A young man, in his mid-twenties, hospitalized in a mental health unit, was admitted with the following complaint, "There is something wrong with my head and I can't keep a job." During a clinical interview, he revealed that his father had not been in his life for almost twenty years. His father had been physically abusive and he was subsequently hospitalized for broken bones. When he was school age, he was hit by a car, resulting in hospitalization for multiple injuries. He was placed in Special Education, as he had trouble learning and controlling his behavior in class. As an adolescent, he began using multiple drugs as well as alcohol. While still a teen, he was involved in another incident, resulting in hospitalization for several days. Thereafter, his ability to concentrate, remember, and control his temper became even worse . . .
After high school, he enlisted in the National Guard and served in Iraq for several months. He was injured in an attack, later describing this experience as 'severe PTSD'. Once he was back in the states, he could not keep a job.
His use of drugs and alcohol escalated and he was jailed for various offenses. He had nowhere to sleep except his car. A mental health crisis resulted in hospitalization. The clinician recognized the likelihood of traumatic brain injury (TBI). Neuropsychological testing revealed to the multidisciplinary treatment team problems with his multiple conditions.
This case study was presented in the recent Brain Injury training co-sponsored by the Lancaster County RMO and the Brain Injury Association of PA.
This young man was indeed a case of "Unidentified TBI". Once brain injury was identified as a contributing factor, he was linked to appropriate services and supports and was able to get supported employment and move along with his life.
The following facts about Brain Injury were presented at that training:
- Studies show 25-87% of inmates report having experienced a Brain Injury (compared to 8.5% of the general population)
Among male inmates, a history of Brain Injury is strongly associated with perpetration of domestic violence and other kinds of violence during their lifetimes.
- One study of male inmates in Minnesota revealed that 83% reported having one or more head injuries during their lifetimes, from a range of causes including assaults, car crashes, sports, gang initiation rites such as "pumpkinhead", and various self-inflicted injuries. (from Traumatic Brain Injury Among Prisoners Marlena M. Wald, MPH, MLS — Sharyl R. Helgeson, RN, BAN, PHN — Jean A. Langlois, ScD, MPH, Brain Injury Professional magazine)
Female inmates who are convicted of a violent crime, are more likely to have sustained a pre-crime Brain Injury and/or some other form of physical abuse.
- Children and teenagers who have been convicted of a crime are more likely to have sustained a pre-crime Brain Injury and/or some other form of physical abuse.
In future articles, we'll share more of the information that was presented by BIA about Brain Injury and how case managers and other service providers can help to identify BI and resources available to help our clients who may have brain injuries.