A mental health discovery that could change criminal justice forever | Kim Gorgens | TEDxMileHigh

Are you ready for a shocking statistic? 50% to 80% of people in the criminal justice system have a Traumatic Brain Injury. In the general public, that number is less than 5%. So perhaps there’s a good reason many people can’t escape the revolving door of criminal justice. Armed with this knowledge, brain researcher Kim Gorgens set out to find a solution – and she did. Dr. Kim Gorgens is a professor of Psychophysiology, Clinical Neuropsychology, and Psychology of Criminal Behavior at the University of Denver. She manages a portfolio of brain injury-related research--studying the reported history, cognitive function and brain biomarkers of probationers, inmates and college athletes. Her mission is to better understand the short and long-term impacts of injuring our most vital organ. She has a fridge filled with human brains, and a love of zombie movies (coincidence?). Simply put, Kim cares more about your brain than you do.

This talk was given at a TEDx event using the TED conference format but independently organized by a local community. Learn more at https://www.ted.com/tedx

Looking around,

I noticed that every one of you
brought you brain today.

(Laughter)

In all seriousness, most of us
take our brain for granted.

You don't actually
have to think about how it works,

it just does.

But that's a luxury that people
with a traumatic brain injury

often don't have.

A traumatic brain injury, or TBI,

is a disruption in brain function
caused by an external blow to the head.

And when you hear that definition,

you might think about sports
and professional athletes

since it's the kind of injury
we're used to seeing on the playing field.

And this imagery has really come
to define TBI in the public consciousness.

I myself do research on TBI
in retired and college athletes,

I stood on a TED stage in 2010,

talking about concussions
and kids' sports.

So I have to say, as someone
who researches and treats these injuries,

that I've been really gratified to see
the growing awareness of TBI

and specifically the short-
and long-term risks to athletes.

Today though, I want to introduce you

to a larger but no less
controversial group of people

impacted by traumatic brain injury

who don't often show up in the headlines.

I've come to recognize
these inmates and probationers

as, surprisingly, among the most
vulnerable members of society.

For the last six years,
we've been doing research

that has completely changed the way we
think about the criminal justice system

and the people in it.

And it may change the way
you think about those things too,

so I'll start with a shocking statistic.

50 - 80% of people in criminal justice
have a traumatic brain injury.

Up to 80%.

In the general public,
in this room, for example,

that number is less than 5%.

And I'm not just talking
about getting your bell rung,

these are the kinds of injuries
that require hospitalization.

Most of them are the product
of a physical assault,

and some of them
are actually sustained in jail.

A study, just last year, found
that the rate of traumatic brain injuries

is 50 times higher in jails
than on city streets.

And as shocking as those numbers are,

all of these numbers are even higher
among the women in criminal justice.

Almost every single woman
in the criminal justice system

has been exposed to
interpersonal violence and abuse.

More than half of these women have been
exposed to repeated brain injuries.

In this way,

these women's brains look like
the brains of retired NFL players,

and they'll likely face the same risks
for dementing diseases as they age -

the same risks.

TBI, together with mental illness
and substance abuse and trauma,

makes it hard for people to think.

They have cognitive impairments

like poor judgment
and poor impulse control,

problems that lead
to the kinds of screw-ups

that make criminal justice
a revolving door.

People get arrested and booked into jail.

They oftentimes get into trouble
while they're in there,

they get into fights,
they fall out of their bunk,

and then they get released
and do stupid things

like forgetting mandatory check-ins,

and they get re-arrested.

Statistically speaking, they're actually
more likely to be re-arrested than not.

A colleague calls this serving
a life sentence, 30 days at a time.

And often times these folks
don't know why this is so hard for them.

They feel out of control and frustrated.

And frankly,

it's frustrating for all of us
because we have to pay for it.

But imagine how frustrating it is

for the dedicated people
who work in that system:

the attorneys and judges,
law enforcement, probation,

correctional officers, social workers.

Not to mention the people
who love these inmates:

their family members and friends.

So, knowing that TBI is at the root
of so many of these challenges,

the mission for a group of us in Colorado
has been to disrupt that cycle,

to jam the revolving door.

So, working together
with my state and local partners,

we crafted a plan
to meet everyone's needs:

the system, the inmates and probationers,
my graduate students.

In this program we assess
how each person's brain works

so that we can recommend
basic modifications

to make this system
more effective and safer.

And here, when I say safer,
I mean safer not only for the inmates -

thank you -
(Laughter)

but also safer for correctional staff.

In some ways,
this is such a simple approach.

