations fall into two main categories:
The recommendations noted the importance of including Aboriginal and Torres Strait Islander peoples and their voices in all matters. Such recommendations included: policy development, criminal justice matters, and the operation of crime prevention programs to ensure that they are culturally relevant and safe.
The report also outlined that certain aspects of the criminal justice system needed significant improvements, including policing practices and support (or lack thereof) for First Nations peoples once they are in contact with the criminal legal system.
Since the release of the RCIADIC Final Report, more than 600 First Nations people have died in police or prison custody. In fact, since 2007 First Nations deaths in police custody have doubled, with the highest number of annual deaths in custody since 1980 taking place in the period between July 1, 2022, and June 30, 2023, when a total of 21 First Nations people died while incarcerated and a further 10 people died in police custody.
Detailed reports on deaths in police and prison custody can be found here.
RCIADIC Reviewed
In 2018, the Australian Government commissioned Deloitte to conduct a review on the implementation of RCIADIC’s recommendations. Deloitte found that 64% of the 339 RCIADIC recommendations had been fully implemented, 30% had been partly implemented, and 6% were not implemented at all. Deloitte asserted that the Government had taken a leap forward in contributing to better policy-making and improved outcomes for First Nations peoples. The report concluded that the Government had made improvements in including First Nations people and their perspectives in the development of policies and the operation of programs and institutions to ensure they were culturally and socially sensitive.
However, the Australian National University’s Centre for Aboriginal Economic Policy Research (CAEPR) stated that the methods of the Deloitte Report’s findings substantially overstate the progress made toward implementing RCIADIC recommendations. The Federal Government’s continued reliance on the Deloitte report’s findings has justified the inaction around preventing further deaths in custody. In this respect, the Government has failed to take the necessary leadership to coordinate RCIADIC’s implementation across jurisdictions, thereby directly contributing to increasing First Nations incarceration rates.
REMEMBER THEIR NAMES
WARNING: Aboriginal and Torres Strait Islander readers are advised that the following article contains names and descriptions of people who have died.
The following names are of First Nations people who have died in police or prison custody. Many of these deaths may have been prevented had the recommendations from the RCIADIC been taken seriously and comprehensively implemented. While the list below is not a full list of victims of the violence of Australia’s criminal legal system, the stories highlight the myriad ways in which Australia’s carceral systems of policing and detention disproportionately target and criminalise First Nations peoples, and often leads to their untimely deaths. For a more detailed list and coverage of First Nations deaths in custody until 2021, see The Guardian’s Deaths Inside project.
ANTAR recognises that despite differing levels of media coverage, each individual remembered here is more than a statistic or a name on a list. Each person was a loved member of their families and communities, and greatly deserving of justice. By telling their stories, we wish to focus not only on the injustices of their deaths, but on the systemic and structural issues which have yet to be appropriately addressed or remedied.
In compiling this list, we have considered individual deaths in custody through the parameters stated under Recommendation 6 of the RCIADIC;
The death, wherever occurring of a person who dies or is fatally injured in the process of that person escaping or attempting to escape from prison custody or police custody or juvenile detention.
Thomas “TJ” Hickey
In February 2004, 17 year old Gamilaraay boy, Thomas Hickey died in the hospital following interactions with Redfern police. Thomas died of injuries sustained when he came off his bike and was impaled on a metal fence. While inquest reports labeled the death as a freak incident, TJ’s family and other members of the First Nations community blame police for chasing the teenager to his death.
Ms Dhu
On 4 August, 2014, Yamatji woman, Ms Dhu, died in police custody in Western Australia with medical and police officers believing she was ‘exaggerating’ or ‘faking’ her pain. After being arrested for unpaid fines, she suffered from septicaemia and pneumonia caused by an infection in a rib broken in a domestic violence incident weeks prior to her arrest. The coroner found that police behaviour toward Ms Dhu was affected by negative preconceptions formed about her and that Ms Dhu had suffered “unprofessional and inhumane” handling by police and “deficient” treatment from hospital staff.
