Indigenous inmates in Victoria are dealing with distressing and confronting conditions in prison, the state's ombudsman has revealed.
A lack of input by First Nations people into health-related policy in jails has a devastating impact, the watchdog's report tabled in state parliament on Wednesday has found.
The findings made it clear Aboriginal people's needs were not being met despite government efforts to create community-led solutions, Ombudsman Deborah Glass said.
"Some of the things we heard were deeply confronting and distressing," she said.
"What we heard also reflected that for Aboriginal people, health is holistic and includes not only physical but mental, social, emotional, cultural and spiritual wellbeing."
Ms Glass said the level of family and cultural support Indigenous people have behind bars often has a direct impact on their health.
Major facilities were visited for the report along with prisons for women, remandees and inmates living with mental health issues.
The Dame Phyllis Frost Centre women's prison, the Melbourne Assessment Prison and Ravenhall Correctional Centre were visited during the investigation.
Stories of prisoner experiences included being unable to access drug use programs, being abruptly denied medications and having to resort to performing their own 'surgery'.
This involved one inmate using a pencil sharpener and tweezers to treat an ingrown toenail due to delays in seeing a doctor.
The report also detailed how Indigenous people said they suffered as a result of being unable to access mental health support.
Seeking help often made things worse as they would be placed in observation cells in inhumane conditions, according to the findings.
"Observation cells are usually monitored by camera and people in them wear no clothes, just a canvas gown or canvas blanket," the report said.
"Prison officers or health staff are required to sight people in observation cells at regular intervals.
"This is designed to prevent people self-harming but does not address their underlying distress or therapeutic needs."
Victoria's Department of Justice and Community Safety said many of the inmate interviews involved took place in May, before significant changes to healthcare provision in public prisons came into effect in July.
"Many of the quotes and case studies relate to experiences under the previous service model and/or providers and that a number of substantial changes have since been made," a statement read.
The Victorian Aboriginal Legal Service slammed the conditions detailed in the report and said prisoners' experience did not match government policy.
"It is particularly horrible that the government is not providing culturally safe services for Aboriginal and Torres Strait Islander people," the legal service's principal managing lawyer Sarah Schwartz said.
"It does not match their commitments to treaty and closing the gap.
"While there has been a lot of talk from the government, we haven't seen the changes on the ground which are needed to prevent deaths in custody."
Recommendations from the report aim to ensure Indigenous people are more involved in decision-making, policy and the healthcare delivery.
Ms Glass acknowledged previous reviews over the past several decades failed to resolve issues or people's experiences.
"These reviews made multiple recommendations to improve healthcare in prisons, some repeated over the years, and various governments made multiple commitments to implement them," she said.
"Yet little has changed, or at best, not enough."