We're not treating the brain injury,

we're treating the underlying problem

that gets people into
all of this trouble in the first place.

And by that, I don't mean we're dragging
therapy couches around county jails,

we do quick neuropsychological
screening tests

to identify strength and weaknesses
in the way an inmate thinks.

Using that information,
we write two reports:

one, a report for the system
with specific recommendations

on how to manage that inmate;

the other is a letter to the inmate

with specific suggestions
for how to manage themselves.

For example, if our test results suggest

that a probationer has a hard time
remembering the things they hear,

that would be an auditory memory deficit.

In that case, our letter
to the court might suggest

that probationer gets handouts
of important information.

And our letter to that probationer
would say, among other things,

that they should carry a notebook
to record that information for themselves.

Now, most importantly
is that I pause here,

to be really clear about one point:

This program does not
minimize responsibility

or make excuses for anyone's behavior.

This is about changing
long-standing negative perceptions

and building self-advocacy.

It's actually about taking responsibility.

The inmates move from
"I am a total screwup, I'm a loser,"

to "Here's what I don't do well,

and here's what I have to do about it."

(Applause)

And the system comes to see
an inmate's problematic behavior

as "the things they can't do"
versus "the things they won't do."

And that change, seeing behavior as a
deficit rather than outright defiance,

is everything in these settings.

We hear from inmates around the country,

and they write, and more than anything
they want to know how to help themselves.

This is an excerpt from a letter
from Troy in Virginia,

an excerpt from a 50-page letter,

and he writes,

"Can you tell me what you think of
all the head traumas I've dealt with?

What can I do?

Can you help me?"

Closer at home, we have thousands
of stories like this and smart stories,

stories that have a great outcome.

Here's Vinny.

Vinny was hit by a car
when he was 15,

and from that moment forward
spent more time in jail than in school.

With some basic skill building,

after our assessment revealed

that he had some pretty significant
memory impairments,

Vinny learned to use the alarm
and reminder function on his iPhone

to track important appointments.

And he keeps a checklist to break larger
tasks into smaller manageable ones.

And with basic tools
like that under his belt,

Vinny's been out of jail for two years,

clean for nine months

and recently back to work.

(Applause)

What's so striking for Vinny is

that this is his first time off
of court supervision

since his injury more than 15 years ago.

He made it out of the revolving door.

(Applause)

He says now, "I can do anything;

I just have to work a lot harder at it."

(Laughter)

And here's Thomas.

Thomas has some pretty significant
attention and behavior problems

after an injury landed him
in a coma for more than a month.

After relearning how to walk,
his first stop, court.

He couldn't imagine a future
where he wasn't in trouble.

He now carries a calendar

to avoid being held in contempt
for missed court dates.

And he schedules a break into his day,

every day, to recharge
before he gets agitated.

And nobody knows the revolving door better

than the person sitting
at the front of the courtroom.

This is my good friend and colleague
Judge Brian Bowen.

Now, Judge Bowen was already on a mission
to make the system work for everyone,

and when he heard about this program,
he saw the perfect fit.

He actually sits down with all
of his prosecutors to help them see

that there're basically two categories
of defendants in the courtroom.

The ones were afraid of,
oftentimes rightfully so,

and the ones were mad at.

There are the ones who miss
all of their scheduled appointments,

and they blow through
the best-laid probation plans,

and Judge Bowen believes
that with a little more support,

we could move people
in this latter category,

the maddening category,

through and ultimately out of the system.

He proved that with Navy veteran Mike.

Judge Bowen saw the correlation

between Mike's history
of a massive 70-foot fall

and his long-standing pattern

of difficulty showing up
on the right day for court appointments,

and complying with mandatory therapy
requirements, for example.

And instead of sentencing him
to more and more jail time,

Judge Bowen sent him home
with maps and checklists and handouts

and recommended instead,
vocational rehabilitation

and flexible scheduling
for those therapies.

And with those supports,
Mike's back to work for the first time

since his injury
while he was in the service,

he's repairing relationships
with his family,

and just last month, he graduated
from Judge Bowen's Veterans Court.

(Applause)

This program shows us the overwhelming
prevalence of traumatic brain injuries

and cognitive deficits

and the accumulation of brokenness
in the criminal justice system.

And it highlights the extraordinary power
of resilience and responsibility.

In Mike and Thomas and Vinny,
even Judge Bowen's story,

you saw the transformation made possible

by a change in perception
and some simple accommodations.

All told in this program,

these inmates and probationers
come to see themselves differently.

The system sees them differently,

and when you meet them in the community,

I hope you see them differently too.

Thanks guys.

(Applause)