Prisons Should Focus on Treatment Rather than Punishment

A study by researchers from the University of Exeter in England has found that assessing new prison inmates for traumatic brain injury (TBI) and treating those affected can significantly reduce their likelihood of future offending.

Source and effect of TBI

TBI can be caused by any of a range of incidents – from difficult childbirth through to seemingly minor childhood injuries, to falls, car accidents, sports injuries, workplace accidents and assaults.

Many are unaware of the even existence – let alone extent – of their conditions, or the impact on important functions of the brain such as impulse control, broader self-regulation, information retention and the ability to concentrate.

Research has found that problems in these areas of brain functioning can increase the propensity for anti-social conduct, including offences of violence.

Prevalence of TBI in prison

The researcher found that between 10 and 20% of inmates studied have “complicated mild TBI or moderate to severe head injury,” and another 30 to 40% could have milder TBI.

This means that between 40 and 60% of those behind bars could be affected by the condition.

Link between TBI and offending

The researchers conducted a meta study which analysed data derived from other studies of inmates, noting that TBI has consistently been identified as a risk factor for “earlier, more violent, offending”, more than doubling the likelihood of the commission of offences.

This finding was broadly consistent with a 35-year population study carried out by psychiatrist Seena Fazel in Sweden.

The Swedish study suggested that 2.5% of that nation’s general population became violent offenders, while the figure increased to 9% for those with head injuries on their medical records.

Inadequate focus on rehabilitation

The researchers from Exeter University noted the lack of emphasis on rehabilitation within correctional facilities, which is due to a range of factors including chronic underfunding for health and other programs, the practical difficulties of treating people behind bars as well as a lack of interest from authorities.

Benefits for the whole community

According to the lead author of the Exeter study, Professor Huw Williams, “Addressing TBI offers a means to not only improve the lives of those who offend, but also to reduce crime”.

The professor explains that “A range of measures could reduce the risk of crime following TBI,” including:

• Forms of neurorehabilitation,
• Brain injury link-workers being placed in prisons to deliver better service; and
• Early treatment being given to young offenders through improved links between emergency departments, community mental health services, GPs and school systems.

He suggests that those entering the prison system should be screened and, where appropriate, placed on a treatment plan.

Neurorehabilitation

Of particular interest to the researchers was the potential benefits of neurorehabilitation, which uses medical procedures to improve the functioning of damaged areas of the brain.

Brain Injury Australia has signalled its commitment to neurorehabilitation, explaining that the treatment is currently difficult to access despite its cost effectiveness and benefits to both the affected person and the community as a whole.

It is hoped greater funding and better access to such treatments will help to decrease crime rates in Australia.