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Kim Gorgens: The surprising connection between brain injuries and crime
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Here's a shocking statistic: 50 to 80 percent of people in the criminal justice system in the US have had a traumatic brain injury. In the general public, that number is less than five percent. Neuropsychologist Kim Gorgens shares her research into the connection between brain trauma and the behaviors that keep people in the revolving door of criminal justice -- and some ways to make the system more effective and safer for everyone.
Kim Gorgens - Neuropsychologist
Kim Gorgens studies the brain's response to injury -- and advocates that we mind our (gray) matter. Full bio
Kim Gorgens studies the brain's response to injury -- and advocates that we mind our (gray) matter. Full bio
Double-click the English transcript below to play the video.
00:12
A traumatic brain injury, or TBI,
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is a disruption in brain function
caused by an external blow to the head.
caused by an external blow to the head.
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And when you hear that definition,
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you might think about sports
and professional athletes,
and professional athletes,
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since it's the kind of injury
we're used to seeing on the playing field.
we're used to seeing on the playing field.
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And this imagery has really come
to define TBI in the public consciousness.
to define TBI in the public consciousness.
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I myself do research on TBI
in retired and college athletes.
in retired and college athletes.
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I stood on a TED stage in 2010,
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talking about concussions in kids' sports.
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So I have to say, as someone
who researches and treats these injuries,
who researches and treats these injuries,
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that I've been really gratified
to see the growing awareness of TBI
to see the growing awareness of TBI
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and specifically, the short-
and long-term risks to athletes.
and long-term risks to athletes.
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Today, though, I want to introduce you
to a larger but no less controversial
to a larger but no less controversial
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group of people impacted
by traumatic brain injury,
by traumatic brain injury,
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who don't often show up in the headlines.
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I've come to recognize
these inmates and probationers
these inmates and probationers
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as surprisingly among the most
vulnerable members of society.
vulnerable members of society.
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For the last six years, my colleagues
and I have been doing research
and I have been doing research
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that has completely changed the way
we think about the criminal justice system
we think about the criminal justice system
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and the people in it.
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And it may change the way
you think about those things, too.
you think about those things, too.
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So I'll start with a shocking statistic:
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50 to 80 percent of people
in criminal justice
in criminal justice
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have a traumatic brain injury.
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Up to 80 percent.
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In the general public,
in this room, for example,
in this room, for example,
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that number is less than five percent.
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And I'm not just talking about
getting your bell rung.
getting your bell rung.
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These are the kinds of injuries
that require hospitalization.
that require hospitalization.
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Most of them are the product
of a physical assault,
of a physical assault,
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and some of them
are actually sustained in jail.
are actually sustained in jail.
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All of these numbers are even higher
among the women in criminal justice.
among the women in criminal justice.
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Almost every single woman
in the criminal justice system
in the criminal justice system
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has been exposed to interpersonal
violence and abuse.
violence and abuse.
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More than half of these women have
been exposed to repeated brain injuries.
been exposed to repeated brain injuries.
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In this way, these women's brains look
like the brains of retired NFL players,
like the brains of retired NFL players,
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and they'll likely face the same risks
for dementing diseases as they age.
for dementing diseases as they age.
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The same risks.
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TBI, together with mental illness
and substance abuse and trauma,
and substance abuse and trauma,
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makes it hard for people to think.
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They have cognitive impairments like
poor judgment and poor impulse control,
poor judgment and poor impulse control,
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problems that make
criminal justice a revolving door.
criminal justice a revolving door.
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People get arrested and booked into jail.
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They oftentimes get into trouble
while they're in there.
while they're in there.
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They get into fights.
They fall out of their bunk.
They fall out of their bunk.
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And then they get released
and do stupid things,
and do stupid things,
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like forgetting mandatory check-ins,
and they get rearrested.
and they get rearrested.
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Statistically speaking,
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they're actually more likely
to be rearrested than not.
to be rearrested than not.
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A colleague calls this "serving
a life sentence 30 days at a time."
a life sentence 30 days at a time."
