The dangerous repercussions of head traumas among NFL football players and Iraq war veterans are becoming big news. To the sports players and war veterans, this is a known job risk factor. But many more kids and adults who suffer brain injury go on to experience consequences for the rest of their lives–and jails and homeless shelters are likely getting more crowded as a result.
At Rikers Island, New York City’s main prison, nearly half of 384 incarcerated teenage boys and girls questioned for a recent study reported having had a traumatic brain injury, or one that caused amnesia or losing consciousness.
Another recent study, conducted by St. Michael’s Hospital in Toronto, found a similar result: Nearly half of the men screened in a large homeless shelter in the city had experienced brain injury. In the vast majority of cases, the injury occurred before they lost their homes and became homeless, says lead author Jane Topolovec-Vranic.
These two findings add to a slowly growing body of evidence that brain injuries are an often unrecognized risk factor for major social ills. A typical rate of brain injuries in the general population is often found to be only around 12%, say Topolovec-Vranic. That’s a much lower rate than found in the prison and shelter system. (Prisoners and homeless men interviewed reported that assault is the most common cause of their brain injuries.)
Wayne Gordon, head of the Brain Injury Research Center at Mt. Sinai, in New York City, says such results are not a surprise to him, but the subject is getting much more attention in the last few years within the broader research and public health community: “Having a traumatic brain injury (TBI) increases cognitive difficulties and behavioral difficulties. … There’s a significant relationship between TBI and criminality, a significant relationship between TBI and depression, and TBI and substance abuse.”
As researchers draw the link between brain injuries and problems functioning later, a major question remains: what to do about it. One problem is that many injuries go undiagnosed, leading to frustration and confusion for people later when they suffer consequences. “People have tremendous functional difficulties without having a clue as to what to relate them to,” says Gordon.
Gordon, for one, suggests that kids should be screened for brain injuries in schools, just like they get vision and hearing exams. This would at least create a record, and so if symptoms or changes in behavior show up later, there might be an explanation. No school systems really do this today. His lab is currently experimenting with a program for 1,000 kids in the juvenile justice system in Texas, developing interventions for the challenges experienced by those who have had brain injuries. The goal is to reduce recidivism.
Topolovec-Vranic believes that better brain injury diagnosis could give sufferers more leeway if they do end up in the criminal justice or shelter systems. “If people know there’s a brain injury, and someone starts acting out, they might treat these kids with a little more compassion,” she says.