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Traumatic brain injury a health problem with serious impact for people in prisons

Toronto, July 21, 2014

By Evelyne Jhung

Dr. Flora Matheson
The hospital’s Centre for Research on Inner City Health has launched a new research program focused on the health of people in prison. Dr. Flora Matheson is looking at the prevalence of TBI to improve screening and treatment. (Photo by Katie Cooper)

The hospital’s Centre for Research on Inner City Health has launched a new research program focused on the health of people in prison. A team of CRICH researchers – including Drs. Flora Matheson, Fiona Kouyoumdjian, Stephen Hwang, Diego Silva and others – have received a CIHR planning grant to identify health priorities in the prison population and build a network of researchers to work together to improve prisoner health.

One branch of this research program will look at the prevalence of traumatic brain injuries and explore ways to improve screening and treatment. Despite evidence that suggests that people in prison have higher rates of traumatic brain injuries than those in the general population, there are no formal screening processes or tailored programs for people who have suffered a traumatic brain injury in prison.

“When some people in prison exhibit behavioural issues, their actions may be a manifestation of a traumatic brain injury,” said Dr. Flora Matheson. “By examining the way TBI impacts people in Canadian prisons, we hope to improve screening and treatment for TBI in prison, and inform training initiatives for correctional staff so they are able to recognize and effectively interact with people with TBIs.”

Improving treatment for TBI upon discharge from prison also helps to prevent re-incarceration.

“We don’t want people to be re-incarcerated because of ‘bad behaviour’ because that’s costly and not what’s going to help them,” Dr. Matheson said. “TBI is a health issue, one that often lands people in prison. We hope that by improving screening and treatment inside and outside the criminal justice system, we can keep more people suffering from TBI out of correctional facilities.”

Correctional Service Canada already has an intake assessment that screens for mental health and substance abuse and the provincial Ministry of Community Safety and Correctional Services screens for mental health. Dr. Matheson sees the potential to incorporate TBI screening into the existing intake assessments.


“We hope that by improving screening and treatment inside and outside the criminal justice system, we can keep more people suffering from TBI out of correctional facilities.”

“The information will help correctional staff plan accordingly so that people with TBI can participate more effectively in programs aimed at rehabilitation. We know people who have suffered from a TBI have impaired cognition and personality disturbances. This means they may not be good at following their correctional program not because they’re trying to be difficult, but because they can’t follow the rules.”

Dr. Matheson recently received permission to link prisoner data (information such as time spent in segregation, incidences of misconduct) to health data (for example, whether the prisoner sustained a concussion) and will soon begin to examine how brain injury relates to incarceration and prison adjustment. She’ll be working with a broad range of stakeholders, including correctional staff at the federal and provincial levels, over the next few years to understand the repercussions of brain injury in among those in prison.

About St. Michael's Hospital

St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael's Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.