What we’re doing: We’re working to explore, expose and address the high rates of traumatic brain injury (TBI) in federal prisons in Canada.

Why we’re doing it: A TBI is a disruption to brain function caused by a head injury. Common symptoms include: difficulty recalling information or following instructions; getting distracted or confused; and, changes to behaviour. Many people sustain TBIs at different points in their lives – often in childhood – and do not receive appropriate screening, treatment or care. Some don’t even know they have a TBI. Research has demonstrated a high level of TBIs among people experiencing homelessness in Canada. We set out to:

  • Uncover the extent to which TBI is an issue for people who have spent time in federal prisons;
  • Explore screening, treatment and care options in the context of health care, criminal justice and social services.

What we’ve done so far:

  • Created a unique database that links Correctional Service of Canada records with health records. This allows us to understand more about the health of people in prison. Description of database here.
  • Explored funding available for prison health research relative to other health research issues in Canada. We found that Canada’s health research investment agency, the Canadian Institutes of Health Research (CIHR), invests only 0.05% of all funding in prison health research. Full paper here.
  • Explored prevalence of TBI in federal prisons in Canada. We found that people who have suffered a traumatic brain injury are approximately 2.5 times more likely to be incarcerated in a federal prison in Canada than people who have not. Read a CBC article here, and plain language summary here. Full paper here.
  • Engaged with correctional staff and organizations to share and explore the health impacts of TBI and potential interventions both inside and outside of prisons.

Our partners: Correctional Service Canada and John Howard Society, Toronto.

Impacts: Our research is now included in training for parole officers, who are told about the consequences of TBI, and made aware of appropriate referral resources in the community.


Action points: Many of our recommendations to date are focused on the criminal justice system. These include asks to:

  • Recognize TBI as a cognitive or mental health concern in criminal proceedings, especially sentencing.
  • Screen for TBI upon entry to correctional facilities.
  • Offer a brain injury class in prison to help people learn about how to manage their behaviour and emotions.
  • Teach correctional staff that TBI is a hidden disability and train them how to respond appropriately.
  • Adapt in-prison programming such as substance programming to enable people with TBI to benefit.
  • Tailor reentry to the unique needs of those with TBI and link them to appropriate services.

Criminal justice systems in some jurisdictions are evolving responses to TBI. Examples include:



  • New South Wales has a policy to address the needs of people with TBI or upon release.


  • New Zealand pilot projects to screen for TBI in correctional facilities

For more information: Please contact Principal Investigator Dr. Flora Matheson at MathesonF@smh.ca