Traumatic Brain Injury Among People in Correctional and Detention Facilities

What you’ll find on this page

• An overview of the challenges people living with TBI in correctional or detention facilities may face.
• Why screening for TBI is important to help improve care and health outcomes.
• Opportunities to improve TBI care and help people living with TBI successfully return to their communities.

Traumatic brain injury (TBI) is common in correctional and detention facilities

Research shows that many people in correctional and detention facilities have a history of TBI. Some studies estimate that nearly half of adults and about one in three youth in these settings have experienced at least one TBI.^1,2 Intimate partner violence (or domestic violence) is commonly linked to TBIs among females in correctional and detention facilities.³

TBI symptoms may increase challenges for people in correctional settings

People living with TBI in correctional or detention facilities may face additional challenges. Symptoms like memory problems, confusion, or impulsive behavior can increase the risk of disciplinary action or conflict.^4,5 TBI is also linked to higher rates of mental health concerns, self-harm, and substance use.^6,7 Some individuals may also have had multiple brain injuries, which can increase the severity of symptoms and make recovery more complex.⁸

Access to care and support can be limited

People living with TBI in correctional settings may have difficulty getting the care and services they need. This can include limited access to brain injury specialists, mental health care, and rehabilitation services.^9,10 These challenges can continue after release, making it harder for individuals to manage symptoms, stay healthy, and successfully return to their communities.

Screening for brain injury can improve care and outcomes

Identifying TBI early is an important step in providing the right support. Screening during intake or after a suspected injury can help staff recognize symptoms and respond appropriately. Screening can help:

• Identify people who need treatment or accommodations
• Increase awareness among staff
• Improve safety and communication

Better identification can lead to more effective care and support.

Support and coordination can help people living with TBI succeed

Improving care for people with TBI in correctional settings requires a coordinated approach. Facility leadership, healthcare providers, and community organizations all play a role. Helpful strategies may include:

• Training staff to recognize and respond to TBI symptoms
• Providing appropriate accommodations and supports
• Connecting individuals to services before and after release
• Partnering with brain injury organizations for education and resources

These efforts can help improve health outcomes and support successful reentry into the community.

Planning for return to the community is an important part of recovery

Many people in correctional facilities will return to their communities. Planning ahead can help ensure they continue to receive care and support after release. This may include connecting with brain injury chapters and associations, mental health care, and community programs. Ongoing support can help reduce health risks and improve long-term outcomes.

References

1. Farrer TJ, Frost RB, Hedges DW. Prevalence of traumatic brain injury in juvenile offenders: a meta-analysis. Child Neuropsychol. 2013;19(3):225–34. doi:10.1080/09297049.2011.647901

2. Hunter S, Kois LE, Peck AT, Elbogen EB, LaDuke C. The prevalence of traumatic brain injury (TBI) among people impacted by the criminal legal system: An updated meta-analysis and subgroup analyses. Law Hum Behav. Oct 2023;47(5):539–565. doi:10.1037/lhb0000543

3. McMillan TM, Aslam H, Crowe E, Seddon E, Barry SJE. Associations between significant head injury and persisting disability and violent crime in women in prison in Scotland, UK: a cross-sectional study. Lancet Psychiatry. Jun 2021;8(6):512–520. doi:10.1016/s2215-0366(21)00082-1

4. Merbitz C, Jain S, Good GL, Jain A. REPORTED HEAD INJURY AND DISCIPLINARY RULE INFRACTIONS IN PRISON. Journal of Offender Rehabilitation. 1995/12/08 1995;22(3-4):11–19. doi:10.1300/J076v22n03_02

5. Matheson FI, McIsaac KE, Fung K, et al. Association between traumatic brain injury and prison charges: a population-based cohort study. Brain Inj. May 11 2020;34(6):757–763. doi:10.1080/02699052.2020.1753114

6. McKinlay A, Albicini M. Prevalence of traumatic brain injury and mental health problems among individuals within the criminal justice system. Concussion. Dec 2016;1(4):Cnc25. doi:10.2217/cnc-2016-0011

7. Blaauw E, Arensman E, Kraaij V, Winkel FW, Bout R. Traumatic life events and suicide risk among jail inmates: the influence of types of events, time period and significant others. Journal of Traumatic Stress. 2002;15(1):9–16.

8. Challakere Ramaswamy VM, Butler T, Ton B, et al. Self-reported traumatic brain injury in a sample of impulsive violent offenders: neuropsychiatric correlates and possible “dose effects”. Frontiers in psychology. 2023;14:1243655. doi:10.3389/fpsyg.2023.1243655

9. Piccolino AL, Solberg KB. The Impact of Traumatic Brain Injury on Prison Health Services and Offender Management. Journal of Correctional Health Care. 2014/07/01 2014;20(3):203–212. doi:10.1177/1078345814530871

10. Fahmy C, Testa A, Jackson DB. Traumatic brain injury and mental health outcomes among recently incarcerated men. Journal of Traumatic Stress. 2023.

Compassionate answers. Real support. Every step of the way.

Contact the National Brain Injury Information Center at 1-800-444-6443 or braininjuryinfo@biausa.org to speak to a specialist about:

• Help with care needs
• Legal and financial resources
• Services in your community