A service evaluation on the impact of brain injury linkworker (BIL) interventions on the anxiety and depression of men in prison and on probation
1Brainkind (formally The Disabilities Trust), RH15 9NP Burgess Hill, UK
DOI: 10.22514/jomh.2023.109 Vol.19,Issue 11,November 2023 pp.41-50
Submitted: 02 June 2023 Accepted: 22 August 2023
Published: 30 November 2023
† These authors contributed equally.
It is well established that the prevalence of Traumatic Brain Injury (TBI) is higher in offender populations than the general population. Men in prison and probation services also have many of the risk factors that place them at higher risk of developing neuropsychiatric complications following a TBI (e.g., low socioeconomic backgrounds, previous history of substance misuse). The BIL service, developed in 2013 by Brainkind (formally The Disabilities Trust) delivers brain injury rehabilitation to men engaged with South Wales (United Kingdom) Prison and Probation Services. As part of a wider service evaluation, we reviewed the levels of anxiety (Generalised Anxiety Disorder assessment, GAD-7) and depression (Patient Health Questionnaire, PHQ-9) of 50 men in prison or on probation pre- and post-BIL intervention. Results showed a significant decrease in the scores reported on the GAD-7 between the start (Mean—M = 15.38, Standard Deviation—SD = 4.64) and end (M = 11.84, SD = 5.15) of the intervention (t (49) = 2.01, p = 0.00000733). Additionally, there was a significant decrease in self-reported depression symptoms as observed by the scores on the PHQ-9 between the start (M = 17.08, SD = 5.55) and end (M = 12.42, SD = 6.55) of the intervention (t (49) = 2.01, p = 0.0000125). These results indicate that overall there was an improvement in the men’s levels of anxiety and depression following the BIL intervention. This service evaluation provides a clear rationale for the development of a more rigorous research protocol to explore the relationship between brain injury interventions and the impact on mental health in this population.
Acquired brain injury; Neurorehabilitation; Offender population
Elorm Boglo,Ryan Jones,Sara da Silva Ramos,Annmarie Burns. A service evaluation on the impact of brain injury linkworker (BIL) interventions on the anxiety and depression of men in prison and on probation. Journal of Men's Health. 2023. 19(11);41-50.
 de Geus EQJ, Milders MV, van Horn JE, Jonker FA, Fassaert T, Hutten JC, et al. Acquired brain injury and interventions in the offender population: a systematic review. Frontiers in Psychiatry. 2021;12: 658328.
 Durand E, Chevignard M, Ruet A, Dereix A, Jourdan C, Pradat-Diehl P. History of traumatic brain injury in prison populations: a systematic review. Annals of Physical and Rehabilitation Medicine. 2017; 60: 95–101.
 Farrer TJ, Hedges DW. Prevalence of traumatic brain injury in incarcerated groups compared to the general population: a meta-analysis. Progress in Neuro-Psychopharmacology and Biological Psychiatry. 2011; 35: 390–394.
 Gorgens KA, Meyer L, Dettmer J, Standeven M, Goodwin E, Marchi C, et al. Traumatic brain injury in community corrections: prevalence and differences in compliance and long-term outcomes among men and women on probation. Criminal Justice and Behavior. 2021; 48: 1679–1693.
 Ramos SDS, Oddy M, Liddement J, Fortescue D. Brain injury and offending: the development and field testing of a linkworker intervention. International Journal of Offender Therapy and Comparative Criminology. 2018; 62: 1854–1868.
 Pitman I, Haddlesey C, Ramos SD, Oddy M, Fortescue D. The association between neuropsychological performance and self-reported traumatic brain injury in a sample of adult male prisoners in the UK. Neuropsychological Rehabilitation. 2015; 25: 763–779.
 Schofield P, Butler T, Hollis S, D’Este C. Are prisoners reliable survey respondents? A validation of self-reported traumatic brain injury (TBI) against hospital medical records. Brain Injury. 2011; 25: 74–82.
 Khellaf A, Khan DZ, Helmy A. Recent advances in traumatic brain injury. Journal of Neurology. 2019; 266: 2878–2889.
 Maas AIR, Menon DK, Manley GT, Abrams M, Åkerlund C, Andelic N, et al. Traumatic brain injury: progress and challenges in prevention, clinical care, and research. Lancet Neurology. 2022; 21: 1004–1060.
 Biegon A. Considering biological sex in traumatic brain injury. Frontiers in Neurology. 2021; 12: 576366.
 Ali A, Morfin J, Mills J, Pasipanodya EC, Maas YJ, Huang E, et al. Fatigue after traumatic brain injury: a systematic review. Journal of Head Trauma Rehabilitation. 2022; 37: E249–E257.
 Kraemer Y, Mäki K, Marinkovic I, Nybo T, Isokuortti H, Huovinen A, et al. Post-traumatic headache after mild traumatic brain injury in a one-year follow up study—risk factors and return to work. The Journal of Headache and Pain. 2022; 23: 27.
 Lezak MD, Howieson DB, Loring DW, Fischer JS. Neuropsychological assessment. 4th edn. Oxford University Press: New York. 2004.
 Timmer ML, Jacobs B, Schonherr MC, Spikman JM, Van der Naalt J. The spectrum of long-term behavioral disturbances and provided care after traumatic brain injury. Frontiers in Neurology. 2020; 11: 246.
