1 / 59

Brain Injury in Minnesota Correctional Facilities: Changing the System

Brain Injury in Minnesota Correctional Facilities: Changing the System. Dr. Charlotte Johnson Psychologist , MN Department of Corrections Mary Enge Regional Resource Specialist , MN DHS , Disability Services Division.

Download Presentation

Brain Injury in Minnesota Correctional Facilities: Changing the System

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Brain Injury in Minnesota Correctional Facilities:Changing the System Dr. Charlotte JohnsonPsychologist, MN Department of Corrections Mary Enge Regional Resource Specialist, MN DHS, Disability Services Division

  2. Types of Brain Injury • Traumatic Brain Injury (TBI) is an injury to the brain caused by an external force after birth • Acquired Brain Injury (ABI) is an injury to the brain which is not hereditary or congenital, occurs after birth, & includes all types of TBI

  3. Centers for Disease Control (CDC) Traumatic Brain Injury (TBI) Statistics • TBI is a contributing factor to a third of all injury-related deaths in the United States • About 75% of all TBIs each year are concussions or other form of mild TBI

  4. Centers for Disease Control TBI Statistics • Each year there are a reported 1.7 million TBIs in the United States • An estimated 5.3 million Americans - 2% of the U.S. population - live with a long-term or lifelong need for help due to TBI

  5. Demographics of MN • US Census population for the state of MN estimated in 2010 as 5,303,925 • 85.3% White • 5.2% Black • 4% Asian • 1.1% American Indian/Alaska Native

  6. TBI in State of Minnesota 2011 Dept. of Health TBI Registry Data • 5,713 Hospital Admissions • 10,429 ER/ED Visits • 853 Deaths 2011 Population of Minnesota: 5,303,925

  7. Chronic TBI in Minnesota Estimate: 90,000 to 100,000 Minnesotans live with a disability that is caused or made worse by a traumatic brain injury

  8. Traumatic Brain InjuryGrant 2006-2009 Goals • Measure prevalence rates of TBI in state correctional facilities • Provide training & education to Department of Corrections employees & partners • Identify / develop release planning & community resources for offenders & ex-offenders

  9. Minnesota Department of Corrections Prison Facilities

  10. Minnesota State Prisons

  11. What Did We Learn?2006-2009: TBI Prevalence • 998 adult male offenders were successfully interviewed to determine TBI History (MCF-St. Cloud) • 100 adult women offenders were successfully interviewed (MCF-Shakopee) • 52 adolescent male offenders were successfully interviewed (MCF-Red Wing)

  12. What Did We Learn?2006-2009: TBI Prevalence 82%+ of offenders successfully interviewed had a history of TBI

  13. 2006-2009 Major Grant Products • Prevalence Data • Extensive TBI Training for Department of Corrections Staff • Development of Three on-line Training modules for Department of Corrections staff & partners

  14. 2006-2009 Major Grant Products Prevalence Data: What Did We Learn?

  15. TBI Severity Criteria • Severe: >24 hours Length of Coma (LOC) &/or >24 hours Post Traumatic Amnesia (PTA) • Moderate: 60 minutes to 24 hours LOC &/or 1-24 hours PTA • Mild: 0-59 minutes LOC &/or PTA <1hour PTA

  16. Another Measure of Severity

  17. Male Findings • Severe: 13.9% • Moderate: 12.4% • Mild: 73.7% • No TBI: 172 Severe & Moderate counts were nearly double using less conservative criteria

  18. Juvenile Males • 49 out of 50 reported history of TBI • Most were moderate & severe • Most were due to domestic assault

  19. Female Findings • 96 out of 100 female offenders met criteria for having sustained a head injury • 22.1% Mild (male=73.7%) • 44.2% Moderate (male=12.4%) • 33.7% Severe (male=13.9%)

  20. TBI in Minnesota Prison Population

  21. MN DOC Offender Statistics as of 01-01-2012 • Incarcerated: • 9,302 adults • 43 juveniles • Average age: 36

  22. MN DOC Offender Statistics as of 01-01-2012 Approximately: • 53% White • 35.5% Black • 9% American Indian • 7.3% Hispanic • 2.4% Asian

  23. What Did We Learn? Needed: • Refined process to identify offenders with TBI & related functional impairment • Plan to assist in prison & with discharge back to the community • Ongoing training & staff dedicated to TBI in critical programs

  24. TBI in Minnesota Correctional Facilities: Changing the System (2010-2014) • MN Departments of Human Services & Corrections 2nd partnership grant is building on the work of our earlier grant • Current grant life: 2010-2014 • $250,000.00 award per year