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And oftentimes, these folks don't know
why this is so hard for them.
why this is so hard for them.
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They feel out of control and frustrated.
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So knowing that TBI is at the root
of so many of these challenges,
of so many of these challenges,
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the mission for a group of us in Colorado
has been to disrupt that cycle,
has been to disrupt that cycle,
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to jam the revolving the door.
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So working together
with my state and local partners,
with my state and local partners,
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we crafted a plan
to meet everyone's needs:
to meet everyone's needs:
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the system, the inmates and probationers,
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my graduate students.
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In this program, we assess
how each person's brain works
how each person's brain works
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so that we can recommend
basic modifications
basic modifications
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to make this system more effective
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and safer.
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And here when I say "safer,"
I mean safer not only for the inmates,
I mean safer not only for the inmates,
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but safer also for correctional staff.
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In some ways, this is
such a simple approach.
such a simple approach.
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We're not treating the brain injury,
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we're treating the underlying problem
that gets people into all of this trouble
that gets people into all of this trouble
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in the first place.
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We do quick neuropsychological
screening tests
screening tests
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to identify strengths and weaknesses
in the way an inmate thinks.
in the way an inmate thinks.
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Using that information,
we write two reports.
we write two reports.
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One, a report for the system
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with specific recommendations
on how to manage that inmate.
on how to manage that inmate.
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The other is a letter to the inmate
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with specific suggestions
for how to manage themselves.
for how to manage themselves.
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For example, if our test result suggests
that a probationer has a hard time
that a probationer has a hard time
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remembering the things they hear,
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that would be an auditory memory deficit.
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In that case, our letter
to the court might suggest
to the court might suggest
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that that probationer get handouts
of important information.
of important information.
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And our letter to that probationer
would say, among other things,
would say, among other things,
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that they should carry a notebook
to record that information for themselves.
to record that information for themselves.
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Now, most importantly,
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is that I pause here
to be really clear about one point.
to be really clear about one point.
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This program does not
minimize responsibility
minimize responsibility
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or make excuses for anyone's behavior.
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This is about changing longstanding
negative perceptions
negative perceptions
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and building self-advocacy.
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It's actually about taking responsibility.
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The inmates move from,
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"I'm a total screwup, I'm a loser,"
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to, "Here's what I don't do well,
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and here's what I have to do about it."
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(Applause)
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And the system comes to see
an inmate's problematic behavior
an inmate's problematic behavior
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as the things they can't do
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versus the things they won't do.
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And that change --
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seeing behavior as a deficit
rather than outright defiance --
rather than outright defiance --
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is everything in these settings.
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We hear from inmates around the country,
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and they write, and more than anything,
they want to know how to help themselves.
they want to know how to help themselves.
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This is an excerpt from a letter
from Troy in Virginia,
from Troy in Virginia,
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an excerpt from a 50-page letter.
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And he writes,
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"Can you tell me what you think
of all the head traumas I've dealt with?
of all the head traumas I've dealt with?
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What can I do? Can you help me?"
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Closer to home, we have
thousands of stories like this,
thousands of stories like this,
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and smart stories, stories
that have a great outcome.
that have a great outcome.
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Here's Vinny.
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Vinny was hit by a car when he was 15,
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and from that moment forward,
spent more time in jail than in school.
spent more time in jail than in school.
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With some basic skill-building,
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after our assessment revealed
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that he had some pretty
significant memory impairments,
significant memory impairments,
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Vinny learned to use the alarm
and reminder function on his iPhone
and reminder function on his iPhone
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to track important appointments,
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and he keeps a checklist
to break larger tasks
to break larger tasks
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into smaller, manageable ones.
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And with basic tools
like that under his belt,
like that under his belt,
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Vinny's been out of jail for two years,
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clean for nine months,
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and recently back to work.
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(Applause)
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What's so striking for Vinny
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is that this is his first time
off of court supervision
off of court supervision
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since his injury more than 15 years ago.
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He made it out of the revolving door.
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(Applause)
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He says now, "I can do anything.
