Noting that about 8.5 percent of non-incarcerated adults in the United States have a history of traumatic brain injury (TBI), an article published in the Scientific American published on February 4, 2012, called attention to the finding that approximately 60 percent of adults in prisons have had at least one TBI. The prevalence has been reported even higher in some systems. The article estimated that each person who suffers a TBI in the criminal justice system costs states an average of $29,000 a year.
“If we don’t help individuals specifically who have significant brain injuries that have impacted their criminal behavior, then we’re missing an opportunity to short-circuit a cycle,” Peter Klinkhammer, associate director of services at the Brain Injury Association of Minnesota, told the Scientific American.
The article mentioned that one of the big challenges in addressing TBI in prison populations is that it is not as easy to diagnose as a broken bone or a blood-borne illness. Scientific noted that because no two brain injuries are alike, not all TBIs result in a medical paper trail. “It’s not as cut-and-dry as a lot of people think,” Elisabeth Pickelsimer, an associate professor at the Medical University of South Carolina, told Scientific.
According to Scientific, a recent South Carolina survey of 636 prisoners found that some 65 percent of males and 73 percent of females reported having sustained TBIs at some point in their lives. The article also noted that injury counts are likely underestimated. Pickelsimer told Scientific that the average reported number of TBIs for an individual prisoner was about four, and some reported up to a dozen. Noting that each assault to the brain compounds damage from the previous TBIs, Pickelsimer told Scientific that it became clear that prisoners are often “not aware that a single event—or a series of them—could be making it harder for them to earn a ticket out of jail, or avoid being sent back in the future.”
Furthermore, Scientific also reported that brain injury also increases the likelihood that people will have other mental health troubles, including substance abuse, and can also make it more difficult to overcome additional conditions. The article mentioned a screening that Pickelsimer and her colleagues did in South Carolina that found that alcohol and crack cocaine were among the most common substances to which both male and female TBI prisoners were addicted. Such habits can “cloud a person’s memory of brain injuries they might have suffered in accidents, altercations or other incidents, which makes accurate diagnosis even more challenging,” Scientific said, also noting that a TBI can also make traditional substance abuse rehabilitation programs less effective.
The Scientific American article is ultimately calling attention to the importance of early intervention and identifying a TBI as soon as possible. Wayne Gordon, a professor of rehabilitation medicine at Mount Sinai School of Medicine, told Scientific that in his research on TBI in substance abusers, the average age when they had their first injury was 14. Future substance abuse and behavioral issues may have been avoided altogether had these injuries been identified sooner. Gordon told Scientific that this was an example of “using screening and identification as prevention—and what you’re preventing is social failure.”
It is important to remember that this does not simply apply to the incarcerated. As Gordon told Scientific, “In any group of folks who are failing—substance abuse, the hardcore unemployed—I would say, the prevalence of TBI is very high.”
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