Headway Justice Programme
Headway UK delivers a range of projects and initiatives to
Raise awareness of the significant number of people in the justice system with an acquired brain injury (ABI) and their resultant needs.
Advocate for change in policy and practice, to ensure brain injury survivors receive appropriate support within the justice system.
Provide opportunities for individuals with an ABI to access support in relation to experiences with the justice system.
The Centre for Mental Health estimates that 60% of the Prison and Probation population have a history of traumatic brain injury (TBI), often involving multiple injuries which evidence shows to have a cumulative impact.
Rates have also been found to be high in the female prison/probation population, with many women sustaining their injuries through intimate partner violence (IPV).
Professionals working within the justice system are highly likely to encounter people who have had an acquired brain injury (ABI), the impact of which can often be misunderstood due to the complex, fluctuating and often hidden effects that can be confused with other conditions, such as mental ill health. In addition to the physical effects of brain injury, an ABI can affect an individual’s emotions and behaviour, psychological state, memory and cognitive skills, including their ability to process and retain information or instructions.
The consequences of ABI can therefore have a detrimental impact on an individual’s journey through the criminal justice system, impacting on:
Interactions with Police Officers.
Understanding of the Court environment and associated processes.
Engagement with interventions.
Ability to cope within a Prison setting.
Transition back into the community.
Engagement with Probation.
Compliance with Community Order/Licence conditions.
Susceptibility to exploitation.
Headway UK is proud to sit on the strategic board of the Acquired Brain Injury Justice Network (ABIJN). ABIJN is a collaborative group, driving forward the issue of ABI across Government and the criminal justice system.
We have delivered training to thousands of professionals, including police, custody staff, appropriate adults, liaison and diversion practitioners, criminal lawyers, prosecutors, Independent Domestic Violence Advisors’ (IDVA) and staff working across HM Prison and Probation Service (HMPPS).
Intimate Partner Violence (IPV) and brain injury
Survivors of intimate partner violence (IPV) also suffer from traumatic brain injuries (TBI’s) at a high rate. This condition can be misunderstood and difficult to spot, due to the hidden consequences. The effects of brain injury can have a detrimental impact on survivors' ability to leave an abusive relationship, as well as their capacity to keep themselves safe. High rates of ABI have also been found in the female prison/probation population, with many women sustaining their injuries through domestic violence.
Not everyone who has sustained a brain injury will have received medical treatment. This is particularly likely to be the case for those who sustain brain injuries as a result of intimate partner violence (IPV). Survivors/victims may have no recollection of the incident or may not recognise the impact a blow to the head has had. A history of attempting suicide may also indicate a brain injury, as depending on the method, it may have caused hypoxia/anoxia (deprivation of oxygen to the brain). Victims of IPV are, therefore, more likely to be living with the consequences of an undiagnosed and untreated acquired brain injury (ABI).
The 2021 Domestic Abuse Act introduced non-fatal strangulation as a specific offence, recognising not only the increased risk of a perpetrator going on to commit domestic homicide but also the potential long-term consequences of ABI.
Every 90 Seconds - Brigitta
View video transcript Hide video transcript
Speaker 1:
I think it's a good thing, to be honest. Today, it is. It's about time you told your story.
I love walking. That was my biggest thing. I absolutely love power walking. I loved it. Just put some music on and just go.
Obviously, I had two children, which I love. I love them to bits. I used to do a lot of sewing and that kind of thing, but obviously that's not happening anymore.
I don't remember nothing. Nothing at all. I don't remember nothing. The day before either. Apparently, I was out with my friends for somebody's birthday, I think it was, or something like that. I don't remember none of it.
Speaker 2:
I remember the phone call.
Because I was actually delivering to her shop. I used to be a bread man. That's how Briggy and I met each other, but at the time we were just good friends.
I remember driving up, dropped the bread off, and all the staff were outside because they were waiting for Briggy to open up.
"Come on, Michael."
It was very unusual because Briggy's normally there at quarter to six. It was weird. She must have overslept or something like that.
Then during the day, in the afternoon, I got a phone call from Pamela saying that her mum had had an accident. I thought at the time that she'd been mugged or something, but when she told me what happened, you couldn't believe it.
Speaker 1:
Yeah, that's the sorry part right now probably. I don't remember, which annoys me.
Speaker 2:
Briggy was in the operating theatre for nearly 14 or 15 hours. They explained to me afterwards what they had to do, and it was a really big shock.
I saw her in intensive care.
Her head was a good three times the size, I'm not joking. She was on the life support machine as well.
Speaker 1:
When you get pretty back on your feet again, I know I was obviously struggling with eating and everything.
I don't know. I don't know what else.
There was a lot of... obviously I was just sitting there all the time. That's what I remember, just being in my room all the time. It was like, "Oh, it's just so boring."
My mum always came in, my sister and my niece. They came to see me. That was nice.
