BRAIN INJURY REHABILITATION BEHIND CLOSED DOORS: Reflections from delivering neurorehabilitation in prisons in the United Kingdom

Internationally the prevalence of traumatic brain injury (TBI) in people in the criminal justice system (CJS) has been found to be far higher than in the general population. Whilst common perceptions of TBI are often associated with physical impairments, the most debilitating difficulties are often the cognitive, behavioural, and emotional. Following a TBI, people often experience difficulties with impulsivity, aggression, and social cognition; all of which impact on effective daily functioning. Furthermore, TBI-related cognitive and social impairments have been found to be associated with higher levels of previous convictions and higher recidivism rates. These findings provide a clear rationale for the need for effective brain injury interventions in the CJS, yet to date there are very few published studies with this population. This chapter will outline our experiences of over a decade of delivering the brain injury linkworker neurorehabilitation service in His Majesty’s Prison and Probation Services in the United Kingdom. It will reflect on lessons learned and consider future directions.