Danny Whitton
25 year old Wonnarua man and doting father, Danny Whitton, died in November 2015 after an accidental drug overdose in Junee Correctional Centre. Despite displaying visible symptoms of pain and distress, correctional staff waited two days before taking Danny to hospital. While in prison, Danny was denied access to appropriate medication that would have given him pain relief and helped him survive, despite prison staff knowing he had previously relied on methadone while living in the community.
David Dungay Jr
In 2015, 26-year-old Dunghutti man, David Dungay Jr died in prison during restraining procedures being performed on him by guards rushing to stop him from eating biscuits. As part of such procedures, David was dragged to another cell, held face down using force by six guards, and repeated 12 times that he couldn’t breathe. Medical staff, including a doctor, failed for periods of up to eight minutes to perform basic CPR. More than 30 years ago, RCIADIC identified that the unnecessary use of force contributes to many First Nations deaths in custody and provided comprehensive recommendations to combat punitive behaviours of authorities that continue to go ignored.
Tanya Day
Yorta Yorta woman Tanya Day died 17 days after falling against a concrete wall in a cell of Castlemaine police station in December 2017 after being arrested for public drunkenness on a Victorian train. During the train journey, Ms Day was approached by a ticket inspector who said she was being “unruly”, lying with her feet blocking the aisle way. Other passengers report that they did not observe anything abnormal. Coroner reports found that the significant head trauma Tanya experienced was preventable had she not been arrested and taken into custody. Staunch advocacy from Tanya’s family resulted in the decriminalisation of public drunkenness in Victoria in November 2022 as per RCIADIC recommendations.
Apryl Day holds a picture of her mother Tanya at a smoking ceremony in Kings Domain Park prior to a Coroners Inquest into Tanya’s death in police custody, 2019.
Tane Chatfield
Gomeroi and Wakka Wakka man, Tane Chatfield, died at 22 years of age from a reported suicide whilst on remand at Tamworth Correctional Centre in September 2017. In the 24 hours prior, he was found unresponsive in his cell, having been treated for a seizure and later placed alone in a cell with potential hanging points. Coronial reports found that Tane died as a result of self-inflicted hanging, and found the care provided to Tane the morning of his death as ‘inadequate’. The family of Tane Chatfield say they do not accept a coroner’s finding that he died of intentionally self-inflicted injuries.
Jonathon Hogan
In February 2018, 23-year-old Wiradjuri, Ngiyampaa and Murrawarri man, Jonathon Hogan died by suicide in his cell at Junee Correctional Centre. Despite having a history of mental health concerns and self-harm, Jonathon was placed in a cell with hanging points, and was given inadequate treatment for mental health issues prior to his death. Deputy NSW coroner Harriet Grahame said Mr Hogan’s death could not be treated as an “isolated tragedy” but must instead be understood in the context of First Nations social disadvantage and dispossession. Despite RCIADIC recommendations advocating for the removal of all hanging points, Aboriginal and Torres Strait Islander people continue to be placed in cells with known hanging points.
Nathan Reynolds
September 2018 saw 36 year old Anaiwan and Dunghutti man, Nathan Reynolds, die in custody following a severe asthma attack. Despite inmates calling for help during the asthma attack, it took 10 minutes for guards to arrive and a further 22 minutes for nurses to respond. Coronial inquests found that the unreasonable delay of medical care reduced Nathan’s chances of survival, which were due to numerous system deficiencies and individual errors of judgement.
Chris Drage & Trisjack Simpson
In September 2018, Chris Drage and Trisjack Simpson drowned in Perth’s Swan River whilst fleeing police. Two officers started chasing the boys following reports of “teenagers jumping fences”. Reports suggest that the river conditions that day were difficult and the tide would have been extreme. Both Chris and Trisjack had previous experience dealing with the criminal legal system. Junior officers, who ‘could not remember their cultural safety training’ were on patrol that day, both of whom had either had been on probation, or had recently stepped out of probation.
