Establishing prevalence of head injury and associated disability in individuals being assessed by a pre-sentencing Criminal Justice Social Work Report & Clinical Research Portfolio
Background:The emotional, social, cognitive and behavioural impact of head injury (HI) can be significant and long lasting. Those with a forensic history are at higher risk of sustaining a HI. There is a growing evidence base on prevalence and linking the effects of HI with offending behaviour. The National Prisoner Healthcare Network (NPHN) recommends evaluation of screening for HI by social workers completing a pre-sentencing Criminal Justice Social Work (CJSW) report. This may help to better understand the role of HI on future offending and guide disposals or interventions.Objectives: The study assessed how many participants undergoing a CJSW assessment would likely benefit from a screening assessment and onward referral following HI. It did this by identifying (a) the prevalence of HI in participants undergoing a CJSW assessment (b) the occurrence of persisting problems, including neuropsychological impairment, emotional difficulties, behavioural difficulties and social disability after HI and (c) whether CJSW reports already indicate HI. The study also investigated relationships between significant HI and re-offending.Method: A cross sectional, between subjects design was utilised. A screening measure that is valid for forensic samples was used to assess severity of HI. Assessments of disability, mental health, cognitive function and effort were carried out on 46 adult participants undergoing assessment at West Dunbartonshire CJSW, Scotland. Participants were grouped by severity of HI (group 1=moderate-severe or multiplemild, group 2=no or mild HI). CJSW reports were scrutinised to identify reference to HI and other impairments (e.g., mental/physical health and disability).Results: HI was reported by 91% of 46 participants. Moderate-severe HI was found in 20% (n=9) and multiple-mild HI in 39% (n=18). HI predicted disability (p=.012) and psychological distress (p=.034) after adjusting for age, education and substance use. Groups performed similarly across cognitive domains. Participants with moderate-severe/multiple-mild HI were more likely to have violent offending histories (p=.002); more convictions (p=.005); and have more prison sentences (p=.007). No CJSW reports identified HI. Conclusions: Disability and psychological distress were more common in participants with more severe HI. Results indicate around 28% of participants would benefit from screening for HI. However, HI was not identified in CJSW reports. Introduction of a HI screening process within CJSW would require training and links with health professionals to be developed. However, this could help to plan and support more appropriate disposals and interventions. Findings are preliminary and further large-scale research is required.
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Establishing prevalence of head injury and associated disability in individuals being assessed by a pre-sentencing Criminal Justice Social Work Report & Clinical Research Portfolio