Evil Or Sick?

14 July 2009

I talked here recently about the people who are filling up our prisons – very few evil, a great number inadequate.

NSW Justice Health has just released a survey of NSW inmates, carried out last year, and it confirms so much of what I said – alcohol and drug problems, unemployment, dreadful family life, little education.  About half of those currently incarcerated in NSW prisons were expelled from school.

But the most interesting fact for me was that more than half have suffered a serious head injury.

I have a good friend in England who works with male prisoners and my sister, who worked with young people who’d suffered head injuries, suggested to him that, as a matter of interest,  he should ask his inmates if they’d ever had a head injury.  He was stunned by how many had.

And we know a young man (16 or 17) who came off his bicycle and was taken to hospital where he received rather perfunctory medical attention because he was so aggressive and abusive to the staff. They assumed he was drunk. He was then arrested for his behaviour and died in police custody.  There was no evidence of alcohol or drugs in his bloodstream BUT he had suffered a frontal lobe injury. 

I have no idea whether anything can be done to stem the behaviour that apparently can follow such an injury (help me out here please, Judith).  But if there is something,  it looks to me like we should be doing it as a matter of urgency.

It would be dreadful to ignore such a statistic. 



  1. The ‘head injury’ theory makes so much sense to me! Hastening to mention that I am NOT in nursing or medicine, this is based on observations.

    I can think of two cases in my experience, admittedly not external head injuries, but the brain was irritated / injured all the same.

    One concerned a lady who collapsed (at Roselands) with a brain aneurysm – for some weeks BEFORE the collapse she was absolutely horrible. Uncharacteristic rages, would drive to husband’s work place and berate him for anything and everything. After surgery (and surgery on a 2nd aneurysm) she reverted to her normal quiet polite self – admittedly with long term problems.

    The other was my own grandmother, still living independently at 91 (back in 1986) apparently began behaving very erratically and irritably, walking the hallways of their unit block at all hours of the night, disturbing her next door neighbour (another LOL) in the wee sma’s with nonsense demands. Unluckily we were away at the time and not making our weekly visits. Then she finally collapsed, on Easter Sunday,(by which time I was back home, luckily) needing the paramedics and all, with blood pressure in the stratosphere, and the medics described it as a ‘sort of’ slow leak near-stroke. In all the period of irritation and bizarre behaviour she had refused her neighbours requests and offers to contact us or my father (Nana was in Chatswood at the time, and Dad lived in Tuross Head). Once treated and rested she reverted to her normal self. But could no longer live alone and went into hostel care.

    So the head injury thing makes perfect sense to me,
    and what are we gunna do about it?

    Gae, in Callala Bay

  2. ALL head injuries, even monor ones, should be taken very seriously. Certainly if there is any change of behaviour or personality, it should be reported to a neurologist and the proper tests made. There doesn’t have to be any external sign of injury as the brain is contained within a hard bony structure, and can be banged around inside this by quite minor incidents, even a light shaking.

    Unfortunately, even an apparently minor blow can cause permanent damage and this is why I think every offender must be asked whether he/she has ever suffered a blow to the head. Even this isn’t foolproof, as it may have happened in infancy or been shrugged off as just “collided with the goalkeeper”, or whatever, and there may have been no loss of consciousness.

    Where damage is identified, there is a dearth of appropriate places for treatment, which consists of psychological rehabilitation – providing some insight, if possible, and training in coping strategies and behavioural modification.

    You’re absolutely right to point out this staggering – and very sad – statistic.

  3. Judith got there first – very hard to predict the effect from the significance of the injury, seems to be down to luck (I’m sure there is better knowledge than I have, but still – not a clear relationship between the force of injury and the personality etc outcomes).

    Also, have you read/heard of The Spirit Level, a book by Wilkinson and Pickett about how closely related to inequality in society are parameters such as numbers in prison (but also all sorts of others – even obesity). Very interesting. I plan to read it!

    Listen to the authors on Thinking Allowed (until next Wed, when it’ll disappear from the BBC archive).http://www.bbc.co.uk/programmes/b00lk12r#synopsis

    details of the book:
    The Spirit Level: Why Equal Societies Almost Always Do Better
    by Richard Wilkinson (Author), Kate Pickett (Author)
    Publisher: Allen Lane
    ISBN-10: 1846140390
    ISBN-13: 978-1846140396

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