SUMMARY
Denver FIRST’s Brain Injuries Screening Program was developed to serve defendants with suspected brain injuries (traumatic and acquired; TBI and ABI) in the Colorado competency system and to enhance TBI-informed interventions. The project is designed to identify and assess acquired and traumatic brain injuries and cognitive functioning in individuals ordered to competency restoration treatment in jail and outpatient settings. The program will work closely with state departments and treatment providers to aid in the implementation of strategies to address the impairment, education and capacity building for restoration staff and program participants, and offer information to assist in community referrals and transition efforts.
BACKGROUND
Defendants with neurocognitive disorders and conditions that affect cognitive functioning, including brain injuries, are overrepresented among persons determined to be incompetent to stand trial. Brain injury is a major cause of disability that can lead to negative health consequences and behavioral problems, including aggression, impulsivity, and emotional reactivity, that may make individuals more vulnerable to becoming involved in the criminal justice system. A history of brain injury is associated with poorer judicial outcomes, including a greater risk for reconviction and probation failure. In one long-term study, individuals with a TBI history had a recidivism rate of 69% relative to 37% for persons without a brain injury history. Persons with a TBI history also have a greater lifetime number of arrests than those without. In Colorado, the rate of reported brain injury history in justice-involved individuals in criminal justice settings ranges from 44% to 97%. Notably, brain injury-related cognitive impairments may also act as barrier to successful competency restoration. In competency restoration settings, a brain injury history is associated with a lower likelihood of restorability and is an area that warrants careful research attention. With the increase in competency evaluation requests, the overtaxed restoration system would greatly benefit from targeted services to aid in individualizing restoration services for individuals with brain injuries.
ELEMENTS
Screening for lifetime history of brain injury, screening for cognitive impairment, implementation of compensatory strategies to address the impairment, delivering education and capacity building for restoration staff and participants; participants are also provided a roadmap of strategies designed to support the participant and competency restoration providers to accommodate and compensate for deficits to improve outcomes
PROGRAM STAFF
University of Denver faculty and staff, Denver FIRST post-doctoral fellows, Masters-level graduate student interns, doctoral-level graduate student interns, and a licensed professional providing clinical supervision
CAPACITY
25-30 clients per month
ANTICIPATED OUTCOMES
Decrease in individuals who require admittance to the state hospital for competency restoration; Decrease in time to reach competency outcome; Increase in treatment service engagement during and after justice involvement.
STANDOUT ASPECTS
This program augments extant competency restoration programs and processes by providing specialized screening, assessment, and treatment recommendations for those whose competency restoration involvement is at least partially attributed to brain injury. This innovative project is the first known program to provide specialized neuropsychological services to a population not only in high need but typically unable to access such services. To control costs and maintain high capacity, as well as adhering to quality standards of care, this program relies on supervised student interns to provide many program services. In line with University of Denver’s commitment to student training and community service, supervising faculty and staff will ensure that students uphold best practices and provide high quality, supported clinical services.
FUNDING
$948,729 for 2 years