The University of Exeter’s Professor Huw Williams recently worked with Devon & Cornwall Police (DCP) to implement techniques for screening and managing offenders with Traumatic Brain Injury (TBI), enabling a better delivery of services for the force.
Brain trauma and other neuro-disabilities are highly prevalent in people in contact with the law. Research shows that Traumatic Brain Injury – which occurs when assaults, car accidents and falls cause lasting changes to the brain – can lead to problems in memory, planning and impulse control.
These effects make Traumatic Brain Injury (TBI) a significant risk factor to consider when managing offenders, with TBI contributing to the earlier onset of crime, reactive violence, and difficulty engaging with rehabilitative programmes.
Professor Huw Williams, a leading neuropsychologist at the University of Exeter and Co-Director of the Centre for Clinical Neuropsychology Research, has won the prestigious BPS Barbara Wilson Award for his research into the links between TBI and crime.
“When we look into the lives of prisoners,” he said, “we find that they were likely to be injured and traumatised. Indeed, we found in one study that, whilst a quarter of young people in prisons felt suicidal, more than half of those who’d had a Traumatic Brain Injury were suicidal. The perpetrators are often – then, at some earlier point of life – victims themselves. Cycles of violence perpetuate.”
Given the huge economic and social costs of crime – UK prisons and re-offences cost £7bn and £13bn a year (respectively), with around 4 million people affected by crime in the UK each year – bringing this understanding of Traumatic Brain Injury into policing practice held clear advantages for Devon and Cornwall Police.
As a result, Professor Huw Williams recently worked with Sarah Carlsen-Browne, DCP’s Senior Manager for Criminal Justice (People), to enable the screening of TBI in their service users and provide advice on techniques for managing users with TBI issues, such as memory and impulse control.
“In our work to reduce harm and reoffending,” said Sarah Carlsen-Browne, “we need to constantly strive to understand the person before us that has offended and use evidence to support the implementation of new approaches. We collaborated with the University to understand and adapt to those that have TBIs.”
The introduction of a screening tool known as the Brain Injury Screening Index enabled the force to highlight the rates of Traumatic Brain Injuries in two reoffender cohorts: Pathfinder, a voluntary intervention scheme that reduces harm and reoffending, and Integrated Offender Management (IOM), a programme which allows local and partners agencies to co-ordinate the management of offenders. This enabled DCP to understand, first-hand, the number of TBI offenders in their vicinity with TBI-related needs and challenges.
“These projects,” Professor Huw Williams says, “help the police find out why someone might have problems when in the community and end up offending.” By understanding the challenges which might lead to offenders missing appointments with support staff, the police can give them support – a text reminder if the offender struggles with remembering appointments, for example. “The key is that this is a low cost, high gain way of supporting people to engage with community orders and stay out of prison.”
The collaboration also enabled the DCP team to engage in training with the University to increase their understanding of TBIs, before also training in collaboration with the Disability Foundation to gain practical advice on supporting individuals with them. These have since been used to respond to service users with TBIs and other neurodiverse conditions.
Overall, this collaborative intervention has enabled DCP to not only identify and sensitively respond to offenders with Traumatic Brain Injuries and manage their engagement with community orders, but to take an equitable approach when doing so.
As Sarah Carlsen-Browne concludes: “This opened up different conversations that we would not have had previously and developed our understanding of their ability to retain information and their difficulty moderating their behaviours. It means that we are doing our best to be equitable in our application of Justice, by ensuring we are not escalating people through the criminal justice system without us first adapting our approach to ensure they understand the consequences.”
Huw Williams is a Professor in Clinical Neuropsychology with a background in Neuro-Rehabilitation of brain injury and PTSD (Post Traumatic Stress Disorder), and, more recently, research on the prevalence, correlates and management of Traumatic brain Injury (TBI) in people in contact with the law.
Alongside his work with Devon and Cornwall Police, Huw works closely with Supt. Stan Gilmore and Thames Valley Police within the Violence Reduction Unit, providing insights into – and preventative measures against – the prevalence and root causes of violence.
Sarah Carlsen-Browne is currently the Senior Manager for Criminal Justice (People) in DCP, with her substantive role as Pathfinder Manager (Deferred Prosecution). Previously, she has worked in Commissioning with OPCC, and with young offenders and excluded young people as County Coordinator for the Hampton Trust, a Young Persons Adviser and Teacher.
Pathfinder has been operational for four years and within that period has undertaken an RCT with Cambridge University, research with Exeter University to understand the prevalence of TBIs in those that come into contact with the CJS and how to adapt approaches; and is currently in discussions with Edinburgh University around a study in relation to perceptions of the Police.