Improper Diagnoses and Brain Trauma in Denver’s Prison Systems

Have you read Lakeside Connect in the past? Then you probably realize how Lakeside’s programs are working in the context of some of the current neurological research to help our students regulate, focus, learn and achieve their personal and academic goals.  As we have worked with so many students in this context, we are finding some of them were improperly diagnosed, labeled incorrectly and so were not being given the care they need.

Improper diagnosis may result in improper care within any system

sherriff's deputy at denver jail
A Denver sheriff’s deputy walks through the Denver jail in 2014. (RJ Sangosti, Denver Post file)

While improper diagnosis and care happens in our educational system, there are other systems whose populations may have been labeled improperly, too, such as the criminal justice system.

A compelling example is in the article which follows by Jennifer Brown in the Denver Post. Here we find 96% of the inmates had a traumatic brain injury (TBI) and did not receive appropriate treatment. This just should not be. We need to be a society with clarity about our approach to treating TBI whether those affected are veterans or inmates. It is the only way these individuals may receive proper treatment and have the opportunity to be restored to their families and communities. I hope you will read this article and realize how many different people are affected by trauma and brain injury.

Nearly all Denver jail inmates in high-risk unit have brain trauma

They were punched in the head in fistfights — or shot, knocked around as children, beaten by spouses or struck by cars.

Almost every inmate in the downtown Denver jail’s high-risk unit has a traumatic brain injury, so many that what began as a one-time university service learning project has grown into a new therapy program spreading to jails along the Front Range.

Neurological researchers from the University of Denver expected to find an above-average prevalence of brain trauma at the Downtown Detention Center. But the results were high enough to shock them.

Nearly every inmate screened — 96 percent — had a traumatic brain injury. That’s significantly higher than national statistics showing from 67 percent to 80 percent of inmates in jails and prisons have a traumatic brain injury, and far higher than the estimated 6 percent to 8.5 percent of the general population.

The results of the Denver screenings were higher in part because researchers screened inmates kept in a high-risk unit of the jail, the unit for people who are considered a risk to themselves or others. More than 90 percent had mental illnesses, and just as many had substance-abuse problems.

Add those two risk factors to the fact that 100 percent of those screened had criminal histories. The combination — criminal behavior, mental illness, substance abuse and traumatic brain injury — is what DU clinical psychology professor Kim Gorgens called the “superfecta.”

Inmates who have all four issues are among the hardest to keep from returning to jail and local emergency rooms.

“They are tricky to treat, but with some easy tweaks and more surveillance, I think we could keep them afloat better,” said Gorgens, an associate professor in DU’s graduate school of psychology.

Gorgens’ graduate students, who needed practice using a traumatic brain injury screening developed at Ohio State University, began interviewing Denver inmates in 2013. They completed a second round of screenings in the summer of 2014. Then, through a partnership with the Colorado Brain Injury Program, the groups secured two grants totaling about $1.5 million to develop a jail-based treatment program.

Treating traumatic brain injury is different from treating severe mental illnesses, such as schizophrenia or bipolar disorder. Recovery is unlikely, so therapy focuses on helping patients understand why it is hard for them to follow directions, how to understand sarcasm and why it’s important to react immediately when a law officer asks them to put their hands up or come out of their cell. They are encouraged to keep calendars, follow a routine, write things down.

The training not only helps the inmates, but sheriff’s deputies who don’t want to have to tell an inmate 100 times to get out of bed.

“The flip side is to help officers understand maybe they are not being obstinate, maybe it’s that they don’t understand,” said Jennifer Gafford, a staff psychologist for the Denver County sheriff’s office.

Besides treatment while behind bars, the new program aims to link brain trauma therapists in the community with inmates upon release, Gafford said.

With grant funding, DU psychology students are expanding screenings to 13 other jails along the Front Range, including the Boulder and Larimer county jails and a handful of youth correctional facilities. Researchers will track inmates involved in the new therapy program to find out whether it impacts future criminal activity, Gorgens said.

National research has found that traumatic brain injury often predates criminal activity, but it’s also true that inmates, especially those who are homeless, are more likely to suffer brain trauma or lose consciousness in fights, car accidents and shootings.

The neurological screens used by the students are verbal and take about 15 minutes, focusing on brain history. Have you ever lost consciousness? Have you ever been knocked out? Have you ever been hit by a fist? A gunshot? A car?

The screening also assesses problems with memory, judgment and decision-making, Gafford said.

Psychology students working in the jail concentrate on the at-risk unit, but plans are to expand the screenings to other inmates.

A more productive life

Thank you, Jennifer for publishing such a compelling article.  It is so important that we understand what is really happening in the brains of those who are in our systems in order to properly deal with the issues that have brought them into our prisons and institutions.  We now have the technology and capability to treat them more effectively and hopefully do a better job of helping them find a productive life.

Gerry Vassar, President/CEO, Lakeside Educational Network

Source: Jennifer Brown: 303-954-1593, or

Leave a Reply

Your email address will not be published. Required fields are marked *