Traumatic brain injury

Abstract In recent decades, traumatic brain injury (TBI) has become an increasingly recognized and discussed phenomenon. This era has been characterized by expanding awareness, research, and concern about TBI of all severity levels. In the midst of this increased attention, researchers and policy makers have made strides toward developing a greater understanding of the risks of TBI, the scope and complexity of the symptom profiles seen after TBI, and treatments that aim to optimize recovery. Up to 86% of incarcerated persons have a history of at least one TBI. Many IPs have experienced multiple injuries and sustained their first TBI in their midteens. Routine screening for TBI is rarely done within carceral settings despite there being a multitude of tested instruments available. The cognitive deficits associated with mild to moderate TBI are often indistinguishable from those associated with many mental illnesses and disorders related to substance use. Educational interventions designed to improve staff knowledge of the prevalence of TBI and frequent symptom patterns are important first steps in mitigating these problems. Training staff to utilize specific methods for facilitating communication with incarcerated persons experiencing these symptoms may reduce episodes of misunderstanding and potential conflict. Similarly, programming may be modified to accommodate the cognitive deficits suffered by incarcerated persons with TBI, as well as other disorders. This chapter reviews the prevalence of TBI in correctional settings; its relationship with and impact upon co-occurring mental illness and substance use disorders; and opportunities to recognize, design appropriate interventions for, and treat patients with TBI.