Link Between Crime and Brain Injuries Prompts Push for Legislation

Andrew Kitchenman | November 10, 2014 | Health Care
Bill would require state to increase screening for brain injury among at-risk youth

Assemblywoman Grace Spencer
Studies have shown a link between early brain trauma and criminal activity later in life. That’s why some state legislators are proposing a bill that would create a program to work with children who show signs of brain injury or have committed crimes.

One study has found that jail and prison inmates report having had a head or traumatic brain injury at three to 10 times the general population. This has prompted groups that provide services to those who have suffered brain injuries to say that criminal activity and serious psychiatric problems could be reduced if young people at risk of crime were diagnosed and treated sooner.

While the bill doesn’t specify exactly which youths would undergo screening, it said that the state Department of Children and Families would develop and implement a reliable screening tool to identify brain injuries among those between the ages of five and 21 who are involved, or who may be at risk of involvement, with the state’s mental-health or juvenile justice systems.

A broad group of professionals and advocates would be given basic training about how to identify, evaluate, and treat those with brain injuries, including
teachers, judges, law enforcement officials, and healthcare providers. Also on the list are workers at state and county psychiatric facilities, state and county juvenile detention facilities, county probation departments, children’s crisis intervention units, and the Division of Children and Families.

The bill, A-3453 is picking up support, but a major question remains: How much will it cost? The state Department of Children and Families has given an initial estimate of $10 million annually, making it unlikely that the legislation will be signed by Gov. Chris Christie outside of the annual budget process.

Supporters of the measure argue that it’s still not known exactly how much it would cost, considering that federal grants may offset part of the funding needed for the program. In addition, they argue that the cost would lead to long-term savings, as the state reduced the number of crimes that are committed.

Assemblywoman L. Grace Spencer (D-Essex), a Newark prosecutor who supports the bill, said she has seen firsthand the effects of childhood brain injuries on those who enter jail or psychiatric facilities.

“We have young adults that are coming in there that from the onset it’s apparent that there have brain injuries that have contributed to the reasons why they are there,” Spencer said of the Essex County Hospital Center. “If they are screened prior to the criminal behavior that led them to the facility, certainly we’re saving money on our county as well as potentially on our state level.”

The legislation was developed with input from members of the New Jersey Special Education and Brain Injury Task Force, which was created five years ago with the goal of addressing the needs of students with traumatic brain injuries and developing recommendations for the governor and Legislature.

Task force member Rene Carfi, a social worker, said the program would provide the hope “that if their brain injury is identified, that they would be receiving the appropriate services instead of going down the wrong path.”

Carfi said it’s not uncommon for children who experience brain injuries to later be behaviour problems or mental-health issues. The injuries could result in criminal behavior or stays in psychiatric hospitals, which could have been avoided if these kids had received appropriate treatment. Carfi works for the Brain Injury Alliance of New Jersey, which provides services to state residents with brain injuries and their families.

Assemblywoman Caroline Casagrande (R-Monmouth) said she had “grave” concerns about the potential cost of the program at a time when the state is struggling with its budget. DCF officials estimate that the $10 million would result from hiring additional staff members to review youth records to identify and evaluate teenagers and young adults for potential treatment; adding training for teachers and school officials; and further costs to healthcare providers to screen individuals.

Supporters said the true cost of the bill wouldn’t be known the state determines the details of how the screenings would be done. They said a similar program in Colorado costs much less and draws on federal funding. In addition, some of the training could be provided at little cost by the Brain Injury Alliance of New Jersey and medical screenings would be covered by health insurance, they said.

But the argument did not sway Assemblywoman Nancy F. Munoz (R-Morris, Somerset, and Union).

“It’s hard for me to want to vote for legislation that would mandate something that we didn’t have the money for, because we would have to get grants” from the federal government to cover the cost, she said.

Spencer said she thought the bill was similar to Gov. Chris Christie’s support for drug courts to treat rather than punish nonviolent offenders. She added that some young people with brain injuries also have addictions.

It has a powerful backer in its primary sponsor, Assembly Speaker Vincent Prieto (D-Bergen, Hudson), who said in a statement that many brain injuries are misdiagnosed because the victim doesn’t show immediate signs of an injury.

“These injuries can eventually manifest themselves as aggression or violent behavior if not treated properly,” Prieto said.

The bill has drawn support from representatives of the New Jersey State School Nurses Association. It was released by the Assembly Women and Children Committee on a 4-0 vote with both Republicans — Casagrande and Munoz — abstaining. It’s scheduled for a vote by the full Assembly on Thursday. A Senate version hasn’t been introduced.