We have to do more to protect vulnerable adults caught up in the criminal justice system

Peter McCabe, Chief Executive of Headway, a UK-wide charity that supports individuals and families affected by acquired brain injury.

Some months ago, I received a call from a very distressed mother. Her adult son, who is living with the long-term effects of an acquired brain injury (ABI), had been arrested and accused of committing a serious crime. He lives in a part of the UK that does not have a Liaison and Diversion service. Had an L&D service been available, the significant impact on this individual’s life may have been mitigated and serious psychological harm avoided.

Despite being a vulnerable adult, he was interviewed without a solicitor with an understanding of brain injury. He was asked to give a voluntary statement, which he did in order to express his innocence.

Like many people living with a brain injury, this young man’s disability is hidden. The cognitive problems which he experiences, such as difficulty in processing, understanding and retaining information, are hard to see and understand.

Despite the incident in question being nothing more than a simple misunderstanding, his answers led the investigating officers to believe he was somehow guilty. No specialist medical advice was sought in order to assess his capacity. On several occasions he was summonsed to appear in court. Each appearance was an ordeal, with great emotional stress and pressure put on him. Eventually, all charges were dropped.

It would be easy to dismiss this incident as ‘unfortunate’, with the young man in question a victim of the appropriate pursuit of justice. But the reality is that this case should not have progressed any further than an initial interview. Sadly, this is just one of many incidents we are aware of where a lack of understanding of brain injury has led to problems.

Brain injury is widely misunderstood in all facets of society and those working in the criminal justice system are certainly not alone in struggling to identify and appropriately support those affected by this often hidden disability.

Numerous studies have shown an overrepresentation of brain injury in offending institutions. Many brain injury survivors who find themselves involved with the police or courts will have never committed a criminal offence before their injury and the effects of their brain injury could have potentially been a contributing factor to behaviours leading to arrest. In these circumstances, the benefit of proper screening and assessment from suitably trained and experienced L&D practitioners could mean the difference between appropriate referrals out of the criminal justice system into proper treatment and an inappropriate court appearance.

However, it is not as simple as suggesting a brain injury should automatically be used as a means of reducing an offender’s culpability. What is important is ensuring that brain injury survivors are identified at the earliest possible stage in order to ensure they have appropriate support and the correct course of action is taken.

If that involves a custodial sentence, we must ensure the individual’s disability is fully acknowledged and access to specialist rehabilitation is provided. Only by doing so can we hope to give prisoners a chance to understand and comply with prison rules and improve reoffending rates.

Having been in post as Chief Executive of Headway for more than 15 years, I have seen significant changes in the way ABI is perceived and discussed. And yet there is so much more work to do across the board. What is hugely encouraging, however, is the way in which agencies have welcomed discussions on the topic of brain injury and the criminal justice system.

Since we began work on our new Justice Project initiative, which will be launched in the coming months, we have had numerous positive conversations with a range of agencies, from local Liaison and Diversion services, to the National Police Chiefs’ Council. The scheme seeks to raise awareness of ABI throughout the criminal justice system, including the use of ID cards, and to support those who come into contact with it, diverting survivors where appropriate.

The motivation to improve the system and raise standards of care appear to be shared across the board, leading to optimism that by working together we can bring this hidden disability out of the shadows.

For more information on brain injury or the work of the charity, visit

Peter McCabe

Peter McCabe has been the Chief Executive of Headway – the brain injury association since November 2001. He has 36 years’ experience in the voluntary sector; Chief Executive of QUIT (the smoking cessation charity), held a variety of posts at SCOPE, Relate (the marriage guidance charity) and the YMCA. He has 30 years’ experience as a local councillor. Has served as a Cabinet Member for Adult Social Services, Mayor of Merton, Chair of the Health Scrutiny Committee, Chair of the Standards and General Purposes Committee and in a variety of other posts.