Veronica Walker
On 31 December 2019, Yorta Yorta woman, Veronica Walker was found dead in her prison cell after crying for help the night before her body was found. Arrested for shoplifting and subsequently denied bail, Veronica’s death is seen as a direct result of Victoria’s punitive bail system that was meant to punish perpetrators of violence. Although the RCIADIC recommends that bail legislation divert First Nation people from police custody, these laws have led to more women with minor offences being denied bail. WorkSafe Australia determined that no criminal charges be laid over justice officials or prison operators as there was “insufficient evidence” of any wrongdoing.
Kumanjayi Walker
Kumanjayi Walker died after being shot three times at close range in Yuendumu when two police officers went to arrest him in November 2019. The officers involved had mentioned in the coronial inquest that they were told to track down Mr Walker, who had supposedly cut off his ankle bracelet and fled back into the community. Concerns have been raised about the way police and health officials dealt with the immediate aftermath of the shooting, and their treatment of the community. The constable who was charged with the murder and granted bail, conceded that he was never before held to account for unprofessional conduct and the racist language that was normalised in the NT Police Force.
Brandon Rich
Wiradjuri man, Brandon Rich, died in December 2021 after losing consciousness during an altercation with NSW police officers. Capsicum spray, batons and further restraints were used to handle Mr Rich before he went into respiratory distress. Coroners determined that Brandon had passed away from the physical exertion and stress involved in the struggle with the officers, who were not wearing body-worn cameras (a requirement of NSW police).
Ricky Lee Cound
Ricky Lee Cound, a Noongar man, was 22 when he died from suicide in WA’s Hakea Prison in March 2022. Earlier that month, Mr Cound had been transferred to Hakea prison and placed on a specific management system used for monitoring prisoners at risk of self-harm and suicide. Despite calls from his family, and Ricky himself, he was placed in isolation for three weeks after contracting COVID. He had previously been held in his cell for prolonged periods due to staff shortages. Ricky’s family believes he did not receive the adequate care whilst incarcerated and his calls for help had been ignored by the prison staff.
Dannielle Lowe
In December 2022, Dannielle Lowe, died in Perth’s Wandoo Rehabilitation Prison after suffering from a suspected aneurysm. Danielle had mentioned weeks prior to her death that she had been experiencing heavy migraines, however was only given paracetamol and no further action was taken. She had repeatedly been told that her pain was “all in her head”.
Cleveland Dodd
In October 2023, 16-year-old Yamathi teen, Cleveland Dodd, died days after self-harming in the Unit 18 child complex in Casuarina prison. Coronial inquiries determined Cleveland threatened to self-harm eight times the night he took his own life, and had made prior requests for medical help. The threats of self-harm were ignored on the basis that young people can use them as “a mechanism to try and manipulate staff”. Despite RCIADIC recommendations to remove all potential hanging points in prison cells, damaged vents provided opportunities for this suicide to take place.
Jeffery Winmar
Noongar man, Jeffery Winmar died in police custody after losing consciousness when handcuffed in November 2023. Jeffery was pursued by multiple police units in Melbourne, including by sniffer dogs, when he started yelling for the dogs not to bite him. That said, there are significant concerns about this arrest, as there was only one body-worn camera in use despite several officers taking part in the arrest, after Mr Winmar suffered from a laceration in his liver.
Heather Calgaret
Yamatji, Noongar, Wongi and Pitjantjatjara woman, Heather Calgarett died in custody after being denied parole one month before she passed due to a lack of suitable accommodation. Although currently unsure of the reason for her passing, the coronial inquest into Heather’s death will consider the quality and cultural appropriateness of healthcare provided to Heather at Dame Phyllis Frost Centre, including whether certain medicine administered the day prior contributed to her death.