They tried to help me to walk again. I don't remember that. They've told me, but I don't remember. I don't remember a lot of things.
At least about... it must have been half a year. I don't remember none of it.
I would love to get back to where I used to be, but this is a struggle.
I needed Headway. I mean, I always had them with me ever since I came home, which I always needed.
At the time, Sally started doing a bit of reading, a bit of writing letters and almost... I had to start from the letters again. Learn it again.
Sally's very good. Very good. Very good at her job.
My memory is, I would say, a bit better because I think what happened and what happened is going back to work.
To me, that was a mental thing. I had no hair. I had no nothing. But I wanted to go to work, even if it meant for an hour or something, just to go back, because I absolutely love my job. I still do, even though I struggle.
Obviously, I need Sally because she helps me. I can't do my other stuff. When I go to the till, I can do the till, but I think they gave me the same kind of jobs now, which is a good thing because it helped my head to learn it. I'm just doing the same kind of things all the time and that helped a lot.
I would love not to have had it happen. I would be able to remind myself, but it's not happening.
Even though I think things got much better.
Speaker 2:
I'm lucky with it because the guys are really good for me.
What people don't realise when they're talking to a person with a brain injury is that they can't actually see what's wrong with them until they actually get to know the person. Then they understand.
If you've not met that person before, you're not going to understand because you don't know that person.
You've got to get to know the person to understand what they're actually going through. To me, that's the most important thing of all.
With a person who has a brain injury, you've got to let them finish their sentence because if you interrupt them, they've forgotten what they were actually talking about. Then they can't remember what they said. It's just the way it is.
Speaker 1:
I just feel like I have to get on with it.
I love walking. Yeah, I still do.
And the dogs. My two little dogs. Definitely. They are my little babies.
Walking is the thing I love the most. I still do that.
I'm staying... no, not by myself. I don't do that anymore.
But housework, yes. That's another thing. I love cleaning and all that. And baking. I love baking. Baking is good. It makes me happy. I love that.
My biggest thing is that you never give up.
I really, really pushed myself all the time. I'm not one of those people who sits down and thinks about it and then cries.
I mean, yeah, I cry. I do. I do a lot. Poor Richard has to put up with it.
But I do cry, and it does help.
It's frustration. I think most of it is that.
But definitely never give up. Always try.
That's definitely me.
You keep writing. That's me.
Definitely.
Well, you keep me on my toes. That's something you have to do.
End of transcript
Explore Headway services
-
Headway Brain Injury Identity Card
This card is designed to help police officers and wider CJS staff more easily identify brain injury survivors and ensure that they receive an appropriate response and support. The card also provides brain injury survivors with added confidence in everyday social scenarios.
Headway Brain injury identity card -
Headway Helpline
Headway's nurse-led helpline is a free, confidential service available to anyone with a question about brain injury - from survivors and carers to students and professionals.
Headway Helpline -
Headway Emergency Fund
Headway’s Emergency Fund also provides one-off small grants in the immediate aftermath of brain injury, to help adult brain injury survivors and their families cope with the sudden practical implications.
Headway Emergency Fund
Understanding brain injury training for criminal justice professionals
The training is delivered to achieve the following learning outcomes:
An understanding of the variety of causes of brain injury and prevalence of brain injury in the criminal justice system
An understanding of the cognitive, physical, behavioural and emotional difficulties people experience as a result of brain injury with particular emphasis on how this may present in offenders
A knowledge of some basic techniques and simple strategies enabling staff to work more effectively with brain injury survivors
For staff to be aware of the Headway Brain Injury Identity Card available, how to apply and to encourage / assist with applications where appropriate
For staff to know where to access additional information and support about the effects of ABI including the referral process to seek further assessment or intervention for people with ABI
Register
If you are interested in having Headway deliver Understanding Brain Injury training to your service or establishment within the criminal justice system, please contact:
Chris Marriott, Justice Project Manager
Making Headway: Probation support programme
Could a hidden brain injury be affecting someone's ability to engage with probation?
Over half of people in prison may be living with the effects of a brain injury.
Brain injury is often described as a hidden disability. Difficulties with memory, emotional regulation, communication and decision-making can sometimes be misunderstood as poor motivation, non-compliance or a lack of engagement, when they may be linked to the effects of a brain injury.
Making Headway: Probation is a specialist brain injury support programme for people currently under probation supervision. The programme helps participants better understand themselves, develop practical strategies and build greater stability for the future.
Making Headway: Probation is currently being delivered across the HMPPS South Central region only.
We are actively exploring opportunities to expand delivery into additional probation regions across England and Wales.
If you are interested in introducing Making Headway: Probation within your region, or would like to discuss commissioning opportunities, please contact the Headway UK Justice Programme team.
