A quarter of all Scottish prisoners have been hospitalised with a traumatic brain injury at some point in their lives, according to new research.

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The study, led by the University of Glasgow in collaboration with the Scottish Prison Service and published today in PLOS ONE, also estimates that 10% of prisoners have suffered a severe head injury in their lives, or multiple head injuries that are likely to lead to a persistent disability.

There is mounting evidence that associates brain injury and offending behaviour.

The study looked at all prisoners in Scotland, alongside electronic records of hospital admissions with head injury, to establish whether prisoners were more at risk of having a head injury at some point in their lives than the general population.

Researchers found that the prevalence of hospital admissions was high in prisoners (25%), and higher than in the general population from similar backgrounds (18%). Having three or more hospitalised head injuries was also more common in prisoners.

Traumatic brain injury can result in persisting emotional and personality changes including: impulsiveness, poorer judgement, aggression and poorer control of temper, reduced concern for others and reduced awareness of the impact of actions on others. Cognitive impairment is also linked with reduced concentration, poorer memory and greater difficulty in solving problems.

Professor Tom McMillan, Professor of Clinical Neuropsychology at the University of Glasgow, said: “It is accepted that there is a need to understand head injury in prisoners in order to plan interventions to reduce associated disability and risk of reoffending.

“This study demonstrates just how prevalent serious head injury is in prisoners in Scotland. And this, combined with the knowledge we have regarding the effects of serious head injury on behaviour and personality, suggests further research and work is needed to support these prisoners and potentially stop them reoffending.”

The work is part of a programme in collaboration with the National Prisoner Healthcare Network, Scottish Prison Service and the Scottish Government to improve services for prisoners.

Professor McMillan added: “To adequately address these issues we needed to estimate not just how many prisoners may have had a head injury at some point in their lives, but how many are likely to have persisting disability and need help – many people recover after a single, non-serious head injury.

“Our programme is working towards development of education and training media for staff and prisoners about head injury and its effects. This will help prisoners who are at risk of further head injury, and help staff to identify and manage prisoners with head injury. We are also developing triage and screening in prisons to identify those who would benefit from more intensive support or intervention.”

The paper ‘The Lifetime Prevalence of Hospitalised Head Injury in Scottish Prisons: A Population Study’ is published in PLOS ONE. The work was funded by the National Prisoner Healthcare Network.

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Enquiries: ali.howard@glasgow.ac.uk or elizabeth.mcmeekin@glasgow.ac.uk / 0141 330 6557 or 0141 330 4831

First published: 17 January 2019