The death of a First Nations prisoner has highlighted the ongoing shortfall in culturally appropriate mental health care in Queensland jails, a coroner has found.

State Coroner Terry Ryan handed down his findings in Brisbane on Tuesday into the death of Frederick Row Row, a Kullili and Darumbal man, in a cell at Rockhampton's Capricornia Correctional Centre the day after his 34th birthday in 2016.

Mr Ryan said over-representation rates of First Nations people in custody have increased significantly in 30 years since the 1991 Royal Commission into Aboriginal Deaths in Custody.

More than one-third of adults in custody in Queensland identified as Aboriginal and/or Torres Strait Islander, while the Aboriginal and Torres Strait Islander imprisonment rate for those aged at least 18 was 14.5 times the rate for others, according to 2020 figures, Mr Ryan said in his published findings.

He noted it had been more than five years since Mr Row Row's death and Queensland Health's Office for Prisoner Health and Wellbeing - which aims to provide "culturally competent" services - had been established in response to a 2018 report.

"However, consultation with Queensland prisoners by the Office for Prisoner Health and Wellbeing in early 2021 identified that access to mental health treatment options remains a significant concern for prisoners," Mr Ryan added.

"I am not confident that the unmet need for culturally appropriate mental health interventions for First Nations prisoners identified in this inquest has been addressed in a significant way."

Mr Ryan said several initiatives already in place may assist with this and he would refer his findings to the Closing the Gap Partnership Committee for consideration.

In a submission to the inquest Mr Row Row's family called for targeted recruitment of male psychologists to provide more culturally appropriate services to First Nations prisoners and more and better cultural awareness training for staff.

The family proposed more funding to improve psychological and mental health services in prisons and allowing community-based providers into jails to boost services.

They also called for more and better training around risk assessment, especially relating to issues unique to First Nations prisoners.

Mr Ryan said some shortcomings relating to documentation about Mr Row Row's risk assessments had been rectified, while training and policy and procedure amendments had addressed others.

Capricornia prison allowing a door between cells and the adjoining exercise yard to be left open for up to eight hours a day - contrary to a practice direction - had been stopped since Mr Row Row's death.

Other local processes had also been reviewed to ensure compliance with practice directions and detention unit staffing boosted to ensure two staff members were always rostered.

Mr Row Row had been convicted of more than 120 offences, consisting primarily of property, motor vehicle and domestic violence-related offences.

Days before his death he punched another prisoner in the head several times after saying several inmates were "eyeballing" him.

He was immediately remorseful and concerned about the prisoner's injuries.

Mr Ryan found Mr Row Row had experience "significant and cumulative trauma and grief" but did not meet the criteria for ongoing mental health support in prison.

He was assessed as being at low risk of self-harm on August 23, 2016.

The following morning he was distressed before his mood seemed to improve considerably.

He took his life soon after an officer left to collect a meal trolley at 11.30am and was found within 20 minutes, but could not be resuscitated.

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