Traumatic brain injury in indeterminate sentenced prisoners

There has been a recent increase in attention focussing on acquired brain injury (ABI) within a forensic population. This thesis specifically concerns traumatic brain injury (TBI) in prisoners in England and Wales. A systematic review of the literature on screening and assessment of TBI and offence-related treatment of prisoners in England and Wales was completed. This yielded 16 papers for inclusion, leading to discussion in three areas: 1. Routine screening for TBI, 2. Research on links between TBI and behaviour or progress in prison and post-release success and 3. Adaptations needed to standard offending behaviour programmes and other rehabilitation programmes for offenders with specific neurodisabilities including TBI. There was found to be a reasonable amount of research on prevalence of TBI, however more widespread use of a standardised screening tool would be beneficial, as would consideration of TBI in intervention programmes. The research component of the portfolio looked at progression in relation to the Parole process of prisoners serving indeterminate sentences for public protection (IPP sentences). A multiple case study design was used which included interviews, assessments and review of file data for six participants. Investigation of the information identified seven relevant conceptual categories; impaired functioning, treatment problems, lack of support, IPP sentence issues, emotional problems, substance misuse problems and behavioural problems. An individualised approach to the varying needs of indeterminate sentenced prisoners with suspected acquired brain injury was recommended, as was early identification of TBI in individuals in contact with the criminal justice system. Further consideration is likely to be needed regarding the suitability of current offending behaviour programmes for prisoners with TBI, and how additional support and offence-related treatment may need to be tailored to better support brain injured prisoners. The final section of the portfolio consists of a critical appraisal of the doctorate degree.