Here, Mark Crane, Directorate Lead Psychologist for HMPPS Wales, talks as part of our #ThroughOUReyes campaign, about his passion for raising the profile of acquired brain injury and other neurodiverse needs in Wales and the wider prison estate.

In his reflective blog, Mark discusses the disproportionately high prevalence of brain injury in the criminal justice system, as well as the positive impact of our Linkworker service in addressing some of the often ‘hidden’ impacts of brain injury, including aggression and irritability through reductions in adjudications and incidents.

"As Directorate Lead Psychologist for HMPPS in Wales I have been passionate about raising the profile of Acquired Brain Injury (ABI) and other neurodiverse needs in Wales and across the wider prison estate and the probation service for several years. I also lead on ABI as a thematic area for Psychology Services Group nationally to ensure impact can be achieved across England and Wales.

It’s important to recognise that as little as five years ago, very little was known about this emerging area of need with most research evidence coming from the USA, but it is really pleasing to see that the profile of neurodiversity is becoming much more prominent across the whole Criminal Justice System (CJS) here in the UK. This can only be a positive thing given the emerging findings which show that the prevalence of ABI is disproportionately higher in our offending populations versus the general population (comparable with findings in the USA), and that a ‘whole system approach’ is needed to ensure fair treatment and equal access to services, ideally from the first point of contact within the CJS.

For many men and women in the CJS they simply don’t know that they may have suffered a brain injury, which is often the result of a road traffic accident or a violent interaction, and the underlying problems this causes are often mislabelled and individuals are perceived to be challenging, disruptive, forgetful, or difficult. This is significant because at the heart of our rehabilitative efforts we must ensure that the needs of individuals we work with are appropriately identified and that rehabilitative efforts can be normed to the needs of neurotypical offenders if we are to successfully support their progression and release back into the community.

We have seen first-hand, following a Ministry of Justice (MoJ) Innovation Grant for a ‘proof of concept’ Brain Injury Linkworker service in 2017-18 (across five prison sites and an Approved Premise in Wales) that the impact of such an approach has a profound effect on an individual’s well-being and rehabilitation journey. It further supported our staff via ABI awareness training to better understand neurodiverse needs so they were able to adapt their practice to engage and work more effectively with such individuals.

As such, HMPPS in Wales has committed to funding a continuation of the service which now includes offering consultation and advice to Community Offender Managers managing individuals in the community under supervision. In turn, we have seen a positive impact on reducing the demand on other vital services or resources and potentially leading to efficiency savings. I’m looking forward to seeing where the next five years will take us in shaping our service to be more responsive to the needs of neurodiverse individuals…"