Brain Injury and Justice

Dr. Carolyn Lemsky is a board certified neuropsychologist with 25 years of experience working in rehabilitation settings in the U.S. and Canada. For the past 15 years she has been the Clinical Director at Community Head Injury Resource Services (CHIRS) of Toronto—a Ministry of Health and Long-Term Care funded agency designed to promote community re-integration of persons living with the effects of acquired brain injury. In this episode, Dr. Lemsky guides a group discussion over zoom, with other professionals about the challenges and barriers individuals with a brain injury experience in navigating the justice system.

Transcript

EPISODE 1 

Narrator (00:01):

What is a brain injury? The answer to this question is more complicated than it may seem.

May (00:07):

I didn't realize the scope and the challenges until I started to struggle.

Stephanie (00:13):

Concussion will change very quickly and rapidly week by week. And we need to adjust very quickly that

Ryan C (00:18):

Pretty hard to self-identify. When you have a brain injury,

Catherine (00:21):

Approximately 80% of adults in the justice system who are incarcerated, have a history of brain injury.

Narrator (00:30):

Our brains are intricate, comprised of billions of neurons, responsible for how we think feel, communicate, and experience life. The significant role our brains play in our everyday life is what makes experiencing an injury to it. Traumatic.

Stacey (00:47):

And I got a call from one of Jake's friends saying that he'd been in an accident

Vijaya (00:52):

Most of the time it's been ignored. So they feel very isolated.

Ryan C (00:57):

I didn't tell anyone. I just mean you just keep going, right?

Blair (01:01):

Light, sensitivity, sensitivity to noise. The irritability, the fact that like things are making you dizzy when they're passing by like all these small signs are things that nobody really understands

Narrator (01:14):

Approximately 165,000 TBIs occur annually in Canada, equaling out to 456 people every day. And one person, every three minutes as the leading cause of death and disability, worldwide brain injury is 15 times more common than spinal cord injury. 30 times more common than breast cancer and 400 times more common than HIV aids. What this also means is that by the time this intro finishes, someone will have experienced a TBI. It is because of the severity of this injury, that two leading organizations in the sector have come together to create a sharing experiences with a concussion or traumatic brain injury podcast, the Ontario brain injury association, and the heads up concussion advocacy network are proud to present yet. Another season of this multimedia series, as we continue our mission to create a deeper understanding towards a varying impacts of this injury, and now a message from the executive directors responsible for creating this series.

Ruth (02:22):

Hi everyone. My name is Ruth Wilcock and I'm the executive director of the Ontario brain injury association.

Ryan S (02:28):

And I'm Ryan. Suton the executive director of the heads up concussion advocacy network.

Ruth (02:34):

I want to welcome you to our multimedia podcast series. The mission of Obi is to enhance the lives of Arians living with the effects of acquired brain injury, through education awareness and support. We are so excited to have partnered with heads up concussion advocacy network to publish this multimedia podcast series. And Ryan is going to tell you a little bit more about our

Ruth (02:58):

Partnership and the series.

Ryan S (03:00):

We are thrilled to be sharing a second season of the series with all of you this season aims to broaden the conversation around concussions and traumatic brain injury by highlighting different perspectives in topic areas that lack representation building off the success of last season. We've found new ways to facilitate discussions between people directly impacted by the injury while gaining up to date insights from industry experts. We are very proud to present the second season of this podcast series and hope you enjoyed this episode.

Narrator (03:34):

Thanks to Ruth and Ryan's commitment to education. This podcast will run throughout brain injury awareness month with episodes releasing weekly. During this season, we will explore a wide range of topics by highlighting group discussions that incorporate elements of lived experience and professional expertise in our collective effort to provide a diverse understanding towards the varying experiences of a brain injury. This series has been broken down into five parts, brain injury and justice, concussion, and TBI within the veteran community impact of brain injury on family members, recovery at home and accommodating a concussion in the classroom. Today's episode is brought to you by our sponsor Bartimaeus Rehabilitation Services Inc., and features a group discussion on the topic of brain injury and justice that was facilitated by Dr. Carolyn Lisky a clinical neuropsychologist with over 25 years of experience, working with people, living with the challenges of a brain injury,

Carolyn (04:36):

The ability to kind of manage emotions and kind of work systematically towards both of those things can be affected. And that might increase the likelihood of someone coming into contact with the justice system.

Narrator (04:51):

We would like to thank all of our participants for their willingness to share these experiences with us and our amazing episode sponsor Bartimaeus Rehabilitation Services Inc., for making this podcast possible. And now please enjoy the conversation.

Carolyn (05:09):

Hi everyone. I'm Carolyn Linsky. I'm a clinical neuropsychologist and the clinical director at community head resource services of Toronto. And joining me here today, our Mary Perrick, Katie almond, and Dr. Katherine Weisman Hakes to have a conversation about brain injury in the justice system. And so what I'm going to do now is to turn it over to folks to, to provide a brief introduction to theirselves before we get started. So, Mary, could you tell us who you are and what your interest is in this topic?

Merri (05:46):

For sure. So I am the communications manager at the brain injury society of Toronto. And I am here mostly because we have created a website it's the first and currently the only resource I believe for people in Ontario who live with brain injury and other cognitive challenges who are involved in the criminal justice system. And our website is a bit unique in terms of half of it is geared towards people living with brain injury and perhaps their loved ones who are supporting them. And then the other half is geared towards legal professionals.

Carolyn (06:25):

Oh, that's great. It's a tremendous resource. And hopefully we get a chance to talk a little bit more about what's in that resource and how folks can access it. And Katie, can you tell us who you are?

