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Home / About brain injury / Brain injury and the criminal justice system
Understanding the prevalence of traumatic brain injury in prison populations
Our studies, backed up by international research, indicate that brain injury is over-represented in the criminal justice system (CJS), affecting approximately six out of ten people in prison. Brain injury is often called a ‘hidden disability’ as the cognitive, behavioural, and emotional consequences may be overlooked or misinterpreted as behaviour that challenges.
The impact of brain injury within the CJS is wide-reaching. Brain injury has also been linked to:
Despite this, there is a lack of awareness of this issue, and evidence demonstrates there is limited support for offenders with brain injury in the CJS.
Brainkind (formerly The Disabilities Trust) has delivered various projects in forensic settings over the last ten years.
Brain Injury Linkworker Service
Our Linkworker service provides a range of effective interventions and support to those identified as likely to have a brain injury within a prison setting.
The Linkworkers use the Brain Injury Screening Index (BISI ®), a validated screening tool developed by our expert clinicians to help identify those with a history indicative of brain injury. This tool is available to anyone who registers for it.
Brainkind currently provides seven Brain Injury Linkworker services across England and Wales, together with three approved premises supporting men with a brain injury.
Data from HMP Cardiff and HMP Swansea, our longest running services, show a significant impact, including:
Throughout these projects, Brainkind consistently found a disproportionately high number (47%) of male prisoners who had injuries indicative of brain injury compared to the general population.
Results also showed that 70% of male prisoners had sustained a brain injury before their first offence.
You can read a Brain Injury Linkworker service evaluation looking at mental health outcomes here.
people in the criminal justice system may be living with a brain injury
of men in prison sustained their brain injury before their first offence
of women in prison with a brain injury sustained it through domestic violence
From 2016-2018, our Linkworker service supported female offenders with brain injuries in HMP/YOI Drake Hall, a closed female prison in Staffordshire.
In 2019, Brainkind produced a piece of research in Drake Hall on female offending and brain injury titled Making The Link.
Our researchers spoke to 100 female offenders within the prison, and screened them for a potential brain injury using the BISI. It found:
Female offenders are some of the most vulnerable individuals within the criminal justice system.
Compared to male prisoners, they are twice as likely to report anxiety and depression, with heightened incidences of self-harm, histories of domestic violence and abuse.
Within this already disadvantaged group, the need to proactively identify and support women who have a history of brain injury is clear.
Despite this, awareness and treatment for brain injury is not routinely available within UK prisons, and female offenders continue to struggle with the often-unknown emotional, behaviour and cognitive consequences of brain injury, all of which may contribute to reoffending behaviour and difficulty with engaging in rehabilitation programmes.
In 2021, Brainkind launched a new Brain Injury Awareness training programme, ‘Ask, Understand, Adapt’.
This is available to all Ministry of Justice staff in England and Wales, found on the myLearning platform.
The training is designed to help practitioners identify and support those who may have a brain injury, and it gives examples of how a brain injury may present within prison and probation settings.
You can watch ‘Invisible Me’, a video produced as part of the training, here.
Brainkind works with experts and policymakers to improve the lives of people with brain injury in the criminal justice system, including the ABI Justice Network and formerly the All-Party Parliamentary Group (APPG) on Brain Injury.
Following campaigning from Brainkind in 2020, the Ministry of Justice and NHS England introduced a standard question on ABI into the service specifications for prison healthcare, both during induction and the later in-depth screening.
Screening can identify those who have a history indicative of brain injury and who may require an onward referral to a specialist service.
In December 2021, the government announced a new cross-departmental strategy for ABI.
The strategy involved a consultation process and a Patient and Public Voice Reference Group (PPVRG), where those with lived experience and stakeholders participated in the drafting of the strategy. Brainkind was involved at all stages of the process.
Progress on the strategy has stalled due to the change in government in 2024. We are calling on the Department of Health and Social Care to commit to the strategy again and carry on this vital piece of work.
Brainkind will be extending its Linkworker service into more prisons throughout the UK in 2024.
A new research project on the prevalence of brain injury in women in the criminal justice system in Wales will be published on Tuesday 26th November, 2024.
More details coming in 2024.
People with brain injuries and other neurological conditions have unique needs. To help as many people as possible, we have a network neurological centres, assessment and rehab services, and community support services across the UK.
