Head injury and associated disability in adults undergoing pre-sentencing assessment by criminal justice social work

Although evidence indicates that head injury (HI) is prevalent in prisoners, little is known about HI in defendants during the Court process. This study assesses history of HI and persisting sequelae in defendants undergoing Criminal Justice Social Work (CJSW) assessment for Court.

A cross sectional, between subjects design was used. HI history was assessed using the Ohio State University TBI Identification-Method and disability with the Glasgow Outcome Scale-Extended in 46 adult defendants undergoing a CJSW assessment in Scotland. Assessments of mental health, cognitive function, effort on tests and dysexecutive behaviour were also carried out. Comparisons were made between defendants with and without significant HI.

Significant HI (SHI) was found in 33/46 (72%) participants and 39% (13/33) of these had persisting disability. Those with SHI were more likely to have moderate-severe mental health difficulties, problematic alcohol or drug use and impairment on the Dysexecutive Questionnaire. Group differences were not found on cognitive tests or in offending history. No CJSW report identified HI.

Disability, psychological distress, dysexecutive behaviour and potentially harmful substance use are more common in defendants with SHI. Training and a screening process for HI in CJSW assessments is needed to inform Court disposals and interventions.