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I just have to work
a lot harder at it." (Laughs)
a lot harder at it." (Laughs)
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And here's Thomas.
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Thomas has some pretty significant
attention and behavior problems
attention and behavior problems
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after an injury landed him in a coma
for more than a month.
for more than a month.
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After relearning how to walk,
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his first stop?
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Court.
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He couldn't imagine a future
where he wasn't in trouble.
where he wasn't in trouble.
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He now carries a calendar
to avoid being held in contempt
to avoid being held in contempt
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for missed court dates,
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and he schedules a break
into his day every day
into his day every day
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to recharge before he gets agitated.
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And nobody knows the revolving door
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better than the person sitting
at the front of the courtroom.
at the front of the courtroom.
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This is my good friend and colleague
Judge Brian Bowen.
Judge Brian Bowen.
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Now, Judge Bowen was already on a mission
to make the system work for everyone,
to make the system work for everyone,
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and when he heard about this program,
he saw the perfect fit.
he saw the perfect fit.
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He actually sits down
with all of his prosecutors
with all of his prosecutors
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to help them see that there's basically
two categories of defendants
two categories of defendants
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in the courtroom:
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the ones we're afraid of --
oftentimes, rightfully so --
oftentimes, rightfully so --
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and the ones we're mad at.
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These are the ones who miss
all of their scheduled appointments
all of their scheduled appointments
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and they blow through
the best-laid probation plans.
the best-laid probation plans.
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And Judge Bowen believes that,
with a little more support,
with a little more support,
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we could move people
in this latter category,
in this latter category,
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the maddening category,
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through and ultimately out of the system.
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He proved that with Navy veteran Mike.
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Judge Bowen saw the correlation between
Mike's history of a massive 70-foot fall
Mike's history of a massive 70-foot fall
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and his long-standing pattern
of difficulty showing up on the right day
of difficulty showing up on the right day
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for court appointments
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and complying with mandatory
therapy requirements, for example.
therapy requirements, for example.
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And instead of sentencing him
to more and more jail time,
to more and more jail time,
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Judge Bowen sent him home
with maps and checklists and handouts
with maps and checklists and handouts
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and recommended instead
vocational rehabilitation
vocational rehabilitation
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and flexible scheduling
for those therapies.
for those therapies.
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And this with those supports,
Mike's back to work
Mike's back to work
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for the first time since his injury
while he was in the service.
while he was in the service.
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He's repairing relationships
with his family,
with his family,
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and just last month,
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he graduated from
Judge Bowen's veteran's court.
Judge Bowen's veteran's court.
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(Applause)
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This program shows us
the overwhelming prevalence
the overwhelming prevalence
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of traumatic brain injuries
and cognitive deficits
and cognitive deficits
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and the accumulation of brokenness
in the criminal justice system.
in the criminal justice system.
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And it highlights the extraordinary power
of resilience and responsibility.
of resilience and responsibility.
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In Mike and Thomas and Vinny,
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even Judge Bowen's story,
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you saw the transformation made possible
by a change in perception
by a change in perception
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and some simple accommodations.
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All told, in this program,
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these inmates and probationers
come to see themselves differently.
come to see themselves differently.
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The system sees them differently,
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and when you meet them in the community,
I hope you see them differently, too.
I hope you see them differently, too.
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Thanks, guys.
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(Applause)
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ABOUT THE SPEAKER
Kim Gorgens - NeuropsychologistKim Gorgens studies the brain's response to injury -- and advocates that we mind our (gray) matter.
Why you should listen
As a neuropsychologist working in the field of brain injuries, Kim Gorgens has seen firsthand the damage sports-related impacts can do. And as chair of the State of Colorado Traumatic Brain Injury Trust Fund Board and a member of the Brain Injury Legislative Collaborative, she’s working to shape Colorado law around youth sports injuries.
Gorgens, an assistant clinical professor in the University of Denver Graduate School of Professional Psychology, also is the president-elect of the Colorado Neuropsychological Society and has an appointment to the American Psychological Association’s Council on Disability in Psychology.
Kim Gorgens | Speaker | TED.com