This month I have discussed traumatic brain injury among victims of domestic violence and brain injury in the homeless population. This silent epidemic also needs to be discussed in our prison population where according to the CDC, studies report anywhere between 25-87% of inmates having experienced a head injury or TBI. The CDC also reports female inmates who are convicted of a violent crime are more likely to have sustained a pre-crime TBI or some other form of physical abuse. And children and teenagers convicted of a crime are more likely to have had a pre-crime TBI or some other physical abuse
Traumatic brain injury may be both a cause and effect of being incarcerated. Besides brain injuries sustained before incarceration, prisoners may become victims of brain injury while incarcerated due to assaults and other causes.
These studies lead to the inescapable conclusion that all prisoners need to be screened for traumatic brain injury.
Why is this important? Because prisons present many challenges for individuals with a brain injury which may further complicate their period of incarceration including:
- Difficulty understanding and following directions
- Appearing to be slow or nonresponsive to staff requests
- Impaired memory which affects all aspects of confinement
- Impulsive behavior, and difficult controlling anger towards prison staff and other incarcerated individuals
- Severe depression and anxiety
- Suicidal thoughts
- And sensitivity to bright light and loud noises.
And if these issues are not addressed during their period of incarceration then discharge may be more difficult with an increased likelihood of return to prison.
Prison staff must be educated to the deficits and symptoms of traumatic brain injury so these individuals can be dealt with appropriately. This often means slowly repeating instructions, understanding why certain anti-social behavior takes place, and why rehabilitation rather than punishment is a more appropriate way of addressing an issue or problem.
And community re-entry programs, and re-entry staff should be trained to identify a history of TBI and have access to appropriate consultation with other professionals with expertise in Traumatic Brain Injury.
The advice and recommendations of the Centers for Disease Control to support new research to develop better methods for identifying inmates with a history of TBI and related problems, and for determining how many incarcerated individuals are brain injury survivors needs to be heeded.