Between 50-80% of individuals in prisons and jails are estimated to have a traumatic brain injury (TBI). Behind these statistics are people unjustly punished for injuries that went unseen. This prevalence is five times higher than in the general population. Yet, there is a consistent issue of lack of diagnosis, treatment, and aid provided to these individuals.

A traumatic brain injury (TBI) occurs when an external force damages the brain. A blow to the head, violent shaking, or a fall can cause such an injury. Factors like impulsivity, substance use, and violence increase the risk of both brain injury and incarceration, revealing a complex overlap of vulnerabilities. Once incarcerated, individuals face a risk of traumatic brain injury that is up to 50 times higher than that of the general population.

Brain injuries can have a dramatic impact on behaviour, how people process information, and how memory works. Individuals report experiencing increased irritability, frustration, and confusion. Many who have a brain injury may not even be aware of it. This lack of awareness can intensify the confusion individuals feel when they notice themselves becoming less rational and more irritable.

According to Kim Gorgens, a researcher at the University of Denver, many symptoms of TBIs are punished in the criminal justice system, such as inability to sit still, remember dates, and regulate emotions. This results in further harm within correctional facilities and courtrooms.

Gorgens points out that people fall between the cracks, both in the justice system and in the community. She further explains that one of the main reasons these individuals go untreated is because most systems don’t implement screening practices.

Gorgens emphasizes that a structured interview is one of the best ways to screen for a brain injury. These interviews are easy to do, don’t require specialized training, and can identify people who may need extra support. Although screening does not provide inmates with a diagnosis, it can connect them to brain injury support networks in their communities.

Recent years have seen some increasing support for TBI screening within the justice system. In Colorado, a pilot program recently received a 1.2 million dollar grant for more screening to occur within Denver correctional facilities. The Colorado brain injury model is being implemented in over 20 U.S. states, and brain injury models are gaining international traction.

In Toronto, the Elizabeth Fry Society is running a program in partnership with the Justice & Equity Lab at St. Michael’s Hospital. The initiative aims to support incarcerated women who screen positive for brain injuries at the Toronto Regional Bail Centre. By connecting these individuals with community-based brain injury support, the program helps reduce the likelihood of reoffending after release.

Meaningful progress is also growing at the government level. In 2021, Colorado passed a law requiring the state to create a program offering brain injury screenings for individuals about to be sentenced. This law was created, in part, with an individual who was serving time in a correctional facility and had been diagnosed as having a brain injury during his sentencing. He found that his diagnosis helped him piece together parts of his life he previously considered unexplainable.

Some may worry that extra screening steps will place financial hardships on correctional facilities or on the government. But the cost to process and house individuals who are repeatedly in contact with the justice system is far greater than the cost of connecting them with proper care. More importantly, the monetary, emotional and mental cost to individuals and their families will also be reduced.

Properly educating correctional officers, probation staff, and judges about TBI can help identify individuals who need support and ensure they receive appropriate treatment. Caring for brain injury in prisons means more than protecting health. It means upholding fairness and justice.

— Natalie Joly, Contributing Writer

Featured Image: Photo by Grant Durr on Unsplash; Creative Commons

Body Image #1: Photo by Xiao Cui on Unsplash; Creative Commons

Body Image #2: Photo by David Matos on Unsplash; Creative Commons