The “silent epidemic” of brain injury among UK prisoners

Mounting evidence of high incidence of acquired brain injury (ABI) among the UK prison population is leading to calls for measures to tackle the issue. The head of the UK Acquired Brain Injury Forum (UKABIF), says levels are “astoundingly high”, while a recent University of Salford study described it as “a silent epidemic.”

Brain image

Costs of ABI

The UKABIF defines an ABI as “brain damage caused by events after birth which can result in cognitive, physical, emotional, or behavioural impairments leading to permanent or temporary changes in functioning”. Symptoms can include exhaustion and overwhelm, difficulty with simple tasks like making a cup of tea, and uninhibited or aggressive behaviour. Exact figures are unknown, but a low estimate is that over one million people live in the UK with the effects of ABI, at an estimated minimum cost of £4.1 billion.

A 2017 House of Commons briefing put the overall UK prison population at some 95,000 (females account for about 4% of that). Amid growing concerns about the country’s overflowing prisons, it acknowledged “a general underlying trend of an increasing number of people held in prison”.

What’s now emerging is evidence that ABI – caused by accident, violence, a health event, substance abuse, or disease – affects a high percentage of the prison population, and that the issue has been going largely unperceived.

“The incidence of previous ABI among young offenders is astoundingly high,” says Chloe Hayward, Executive Director at UKABIF. “It’s something like 60-80%; the cost to society is massive. There’s lots of work going on now to identify numbers, screen prisoners, and set up systems to help workers in prisons rather than just leaving them to it.”

This approach is echoed by Clare Allely, Lecturer in Psychology at the University of Salford, who published research outlining the scale of the problem of prison ABI and suggesting measures to tackle it – including early stage screening for prisoners. An important 2009 review exploring the mental health needs of prisoners made “no reference to brain injury at all”, she says.

Chloe Hayward says the realisation that prisoners could be affected by head or brain injury is proving helpful in UKABIF’s campaigns: “One of the prison governors we work with said it was a real light-bulb moment when we explained this. He said it changed the way prisoners were viewed as ‘mad or bad’ to thinking they were ‘mad or bad or ABI-affected’ – it opened up a whole new line of thought.”

‘It changed the way prisoners were viewed as ‘mad or bad’ to thinking they were ‘mad or bad or ABI-affected’





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