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Prison nurses urged to check offenders for history of head injuries to avoid future issues

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Offenders should be routinely checked for signs of past head injuries that could lead to further problems down the line, according to researchers.

They concluded that traumatic brain injuries were linked to greater violence and other problems when in prison, so better support may help to reduce the likelihood of offending or re-offending.

“There is an opportunity to deliver routine screening for traumatic brain injury and provision of treatment options”

Huw Williams

Entering the justice system provided an “opportunity” to screen someone for traumatic brain injury, noted the team from the universities of Exeter, Manchester, Oxford, Glasgow and Sheffield.

Traumatic brain injuries result from serious blows to the head that cause permanent brain changes, for example in an assault. With increased injury severity, there is a higher risk of chronic problems.

They suggested such injuries may compromise the neurological functions for self-regulation and social behaviour and increase the risk of behavioural and psychiatric disorders.

The researchers reviewed existing evidence and found 10-20% of people in custody had “complicated mild traumatic brain injury or moderate to severe head injury”.

Based on the review, they also concluded that young people with traumatic brain injury were at greater risk of early, more violent offending.

“A range of measures could reduce the risk of crime following traumatic brain injury”

Huw Williams

The researchers estimated traumatic brain injury more than doubled the risk of “earlier, more violent, offending”.

The study, published in the Lancet Psychiatry journal, also found that young offenders with traumatic brain injury were particularly at risk of self-harm and suicidal behaviour.

In addition, such injuries were linked to poor engagement in treatment, infractions when in custody and reoffending.

Meanwhile, histories of abuse, neglect, and trauma appeared particularly elevated in those with past injuries versus those without, as were ongoing mental health and drug and alcohol problems.

The study authors highlighted that there were already initiatives in England that allow neuro-disability screening for people entering youth custody.

There were also pilot projects to assess for traumatic brain injury and other neuro-disabilities in young adults and adult prisons, they said.

Lead author Professor Huw Williams, from the University of Exeter, said: “Addressing traumatic brain injury offers a means to not only improve the lives of those who offend, but also to reduce crime.

University of Exeter

Prison nurses urged to screen for head injury history

Huw Williams

“A range of measures could reduce the risk of crime following traumatic brain injury,” he said. “These could include any form of neuro-rehabilitation, and better links between emergency departments, community mental health services, GPs and school systems.”

Such measures might lead to early identification and management of traumatic brain injury in children and young people, particularly in areas of socio-economic deprivation, they said.

They added: “On a person’s entry into the justice system, there is an opportunity to deliver routine screening for traumatic brain injury and provision of treatment options.

“Another beneficial step could be brain injury link-workers in prisons to enable screening and support for those with traumatic brain injury,” they said.

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Readers' comments (1)

  • There is a lot more to be done first- my own experience working in prisons is that the nurses I worked with would have been better suited as prison Officers. No Nursing ethic whatsoever! Disliked me calling those on my wings Patients! Trying to report a concern when present with a detained prisoner about over use of restraint, goading prisoners to allow the restraint to be used more forcefully fell on deaf ears. Reporting of suspected rotator cuff , neck or lower spine injuries deleted. Now they want a neuro exam! Far too many cannot reliably manage colds, toothache or many of the other needs of a prison population. Until they treat prisoners as patients and strive to meet the needs of these individuals rather than the needs of the prison I doubt this will ever happen.

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