An exploratory study of crime and brain injury: Implications for mental health management

There is emerging evidence to link criminal offending and brain injury, but there is still limited research in this area, in particular for people with brain injury and psychiatric disorders. To explore this issue, we reviewed 276 individuals presented to the New South Wales Mental Health Review Tribunal (MHRT), an independent agency that reviews people who are deemed not guilty of offending by reason of mental illness. Nine individuals (3.3%) were identified with brain injury and psychiatric disorders, the majority as a result of non-traumatic brain injury related to alcohol and substance abuse. All of them were male. They were diagnosed with serious psychiatric disorders such as paranoid psychosis and schizophrenia and had committed serious offences such as murder, intent to murder, sexual assault and physical assault. Most had previous psychiatric, criminal, and alcohol and substance abuse histories. Two case studies suggest a lack of treatment follow-up. The study suggests an urgent need to consider early intervention and how services are offered post-rehabilitation, and the importance of collecting and maintaining data to ensure appropriate mental health management and policy formulation.