Deborah Fortescue of the Disabilities Trust Foundation writes about the ‘silent epidemic’ of brain injury.
It is estimated brain injury and the resulting long term disability may affect at least 1 million people in the UK. Yet, Brain injury often goes unrecognised, undiagnosed and unsupported due to a lack of awareness and recognition within society. Even when ‘mild’ in nature, brain injury can damage the parts of the brain that control memory, communication, anxiety and aggression. If left unsupported, seemingly small impairments, coupled with mental health issues and addiction issues, can lead to a series of poor judgements and can result in problems sustaining a job, home or relationships.
Brain Injury in Prison Populations
Given its possible link to social exclusion, the Disabilities Trust Foundation undertook the largest study in the UK on the prevalence of brain injury within an adult male prison. Carried out at HMP Leeds, initial research findings published in November 2012 showed that almost half of adult male offenders (47%) had a history of brain injury[i]. Of those, 63% reported that their first Traumatic Brain Injury (TBI) happened before their first offence, and 30% had experienced more than five TBIs. Because of this finding, the Disabilities Trust Foundation has set up a service within HMP Leeds providing screening, training and support programmes to look at the over-representation of brain injury within this group.
Supporting Offenders with Brain Injury
An NHS approved assessment tool, developed by The Disabilities Trust Foundation called the Brain Injury Screening Index ©, is used to screen all offenders entering HMP Leeds, to identify those who may have an acquired brain injury. Positively identified offenders then work with the Foundation’s ‘Linkworker’, to deliver person-centred rehabilitation and develop partnerships with health, probation, homeless, and drug and alcohol services to ensure each individual has an appropriate support network in place.
Carolyn Lund, Acting Governor, HMP Leeds said: ‘We’re used to people being complex and having a whole range of needs that are challenging to address but the dedicated Linkworker means that all staff have someone to turn to for advice.’
National Recognition
Brain injury among offenders is beginning to be addressed on a national level. The HMP Linkworker service has led to inspectors routinely asking prisons what services they have in place for offenders with brain injuries. The Foundation has also taken a leading role in advising NOMS, Department of Health and NHS England on intervention, liaison and diversion strategies for offenders with brain injury.
Next steps
Supported by The Barrow Cadbury Trust, the Foundation is now evaluating the Specialist Brain Injury Linkworker service within the youth justice system. Replicating the HMP Leeds model, a study at HMYOI Wetherby will evaluate whether routine screening, increased awareness, staff training and tailored support reduces recidivism among brain injured offenders.
Working with Professor Huw Williams, a renowned expert in the area of brain injury and author of the Barrow Cadbury Trust-funded T2A (Transition to Adulthood Alliance) report, Repairing Shattered Lives: Brain injury and its implications for the criminal justice system, the 12-month study will conclude with the publication and dissemination of an impact evaluation report.
Professor Huw Williams will be investigating the scale of the problem, looking at preventative action and improving detection and management of brain injury in the youth justice system in a follow up to this blog in March.
This blog is an abridged version of an article which was published in Criminal Law and Justice Weekly