Expert calls for a new framework to support young offenders with brain injury

Fiona Summers, Chair of the BPS Division of Neuropsychology in Scotland and a consultant clinical neuropsychologist with NHS Grampian has called for further investigation into the rate of brain trauma among young offenders.  A picture of Polmont Young Offenders institute used to illustrate the article "Expert calls for a new framework to support young offenders with brain injury" Writing for the Scottish Herald, Summers cites various research including a study completed by Exeter University, all of which demonstrate the impact that a childhood brain injury can have on later life, including increased rates of offending.  She reports: “There are around 8,000 inmates in Scottish prisons; and work conducted at Exeter University has shown that around 60 per cent of prisoners, including both young and adult offenders, report they have suffered from a head injury at some point in their life. In addition, 45 per cent report being unconscious as a result of a head injury. These numbers represent about three to four times as many people compared to those with a head injury in the general population.”

What is traumatic brain injury (TBI)?

The result of an impact to the head. Examples might be a car accident or a fall. Healthcare staff will make the distinction between this kind of injury and ‘atraumatic’ or non-traumatic brain injury, which is the result of something like meningitis or a brain tumour. One way of thinking about it is to say traumatic brain injury is the result of things happening outside the body, such as a blow to the head. Non-traumatic brain injury is the result of things going on inside the body, such as a stroke or a lack of oxygen. You can read more about traumatic brain injury on our dedicated page here. TBI is the most common cause of death and disability in people under 40 in the developed world.
Summers argues that with reoffending rates high, associated costs rising and the government’s purse tightening, it is essential we focus on putting in place a preventative framework:
  1. Identification: children, young people and offenders who have had a TBI need to be offered support within school, work and local communities. This safety net can help to maintain stability, and avoid individuals affected by TBI “falling by the wayside” and “potentially engaging in various risky behaviours such as being in gangs or being involved in various criminal activities.”
  2. Understanding: where an individual has sustained a TBI all personnel involved in the criminal justice system (police, lawyers, judges, prison staff, probation staff etc) need to understand the potential impact and complexity of such an injury, the ways in which it can alter behaviour and the role that rehabilitation can play.
  3. Assessment: a new, nationwide system of assessment and treatment throughout the criminal justice system would ensure that offenders who have suffered a TBI would have their needs understood and rehabilitation put in place. Currently the system is disjointed: “offenders with a head injury are not having their needs assessed let alone met within the secure estate. These individuals fall through the cracks upon release into the community, where they may miss out on community brain injury rehabilitation input because of lack of continuity and communication between systems.”
  4. Rehabilitation: support for offenders with a TBI is currently limited, but this can make all the difference to the onward path of an individual: “For example, an offender who is impulsive and has a poor memory would benefit greatly from strategies on how to manage anger, stop using drugs and make constructive plans for the future.”
  Putting such a framework in place would give “clear direction to the prison service and NHS about how to best identify and manage brain injuries.” Summers argues that if we fail to do so “children and young people with head injuries are being failed” and we will “continue to see individual’s lives and billions of pounds wasted every year.”
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