Tailored Support Improves Outcomes for People with Acquired Brain Injuries in the Criminal Justice System

Providing tailored support to people in the criminal justice system (CJS) with an acquired brain injury (ABI) could help to enhance rehabilitation, improve mental health, and support positive engagement with the prison regime, according to new research from Brainkind, the UK’s largest charity supporting people with ABIs and complex neurological conditions.

The findings are contained in a new report evaluating the effectiveness of tailored treatment and support for people who screened positive for a possible ABI in two prisons in South Wales. Since 2002, the Brain Injury Linkworker Service has been supporting people in prison and on probation in HMP Cardiff and HMP Swansea.

Assistant psychologists – known as ‘Linkworkers’ – create tailored support plans to target their individual challenges and personal goals. Following the neurobehavioural model of brain injury rehabilitation, they address a range of cognitive or emotional difficulties and provide opportunities to practice relevant strategies.

Under the supervision of a consultant clinical neuropsychologist and clinical psychologists, Linkworkers also educate people in prison or on probation about brain injury, offer self-help resources, and refer them to other services.

The report found that:

• All individuals felt that they had ‘achieved’ or ‘mostly achieved’ their personal goals, such as increased emotional regulation, greater control of impulsive behaviour, and improved concentration.
• The number of people on the enhanced regime – requiring a commitment to rehabilitation and an enhanced engagement with prison life – was three times greater post intervention.
• Participants reported being better able to understand their ABIs and explain their difficulties to others. Over half (61%) reported feeling more in control of how they respond to their circumstances.
• The service had a significant impact on the mental health of participants. Levels of reported severe anxiety dropped from 65% to 30% post-intervention. Likewise, levels of severe and moderate-to-severe low mood declined from 59% to 39%.

Commenting on the report, Davina Jones, Head of Policy at Brainkind, said:

“This evaluation highlights the positive impact that tailored support can have on rehabilitation, mental wellbeing, and engagement for people within the criminal justice system.

“The men who participated in the Brain Injury Linkworker Service are better able to understand and explain the impact of acquired brain injury on their everyday experiences. This has enabled greater participation in prison activities and helped them to have more positive relationships with peers and prison staff.

“The report also underlines the importance of raising awareness and increasing the availability of appropriate support within the criminal justice system. The prevalence of acquired brain injury is higher among the prison population but, because the consequences can be invisible, they often go unrecognised.

“Without screening and support, the resulting challenges can have an adverse impact on people in prison or on probation and their engagement with the rehabilitation available to them within the criminal justice system.”