Making Headway: Probation programme further info and FAQs
Programme at a glance
Delivered remotely via Microsoft Teams
Four weekly group sessions
Groups of up to 12 participants
Sessions start at 17:30
Each session lasts approximately 2–3 hours, including breaks
A formal diagnosis is not required
Why this programme matters
Brain injury can affect many aspects of everyday life, including:
Memory and concentration
Emotional regulation
Communication
Decision-making
Impulse control
Relationships
Engagement with support services
For many people, these difficulties can create barriers to successful engagement with probation and rehabilitation services.
Making Headway: Probation has been developed to help participants recognise the impact of brain injury, increase self-awareness and develop practical skills that support positive change.
What participants will learn
The programme is delivered across four structured modules that combine practical learning, discussion and reflection.
Module 1 - Understanding Brain Injury, Health and Recovery
Explore how brain injury can affect thinking, emotions, behaviour and everyday life. Learn about recovery, wellbeing and practical ways to support day-to-day functioning.
Module 2 - Managing Emotions and Behaviour
Develop practical strategies to recognise triggers, manage difficult emotions, improve self-awareness and reduce impulsive reactions.
Module 3 - Relationships and Communication
Learn techniques to improve communication, manage conflict, reduce misunderstandings and build healthier relationships.
Module 4 - Moving Forward and Building Stability
Bring together everything learned throughout the programme and develop practical strategies to support long-term stability, wellbeing and positive progress.
Programme benefits
Participants can:
Better understand how brain injury may affect them
Improve emotional regulation
Develop practical coping strategies
Strengthen communication skills
Improve self-awareness
Build confidence and resilience
Build stability while under probation supervision
Engage more effectively with probation and support services
Thinking hidden brain injury?
Consider a referral if someone:
Frequently forgets appointments, information or instructions
Experiences emotional regulation difficulties
Acts impulsively or struggles with decision-making
Has communication difficulties
Frequently misunderstands information
Repeatedly struggles to engage with services
Experiences ongoing compliance difficulties
Has a history of head injury, concussion, assault, domestic abuse, strangulation or loss of consciousness
Has experienced repeated head impacts, including participation in competitive contact sports such as rugby, boxing or MMA
A formal diagnosis is not required
Evidence of a diagnosed brain injury may already be recorded within:
OASys
Arrest or police documentation
Court records
Medical records
Why refer?
The programme helps participants develop practical skills that can support:
Improved self-awareness
Better emotional regulation
Improved communication
Increased engagement with probation and support services
Greater stability while under probation supervision
More positive rehabilitation outcomes
Developed by Headway UK
Making Headway: Probation forms part of the Headway UK Justice Programme.
The programme has been developed using clinical expertise, current evidence and lived experience to provide practical support for people affected by brain injury within the criminal justice system.
Headway UK – the brain injury association works to improve awareness, understanding and outcomes for brain injury survivors across the UK.
Further Information
For programme enquiries, partnership opportunities or regional delivery discussions, please contact:
Headway UK Justice Programme
justiceprogramme@headway.org.uk
Research into brain injury and the criminal justice system
The following studies have revealed a high prevalence rate of brain injury in offending institutions in the UK and around the world, highlighting the need for Headway to take action to ensure there is a greater understanding of brain injury within the UK’s criminal justice systems:
Hospitalised Head Injury (HHI) was found in 24.7% (1,080/4,374) of prisoners and was significantly more prevalent than found in the matched general population sample (McMillan et al, 2019)
64% of female offenders at HMP/YOI Drake Hall reported a history indicative of brain injury (The Disabilities Trust, 2019)
The estimated prevalence of TBI in the offender population is 60.25% (Shiroma, Fergyson and Pickelsimer, 2010)
Another study found that over 60% of male offenders reported having had a head injury. 48% reported mild TBIs, 16% had moderate to severe (Williams et al, 2010)
TBI with loss of consciousness was reported by 46% of a sample of young offenders (Williams, Tonks and Mewse, 2010)
A meta-analysis found that 30% of juvenile offenders have sustained a previous brain injury, and that juvenile offenders are more likely to have a TBI compared to controls (Farrer, Frost and Hedges, 2013)
82% of offenders had a history of at least one TBI; 65% had a history of TBI with a loss of consciousness (Schofield et al, 2006)
The Centre for Mental Health estimates that around 60% of adult offenders (those aged 18+) and 30% of young offenders (those aged under 18) have a history of TBI, often involving multiple injuries which evidence shows to have a cumulative impact (Michael Parsonage, 2016)
In fully adjusted models, men and women who had sustained a TBI were about 2.5 times more likely to be incarcerated than men and women who had not sustained a TBI (Kathryn E. McIsaac et al, 2016)
Support our work
We need your help
Every 90 seconds, someone is admitted to a UK hospital with a brain injury. Your donation helps Headway UK provide specialist advice and support to brain injury survivors and their loved ones.
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could help fund a Headway Brain Injury Identity Card every month, giving brain injury survivors confidence in social situations and access to the right support.