Studies have shown that up to half of the prison population have suffered brain trauma caused by accidents and assaults that could be a factor in persistent offending.
Now the Howard League Scotland, a penal reform charity, is urging the Scottish Prison Service to introduce screening programmes to pick up injuries that could be treated using drugs. Research has found that criminals with attention deficit hyperactivity disorder (ADHD) – which can be caused by brain injury – who took drugs such as Ritalin were between 32 and 41 per cent less likely to re-offend.
Trials of screening systems are already taking place south of the Border, including at HMP Leeds, and will be rolled out to include young offenders found to have traumatic brain injury.
The Howard League believes Scotland should also become a test base, as while crime has fallen to a 37-year low, re-offending rates have remained high, with 42 per cent of offenders committing another crime within two years.
A spokeswoman for the Howard League Scotland added: “There is a need to better understand the complexity of issues that contribute to offending behaviour. Research suggests a higher incidence of traumatic brain injury (TBI) amongst the prison population than in the population at large, and this clearly has implications for those working across the criminal justice system.
“Howard League Scotland has written to the chief executive of the Scottish Prison Service to highlight these findings and to emphasise the importance of early identification of those with a history of TBI.
“This holds the key to enabling effective rehabilitation and, within a custodial setting, ensuring that those affected are offered the most appropriate treatment.”
According to researchers, although brain injuries can affect judgment, memory and behaviour and lead to a pattern of offending, this “hidden disability” can go unrecognised and untreated.
Professor Huw Williams, a neuropsychology expert from Exeter University who has carried out brain injury research in prison populations, said: “Given the prevalence of brain injuries in the prison population, it is very important that judges and sheriffs do know if it has been a factor in a person’s behaviour.
“[Testing] is not something that happens in any routine or regular manner, but it could come in as part of a more thorough medical assessment. There’s an explosion of understanding in this field and some excellent work is happening.”
Testing could involve brain scans, but would more commonly be done initially through asking prisoners questions and looking at medical records and histories of assaults. However, as technology develops, scanning could become more common.
“It could become routine,” Williams said. “That is an area we are looking into, to deliver low-cost, effective ways of scanning people to pick up on these problems.”
Williams has carried out work with Glasgow University, looking at brain injuries in general, and experts there said they would be keen to help set up a programme for the Scottish Prison Service.
Tom McMillan, professor of clinical neuropsychology at Glasgow University, said: “If people have had head injuries recently or more remotely, it is an opportunity to give them information and look into the potential to set up some intervention work.”
The approach has the support of Brigadier Hugh Monro, the HM Inspector of Prisons, who said: “Where I think there is a real issue in reducing re-offending is this business of through care, from prison back to the community.
“If that requires particular medication then I would be entirely supportive of that.”
He added: “I don’t have a clinical or technical understanding of the effects of Ritalin, but I would be entirely happy if the diagnosis was that it would be effective.”
Research at Leeds Prison found that almost half of its adult male prisoners have a brain injury which could be contributing to their repeat offending.