The health of people in Australia's prisons 2022

Among the general adult population, about 17% of males and 9% of females have had a head injury leading to a loss of consciousness, an indication of possible traumatic brain injury (Frost et al. 2013). The prevalence of acquired brain injury among people in prison is much higher, at 40–90% (Alderman et al. 2018; Colantonio et al. 2014; Kelly et al. 2018). Acquired brain injury has been associated with an increase in aggression, impulsivity, impaired judgement, and reduced empathy – all of which are also associated with criminal behaviour.

Acquired brain injury refers to any damage to the brain that occurs after birth and/or due to fetal alcohol syndrome. The most common causes are stroke and other organic causes, accident, or trauma, known as traumatic brain injury (Alderman et al. 2018).

Acquired brain injury can cause difficulties with memory, attention, information processing, and mood regulation. It is a risk factor for criminal behaviour and for re-offending after prison release (Alderman et al. 2018).

Brain injury among people in prison has a substantial impact on prison health services, with an increased need for medical and psychological services (Piccolino and Solberg 2014).

Prison entrants who have had head injuries

Prison entrants were asked whether:

• they had ever had a head injury resulting in a loss of consciousness
• they had noticed symptoms such as headaches, memory changes, behavioural, and/or mood changes as a result of that head injury
• those symptoms had persisted.

A similar number of males (39%) and females (37%) reported a history of head injury resulting in loss of consciousness. More non-Indigenous prison entrants (44%) than First Nations prison entrants (33%) had such an injury.

Of those who reported a head injury, 3 in 5 (59%, or 23% of all prison entrants surveyed) said they had noticeable symptoms following the head injury, and 1 in 2 (51%, or 20% of all prison entrants surveyed) were still experiencing symptoms.   

Prison dischargees who have had head injuries

Prison dischargees were asked whether they had sustained a head injury resulting in loss of consciousness while in prison and, if so, whether they experienced symptoms such as headaches, memory loss, or behavioural and/or mood changes following the injury.

Of those who reported a head injury in prison, almost 3 in 4 (70%, or 5.3% of all prison dischargees surveyed) said had noticeable symptoms following the head injury, and 3 in 5 (58%, or 4.4% of all prison dischargees surveyed) were still experiencing symptoms.