Stop treating brain injury as a crime problem, new report

Wednesday, 9 December 2015

The youth justice system has become the primary service provider to a large number of young people with brain injuries and other brain impairments, according to a new report published today by the Centre for Crime and Justice Studies.

The report – Supporting young people with neurodevelopmental impairment – calls for health, education and family based interventions and an end to brain injuries and impairments among young people being treated as a crime problem. The report is co-authored by Consultant Child and Adolescent Psychiatrist, Dr Prathiba Chitsabesan, and Senior Lecturer in Social Policy, Dr Nathan Hughes.

Serious head injuries prior to imprisonment are four times as common among young people in custody as among young people in the general population, the report finds.

Other findings include:

  • Between 60 and 90 per cent of young people in custody have a significant communication impairment, compared with only five to seven per cent among the general youth population.
  • 23 to 32 per cent of young people custody have a learning disability, compared with only two to four per cent in the general youth population.
  • 15 per cent of those in custody are on the autism spectrum, compared with only one per cent in the general youth population.

Young people with brain injuries and impairments can behave in a confrontational or anti-social manner, putting them at risk of being criminalised for behaviours related to their underlying medical condition, the authors argue. In place of criminalising young people with brain injuries and impairments, the authors call for early and sustained interventions, led by health and education practitioners, to support young people whose medical conditions can be manifested in disruptive and confrontational behaviour, along with their families.

Dr Prathiba Chitsabesan, one of the report co-authors, said:

Clinical and research evidence supports the finding that a significant number of young people who come into contact with the criminal justice system have missed neurodevelopmental needs. Early recognition and support to young people and families may prevent secondary difficulties developing across a range of areas including education, health and social needs as well as impact on services. These findings strengthen the argument for a public health response through a more co-ordinated multi-agency approach across public sector services.

Dr Nathan Hughes, the other co-author of the report, said:

The research evidence clearly demonstrates a youth justice system that continues to criminalise and punish young people for the risks and vulnerabilities associated with neurodevelopmental impairment. What’s more, these young people are within the criminal justice system as a result of the failures of schools and health services to effectively support them and their families.

However, improved understandings of neurodevelopmental impairments also offer opportunities to address this, enabling screening and assessment to ensure earlier identification, and supporting practices and interventions that are responsive to learning and support needs.

Deborah Fortescue, Head of Foundation, The Disabilities Trust, who are launching a new case study video, Byron’s Story (below) to co-incide with the launch of the report said:

The evidence is clear, there are too many young people in the criminal justice system who have neurodevelopmental disorders, which are often unrecognised and subsequently undiagnosed.  We need to raise awareness, start screening for brain injury and educate people on the consequences of such disorders to enable them to support and divert people away from the criminal justice system wherever possible.  The earlier in the system this can happen the better.

Will McMahon, Deputy Director at the Centre for Crime and Justice Studies said:

The criminal justice system cannot effectively address these issues. There needs to be a radical rethink of service provision that begins with the family and school and has no need of criminal justice intervention.

The Disabilities Trust Foundation has launched a video which highlights the importance of effective rehabilitation following traumatic brain injury.

Featured in the video is a young man who sustained a traumatic brain injury in 2010 following an unprovoked assault. In 2013 he was convicted of an offence. On entering prison he completed the Foundation’s brain injury screening index (BISI®) and was subsequently referred to the Foundation’s brain injury Linkworker service.