Why the brain matters in youth justice…

Neuro-disability: what it is & what to do about it...

The very first youth justice case I had, involved brain injury.

It took me the best part two years to discover this, by which time it was too late. The lad went to custody. Needlessly.

Sketch - Brain matters in YJ

Image courtesy of ©123rf/likewise

So it’s crucial that those working with all troubled teenagers know a bit about neuro-disability…

Here’s a summary of the issues…

The British Psychological Society recently released a position paper* on children and young people with neuro-disabilities in the criminal justice system. What follows is a summary of that paper.

But first a word about why it’s important.

Image courtesy of ©BPS

Image courtesy of ©BPS

My first case was a young man whom we later discovered had suffered a traumatic birth and was starved of oxygen for a period. His mother described him as a “blue baby.”

The resulting issues set him on a collision course with the justice system. Eventually landing him in prison.

Had his condition been identified earlier, he might have been helped. In fact I’m certain he would. But he was already 16 when we uncovered the problem. By which time he needed to consent to treatment in hospital, which he refused.

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So what do we mean by neuro-disability?…

Here are some of the common conditions:

  • Intellectual disabilities
  • Specific learning difficulties
  • Communication disorder
  • Attention deficit hyperactivity disorder (ADHD)
  • Autism spectrum disorders (ASD)Justice
  • Traumatic brain injury (TBI)
  • Epilepsy
  • Foetal alcohol syndrome

(I’ve written before on some of these issues; e.g. traumatic brain injury and foetal alcohol syndrome.)

Neuro-disabilities can result in a variety of problems, including:

  • Difficulties with memory and concentration
  • Decreased awareness of an individual’s emotional state
  • Poor impulse control and poor social judgement
‘These associated problems have all been linked to an increased risk of crime and can make it more difficult for those individuals to engage effectively in their judicial proceedings or to benefit from traditional forms of forensic rehabilitation.’ (BPS, 2015:2)

How big an issue is neuro-disability in youth justice?…

Check out these figures:

  • 30 per cent of juvenile offenders have sustained a previous brain injury
  • 14 per cent have possible intellectual disability (IQ under 69)Bandaged brain - iStock_000011517001XSmall
  • 32 per cent have a borderline intellectual disability range (IQ 70 to 79)
  • 30 per cent of the youth prison population have clinically diagnosed ADHD
  • 50 per cent of individuals convicted for non-violent crimes have a past history of TBI compared with only 5–15 per cent in comparison samples
  • Violent offenders have disproportionately more lesions in their brains, particularly in frontal areas. (Source: BPS, 2015:2)

So it’s a huge issue. This is even more starkly the case when we compare offending populations with the general one.

For example, traumatic brain injury occurs at a rate of 10% in the general population. Amongst young people in custody the figure in one recent study in England was 60%.

So what needs to be done to deal with this injustice? The BPS position paper makes a number of recommendations…

Recommendations to deal with neuro-disability in the justice system…

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1. Early intervention:

  • Earlier screening in the community of children and young people who may be need it – for example after school exclusions
  • Use of the new Comprehensive Health Assessment Tool (CHAT) with those at risk or showing early signs of offending

2. Screening and rehabilitation:

  • Routine testing in custody suites for neuro-disability, as well as mental health, substance misuse and fitness to plea.
  • Suitable intervention and support pathways for those in custody who screen positive
  • All interventions – whether preventative or rehabilitative – need to take account of the cognitive limitations of sufferers

3. Training and guidance:

  • For all professional groups who care for children, including criminal justice staff
  • Additional support for parents and carers to provide appropriate responses at home
  • For education, health and care professionals who could identify problems before children reach the justice system

In addition the BPS calls for changes in commissioning of services and in data-sharing. As well as for more research on the links between neuro-disability and offending.

‘Given the current neglect of neuro-disabilities within society and the criminal justice process, there exists an opportunity to deliver improved outcomes for these children and young people both within secure settings and through earlier interventions. Additionally, there remains an opportunity to secure significant economic savings, both in terms of direct costs to the public purse and through associated costs by reducing offending and improving social outcomes.’ (BPS, 2015:3)

Final word…

The lad I dealt with – a prolific user of amphetamines – finally got the assessment he needed. It took me a year to persuade the powers-that-be to fund a second opinion psychiatric assessment.

The verdict? Hospitalisation for further assessment and the controlled administration of…yes, you guessed it… an amphetamine-based drug treatment.

He’d been self-medicating all this time! If only we’d discovered this sooner…

What do you think?…

  • What are your thoughts about the impact of neuro-disability on offending?
  • Please let me know your thoughts…   Leave a comment below or click here.

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© Jonny Matthew 2015

  *  BPS (2015) Position paper: children and young people with neuro-disabilities in the criminal justice system. March 2015

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