Barbara Curtis, MSN, RN, Director of Nursing Service, Washington State Department of Corrections talks about the high prevalence of traumatic brain injury in the correctional patient population and responses to the condition. Barbara has been an RN for over 30 years with 20 of those in emergency services both as administrator and clinician. She has been with correctional nursing for 11 years.
Although an estimated 2% of the general population has sustained a TBI with continuing disability, a meta analysis of studies in the inmate population indicates a prevalence of over 60% . It is suggested that this condition may be under-reported for a variety of reasons. A study performed in the Washington State Correctional System found as much as 89% prevalence. That equates to 9 out of 10 of our inmate patients having some form of brain injury.
The long-term effects of TBI are memory problems, inability to focus, and poor impulse control. Inmates with this condition may respond in anger, aggression or verbal disrespect to cover for their deficits. This means that our patients with TBI often show these behaviors:
- Act out in anger or irritation
- Forget rules of prohibited conduct
- Not remembering where they should be or by when
- Forgetting that they cannot go into certain areas
- Increased behavioral infractions
TBI treatment focuses on symptom management and compensation for cognitive deficits. A careful intake history is an important first step to diagnosing TBI and managing symptoms. The CDC recommends that special attention be given to impulsive behaviors, violence potential, sexual behavior and suicide risk if the inmate is depressed.
Barbara suggests nurse interventions that focus on assisting patient to remember and follow direction.
- Speak slowly and clearly
- Give the patient time to register the information and respond
- Provide memory tools like writing down health instructions
- Give only a few directions at a time and keep it simple
She also emphasizes the importance of awareness of the condition for both custody and health care staff.
Jennifer Dawn Capps says
That is great because as a TBI patient I have been the subject of aggresive, unprofessional disrespect by authoritive individuals that has resulted at times my arrest to be denyed my critical medications and some PD charges Ive had no choice to accept and pay fines and cost for to be able to be released with little or no bond; however i had severe seizures which they were aware since they failed to protect me from the man that never served a day for any of my brutal assaults. But the next generation has harrassed me by questioning my involuntary factors from the trauma and severe damage. I have been there but felt much better toward our courts and policies their taught these bias procedures as ok and supported by all in judicial system in unity.; when I act the way they treated me as typical criminal class and menace in society by their riducule of my speech and deformaties as I am town drunk or such. it has felt better when this pc of trash skum 5’3 105 pound longlife criminal has showed and say just what they are and where they belong and so far I stayed in my rights to voice that and although I had stay * days due to outrageous bond due to nature of charges / terroristic threats to a police official. glad I stuck it out and didnt pay out for my remarks that she was informed I said nothing criminal or civil that was wrong doing . That could resulted in 20 year+ sentence and I did have to accept guilty plea of PD instead of truth that I. seized with major head and facial fractures.
it would be a start and slight hope to TBI survivors if awareness and training included us as equal citizens that at least to have same rights and respect as the criminals that haven’t been falsely or unfairly incarcerated and charged for involuntary episodes they respond to also. However I am the only resident in entire block that will always have my burning permit approval and number and all rules followed according to my specific county codes while rest burn trash, tires, etc. and wouldnt have any idea of first step to try to get permit or department to ask about. lol But what’s wrong with that picture? If your now annoyed by my comments or advising the acts that i
know personally, then join the rest of whatever ya’ll are but those may be against us (people with TBI or related disorders; however sorry to all for this truth you are not superior beings that are fed off creatures u see us as and live stock to feed on. Just scavengers that cant feed themselves or respect others in general.
Until more groups and associations promote and support the truths and awareness of facts this will continue in forensic studies and populations of inmates as history has allowed by silence.