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

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 semistructured 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 subthemes: (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.