  25. Current Grant Project Literature suggests that cognitive problems associated with a past TBI may affect potential to succeed in rehabilitation (Valliant, et al, 2003; Corrigan, 1995, as cited in Wald, Helgeson, & Langlois, 2008, para. 8), including SA treatment (SAMHSA, 1998a, as cited in Wald, Helgeson, & Langlois, 2008)

  26. Current Grant Project: Successful Return to Community • Long term goal: systemic change within the DOC to offer an improved response for offenders with TBI • Coordination of services to better transition to the community

  27. Current Grant Project: Successful Return to Community • Development & implementation of DOC system to identify & track offenders with TBI requiring supportive services • Follow identified offenders as they complete chemical dependency treatment

  28. Current Grant Project: Successful Return to Community • Release planning to coordinate appropriate TBI services in the community after leaving prison • Comprehensive psychological / cognitive assessment process to identify offenders with special needs

  29. Changing the System: Current Grant Accomplishments • Developed / Refined MN DOC TBI Screening Tool • Grant funded DOC Neuropsychologist & TBI Release Planner • Developed CD Treatment protocols for offenders with TBI / cognitive deficits

  30. Changing the System: Current Grant Accomplishments • Continue DOC staff/ Community Training • Established DHS TBI Advisory Committee grant subcommittee • Developed Native American Resource Guide • Held American Indian Listening Session

  31. Changing the System: Identified Populations • Primary population served: “Offenders in the state prison system, including those who test positive for TBI & have functional needs” • Secondary population served: “incarcerated American Indians”

  32. American Indians • U.S. Study found TBI-related hospital discharge rates were highest for American Indians / Alaskan Natives - 75.3 per 100,000 (Langlois, Kegler, & Butler, 2003, as cited in McCrea, 2008) • Risk factors include SES & substance abuse • American Indians are identified as a group of interest for the current grant

  33. 2005-2009 MDH TBI Registry:Rate of Nonfatal Hospitalizations • White: 87.7 • Black: 100.2 • Am. Indian/Alaska Native: 162.7 • Asian/Pac. Island: 48 • Hispanic: 1.1

  34. American Indian Listening Session: Suggestions On Policy • TBI education for Chemical & Mental Health workers • Ensure TBI is taken into account during sentencing, mental health assessment, & child protection case investigations

  35. American Indian Listening Session:Suggestions On Policy • Inform Law Enforcement/Community Services of offender return to community • Formalize inmate access to spiritual & cultural practices – increase access to spiritual leaders.

  36. Changing the System: Grant Plans • Share updated on-line DOC training • Work with MNHELP.INFO to enrich site content for ex-offenders & people with BI • Follow-up on selected American Indian Listening Session recommendations

  37. What You Need To Know About TBI Symptoms

  38. TBI Symptoms • Tremors • Weakness/fatigue • Sensation deficits • Vision problems

  39. TBI Symptoms • Language problems • Poor judgment of space • Confusing right/left

  40. TBI Symptoms • Problems reading or writing or adding • Problems following conversations • Getting stuck on topics • Not following instructions

  41. TBI Symptoms • Tremors • Weakness/fatigue • Sensation deficits • Vision problems

  42. TBI Symptoms • Cognitive: • Learning new information • Easily Distracted • Losing train of thought • Forgetting things that have been completed

  43. TBI Symptoms • Ignoring one side of body • Irritability, anger, mood swings • Change in appetite / hygiene / social skills

  44. TBI Irritability & Anger • 35% to 96% show agitated behavior during acute recovery (Silver, Yudofsky, & Anderson, 2011) • Of 60 offenders in jail those who sustained TBI in last year showed worse anger/aggression (Slaughter, 2003) • Risk factors: irritability, impulsivity, & past aggression

  45. What You Need To Know About TBI Diagnostic Considerations & Memory Strategies

  46. Diagnostic Considerations • Post-traumatic Stress Disorder • Frequent incidence in soldiers—blast injury • Amnesia for certain parts of the trauma • Difficulty concentrating

  47. Diagnostic Considerations • Somatic complaints • Perceptual symptoms • Severity does not influence • Over 40% comorbid PTSD/TBI failed effort tests (consideration of meaning of effort)

  48. Diagnostic Considerations • Obsessive-compulsive behaviors • Comorbid with attention deficits • Perseveration & hyper vigilance

  49. Diagnostic Considerations • Schizophrenia-like psychosis ● Paranoid delusions ● Auditory hallucinations ● Catatonic features, formal thought disorder & negative symptoms uncommon (Johnson & Lovell, 2011)

  50. Memory Strategies • Take notes—Keep notepad, post-it, or cell phone handy to immediately record • Things to do • What was completed in a day • Important phone numbers & addresses • Ideas & feelings • What to do in an emergency

More Related