IRB Number

24-0517-058

Date of Award

Fall 12-18-2024

Document Type

Capstone

Degree Name

Doctor of Occupational Therapy (OTD)

Department

Occupational Therapy

First Advisor

Cassandra M. Nelson

Second Advisor

Keith McWilliams

Medical Subject Headings

Humans, United states, Brain, Concussion, Post-concussion syndrome, Criminals, Prevalence, Incarceration, Social determinants of health, Universities, Traumatic brain injuries, Surveys and questionnaires, Prisoners, Comorbidity

Abstract

The United States has the highest documented incarceration rate in the world (Carson, 2022), with an increasing number of justice-involved individuals (JII) potentially affected by mild traumatic brain injury (mTBI). Despite the high prevalence of mTBIs in the general population, limited research exists on the prevalence and impact of mTBIs in JII. Preliminary evidence suggests that the prevalence of mTBIs in incarcerated individuals is 50 times higher than in the general public (Siegler et al., 2017). This study aimed to explore the lived experiences of JII with mTBI, focusing on the origin of mTBIs, executive dysfunction, and the occupational barriers faced during the transition and reentry process. A mixed-methods, descriptive phenomenological approach was utilized to capture data from six study participants who were formerly incarcerated. Quantitative measures included demographics, comorbidity and social determinants of health survey (SDoH), the Rivermead Post-Concussion Symptoms Questionnaire (RPQ), and the Executive Skills Profile (ESP). Qualitative data was gathered via the Ohio State University Traumatic Brain Injury Identifier (OSU TBI-ID) and a 15-question semi-structured interview. Results indicate that JII experience several compounding disparities including socioeconomic status, comorbidities, and social determinants of health that are further exacerbated by persistent post-concussional symptoms and executive dysfunctions. This research demonstrated how mTBI and associated executive dysfunction complicate interactions for both those who have the injury and for professionals in the criminal legal system. Ultimately, it is in the best interest of all parties involved to create a justice system that is responsive and inclusive to mTBI.

Comments

Capstone project submitted to the University of St. Augustine for Health Sciences in partial fulfillment of the requirements for the degree of Doctor of Occupational Therapy

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