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Traumatic Brain Injury and the Criminal Justice System

A recent article in The Lancet Psychiatry (Williams et al, 2018) has discussed the association between traumatic brain injury (TBI) and unlawful behaviour.


TBI occurs when a blow to the head (for instance from a fall or car crash) results in long-lasting damage to the brain. Damage is most commonly found in the frontal lobes, an area important for impulse control and social decision-making, leading to predictable difficulties when it comes to behaving as expected at school or work and in wider society. While estimates vary as to what proportion of the prison population may have suffered a previous brain injury, Williams and colleagues cite evidence that up to 82% of incarcerated adolescents and 51% of incarcerated adults have a history of possible TBI.


In their article, Williams and colleagues recommend a few interventions to reduce the offending rates of people living with TBI. The first and perhaps most important recommendation is for some form of community neurological rehabilitation following injury. Relatedly, it is suggested that improved communication between mental health services, rehabilitation services, general practitioners, emergency departments and schools could help with the early identification and referral to appropriate support of children or adolescents exhibiting difficult behaviour secondary to brain injury. Apart from this, and later down the line, it is suggested that routine screening for TBI be introduced into the justice system, to ensure the appropriate provision of treatment options as part of, or as an alternative to, criminal sentencing



Williams, W. H., Chitsabesan, P., Fazel, S., McMillan, T., Hughes, N., Parsonage, M., & Tonks, J. (2018). Traumatic Brain Injury: A potential cause of violent crime?. Lancet Psychiatry.


Joe Rehling, Assistant Psychologist