Processes for identifying and managing traumatic brain injury in the justice sector

Lara Wilson; Jason Chua; Christine Howard-Brown; Michelle Wilkinson; Kay Sloan; Kirsty Fraser; Alice Theadom

doi:10.1071/IB23069

RESEARCH ARTICLE (Open Access)

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Processes for identifying and managing traumatic brain injury in the justice sector

Lara Wilson

^A , Jason Chua

^A , Christine Howard-Brown ^B , Michelle Wilkinson ^B , Kay Sloan ^C , Kirsty Fraser ^C and Alice Theadom

^A ^*

+ Author Affiliations

- Author Affiliations

^A TBI Network, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand.

^B ABI Rehabilitation Ltd, Auckland, New Zealand.

^C Department of Corrections, Wellington, New Zealand.

^* Correspondence to: Alice.Theadom@aut.ac.nz

Handling Editor: Jenny Fleming

Brain Impairment 25, IB23069 https://doi.org/10.1071/IB23069

Submitted: 22 May 2023 Accepted: 21 November 2023 Published: 17 January 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of the Australasian Society for the Study of Brain Impairment. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Background

Individuals engaged with the justice sector have complex health needs, which often intersect with traumatic brain injury (TBI). Prior research suggests that the prevalence of TBI is high among offenders. However, it is unclear what processes are in place to support their TBI-related health needs. This study aimed to establish how TBIs are currently identified and managed across the justice sector and to identify opportunities improve access to healthcare services for individuals following TBI.

Methods

This study was conducted through semi-structured interviews with justice sector staff, underpinned by the interpretive description approach. Participants were asked about how TBIs were managed in their setting and what would improve how they supported people in their care.

Results

Nine interviews were conducted with clinical managers (n = 2), probation officers (n = 2), psychologists (n = 2), a mental health nurse (n = 1) and program coordinators (n = 2). Analysis identified one overarching theme, ‘The need for national standards to facilitate practice change’, which incorporated five sub-themes: (1) Need to know about current and historical TBIs, (2) Need to address factors affecting reporting of new injuries, (3) Need for clear healthcare pathways, (4) Need for communication across the justice and healthcare sectors, and (5) Need to upskill people across the justice sector.

Conclusion

Routine screening processes, clarifying professional roles, streamlining healthcare pathways, facilitating data sharing and upskilling workforce knowledge about managing people affected by TBI may help to improve identification and management of TBI across the justice sector.

Keywords: concussion, interviews, justice sector, prison, processes, qualitative, TBI, traumatic brain injury.

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