 McMillan TM, McVean J, Aslam H, Barry SJE. Associations between significant head injury in male juveniles in prison in Scotland UK and cognitive function, disability and crime: a cross sectional study. PLOS ONE. 2023; 18: e0287312.
 Albrecht JS, Abariga SA, Rao V, Wickwire EM. Incidence of new neuropsychiatric disorder diagnoses following traumatic brain injury. Journal of Head Trauma Rehabilitation. 2020; 35: E352–E360.
 O’Rourke C, Linden MA, Lohan M, Bates-Gaston J. Traumatic brain injury and co-occurring problems in prison populations: a systematic review. Brain Injury. 2016; 30: 839–854.
 Parrott DR, Trexler LE. Traumatic brain injury in Indiana’s correctional system: prevalence and recidivism. Journal of Correctional Health Care. 2022; 28: 308–314.
 Williams WH, Chitsabesan P, Fazel S, McMillan T, Hughes N, Parsonage M, et al. Traumatic brain injury: a potential cause of violent crime? The Lancet Psychiatry. 2018; 5: 836–844.
 The Disabilities Trust. Brain injury linkworker service: 2016 edition. 2016. Available at: https://brainkind.org/wp-content/uploads/2023/09/Foundation-Outcome-Report_dft4.pdf (brainkind.org) (Accessed: 02 June 2023).
 Wood RL, Worthington A. Neurobehavioral abnormalities associated with executive dysfunction after traumatic brain injury. Frontiers in Behavioral Neuroscience. 2017; 11: 195.
 Felmingham KL, Baguley IJ, Green AM. Effects of diffuse axonal injury on speed of information processing following severe traumatic brain injury. Neuropsychology. 2004; 18: 564–571.
 Piccolino AL, Solberg KB. The impact of traumatic brain injury on prison health services and offender management. Journal of Correctional Health Care. 2014; 20: 203–212.
 Schofield PW, Butler TG, Hollis SJ, Smith NE, Lee SJ, Kelso WM. Neuropsychiatric correlates of traumatic brain injury (TBI) among Australian prison entrants. Brain Injury. 2006; 20: 1409–1418.
 Linden MA, O’Rourke C, Lohan M. Traumatic brain injury and social competence among young male offenders. Disability and Rehabilitation. 2020; 42: 2422–2429.
 Howlett JR, Nelson LD, Stein MB. Mental health consequences of traumatic brain injury. Biological Psychiatry. 2022; 91: 413–420.
 Awan N, DiSanto D, Juengst SB, Kumar RG, Bertisch H, Niemeier J, et al. Evaluating the cross-sectional and longitudinal relationships predicting suicidal ideation following traumatic brain injury. Journal of Head Trauma Rehabilitation. 2021; 36: E18–E29.
 Teplin LA, Swartz J. Screening for severe mental disorder in jails: the development of the referral decision scale. Law and Human Behavior. 1989; 13: 1–18.
 Lattimore PK, Richardson NJ, Ferguson PL, Pickelsimer EE. The association of traumatic brain injury, post-traumatic stress disorder, and criminal recidivism. Health & Justice. 2022; 10: 7.
 Trexler LE, Parrott D. The impact of resource facilitation on recidivism for individuals with traumatic brain injury: a pilot, non-randomized controlled study. Brain Injury. 2022; 36: 528–535.
 Löwe B, Decker O, Müller S, Brähler E, Schellberg D, Herzog W, et al. Validation and standardization of the Generalized Anxiety Disorder Screener (GAD-7) in the general population. Medical Care. 2008; 46: 266–274.
 Kroenke K, Spitzer RL, Williams JBW. The PHQ-9. Journal of General Internal Medicine. 2001; 16: 606–613.
 Coetzer R, Ramos SDS. A neurobehavioral therapy approach to the rehabilitation and support of persons with brain injury: practice-based evidence from a UK charitable rehabilitation provider. Frontiers in Rehabilitation Sciences. 2022; 3: 902702.
 D’Cruz K, Douglas J, Serry T. Narrative storytelling as both an advocacy tool and a therapeutic process: perspectives of adult storytellers with acquired brain injury. Neuropsychological Rehabilitation. 2020; 30: 1409–1429.
 Buchan LD, McMillan TM. Prisoner knowledge about head injury is improved by brief psychoeducation. Brain Injury. 2022; 36: 401–405.
 Dromer E, Kheloufi L, Azouvi P. Impaired self-awareness after traumatic brain injury: a systematic review. Part 1: assessment, clinical aspects and recovery. Annals of Physical and Rehabilitation Medicine. 2021; 64: 101468.
 Dromer E, Kheloufi L, Azouvi P. Impaired self-awareness after traumatic brain injury: a systematic review. Part 2. Consequences and predictors of poor self-awareness. Annals of Physical and Rehabilitation Medicine. 2021; 64: 101542.
 Schwartz JA. A longitudinal assessment of head injuries as a source of acquired neuropsychological deficits and the implications for criminal persistence. Justice Quarterly. 2021; 38: 196–223.
 Carr N. The Lammy Review and race and bias in the criminal justice system. Probation Journal. 2017; 64: 333–336.
 Abbas S, Farooq R. ‘Is it time to decolonise neuropsychology?’ Critical reflections on colonial structures, neuropsychology and the role of clinical psychologists. Clinical Psychology Forum. 2022; 1: 40–47.
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