Six-month Post-release Outcomes for Inmates with Traumatic Brain Injury in Supported Community Programming

Traumatic brain injury (TBI) is a serious public health issue. The incidence of TBI is much higher in the incarcerated population than in the general population, making this a uniquely vulnerable population. Methods: This study looks at data from the Jail Based Behavioral Health Services (JBBS) to examine recidivism rates among inmates participating in supportive programming. It also uses data from a state brain injury program to examine the impact of case management on community engagement in the justice-involved population with a history of brain injury. Results: Statewide data for a population of inmates who elect to participate in jail-based behavioral health service program reflect a self-reported TBI history rate of 36.4%. Six-months after release from jail, 11.9% of those persons with TBI reported a reoffense relative to 8.5% of those individuals without a history of TBI. Recidivism rates comparing individuals with a history of TBI and those without a history of TBI were not significant. Participating inmates with a reported TBI history were 4.22 times more likely to have experienced trauma (χ2 = 35.58, p < .001) and 3.52 times more likely to have a mental illness diagnosis relative to incarcerated persons without TBI (χ2 = 27.85, p < .001). Six months after release, 56.8% of participating individuals with a history of TBI were receiving community treatment, 27.8% of these individuals were not in treatment, and 3.4% reported that they had completed treatment. Case management also appears to confer a protective benefit and prevent escalation of needs. A closer study of recently-released inmates receiving individual case management confirms that there is an extraordinarily high attrition rate from referral to receipt of services where 70% of people referred for case management fail to make a connection. For those that do receive services, these data suggest that it prevents an escalation of psychosocial needs. In this study, there were no differences in reported community participation as measured by M2PI scores (t24 = .497, p = 0.624) at intake and at six months of case management. Conclusions: The present study confirms that case management confers a benefit to persons with TBI who are released from the criminal justice system. Further, in a population of persons who elect to participate in jail-based behavioral health service program, the recidivism rates for the more vulnerable population of persons with TBI history are no different from the larger population of returning citizens. Future research should examine the degree to which these outcomes are directly impacted by the level or type of treatment. The limitations of the present study are discussed.