Katie (06:38):

Hi, I'm Katie almond. I'm a probation and parole officer. I work in the Moss park area. I worked in the justice system for 37 years. I have a complex caseload with a, a large proportion of individuals who I suspect have brain injuries. I don't always actually have a diagnosis on file. I also chair the downtown Toronto local human services and justice coordinating committee and its provincial counterpart. And that brings together a number of community partners to try to affect positive change for our clients, particularly those who are presented with physical and cognitive challenges. Thank you.

Carolyn (07:09):

Oh, great. Thanks. And Dr. Weisman hates.

Catherine (07:12):

Thank you, Carolyn. Please call me Catherine <laugh> I'm Catherine. I'm a speech language pathologist and my doctor work is in the area of clinical neuroscience. So I am a an assistant clinical professor in speech language pathology in the school of rehabilitation science at McMaster university. And I'm also an affiliate scientist with the kite research Institute university health network, Toronto rehab Institute. I'm also the director of a nonprofit organization called the compassionate justice fund. And Katie almond is a very valued and important member of our advisory committee. The aim of that the compassionate justice fund is to provide funding to support rehabilitation primarily as well as other needs or services for individuals with brain injury from underserved and marginalized committee communities, for example, individuals with brain injury in the criminal justice system. So thank you very much for having me here today and very passionate about this topic.

Carolyn (08:21):

It is, it's a very important topic and I know that supporting folks long term in the community, it is something that unfortunately becomes relevant for a lot of the folks that we serve. And I guess what we should probably do is to get started by saying, you know or talking a little bit about why it's such an important topic why brain injury in the justice system is such an important topic. And I'm wondering if you could tell us a little bit about the research that you've had, that that kind of tells us something about the intersection between brain injury and the justice system

Catherine (08:54):

I'd be to to respond to that. So, first of all we know that the prevalence of brain injury in the criminal justice system internationally is staggeringly high, that research evidence has shown that approximately 80% of adults in the justice system who are incarcerated. We also know that among the youth justice system, that the it's at least a minimum of 50% or greater have a history of brain injury. The second thing that I think is also very important is that the majority of these individuals have had more than one injury research that I've conducted. We had an average among the participants in our study of three and a half injuries and some evidence from the United States that people have shown up to 12 injuries. So many of these individuals have been involved in, in violence and have a history of, of violence and abuse.

Catherine (09:58):

So they have many of them have sustained, repeat hits to the head face body attempted strangulation over their lifetime. So many have repeat injuries. So it's a huge issue. And the other reason that it's so important is that brain injury can cause a number of challenges and issues for individuals that may, and in many cases can be a contributing factor if not the contributing factor to them ending up in the justice system in the first place. And really it should be a rehabilitative approach rather than a punitive approach.

Carolyn (10:37):

So some of the changes that happen with brain injury that might include, you know, more difficulty in communicating with other folks greater difficulty in reading social cues and communication can lead to a greater likelihood of having conflict in the community also to changes in self-regulation which often happen as a result of brain injury. And by that, I mean, you know, the ability to kind of manage emotions, kind of work systematically towards both of those things can be affected, and that might increase the likelihood of someone coming into contact with the justice system.

Catherine (11:14):

Mm-Hmm, <affirmative> absolutely. I mean, we, we often, as you so clearly stated, you know, we see significant challenges with communication, with aspects of cognition. So thinking and memory difficulty with impulse control as you also said, emotional liability, difficulty reading, social cues. So not understanding, you know, when someone might be really angry or upset and that can result in violent confrontations. We can also see increased aggress aggression and, and violent behavior as well as other challenges with you know, being exploited and, and being abused, not really understanding when someone is trying to coerce them into doing something that likely they should not be doing so there's many factors.

Carolyn (12:06):

And in fact, I think that's a really good point. I think I've been involved with a number of cases where some of my clients weren't really able to kind of accurately discern what the motives that somebody might be, and they got taken advantage of, you know, some of the scams where they say, you know, you can go and cash a check because a relative died and they truly believed that they were doing a good thing and then perhaps were arrested for fraud in one case or believing in, in another case that a woman might have been interested in their attention and then coming to the attention of the law because they were misreading those social cues and were arrested for sexual harassment. And so that's something that we do see, and it's some misunderstanding in many cases. And in some cases, you know, even if there was a criminal act that did occur, there was some contribution of the brain injury then. So it's really an important issue. It's really an important issue. So I'm wondering what what we're seeing as sort of the biggest barriers in terms or problems presented for folks when they come in contact with the justice system. And then I'm interested to hear from from anybody who might have a perspective on

Catherine (13:20):

I'm happy to, to share, but I'm, I'm wondering Katie, if you to go ahead.

Katie (13:24):

Yeah. I'll just, if I could just jump in here sure. Where do I start? So I would say one of the difficulties is that the justice system is such an abstract place. It's, it's when it's in, when it's running, when it's, there's not a pandemic, it's, it's loud, it's chaotic, it's hard for people who don't have a brain injury to understand what's going on. It really is sort of an echo chamber and in the midst of that echo chamber, and now that echo chamber exists mainly on zoom. And although that will transition, I suppose, in the next few months clients are provided with instructions or directions to follow, and they often just agree to them. They don't really understand what's going on. And when I say abstract, and I'll give you a quick example a client will be told, there'll be a condition on a probation order that says you are not to be in an area bound by, you know, DNDA street to the north queen, to the south.

Katie (14:13):

They're given these sort of difficult parameters to even grasp and what they so they come in to see me and it turns out, of course, they've reached the order because they've gone into that sort of zone. And what I say to them is that's where the Eaton center is. You're not allowed to go to the Eaton center. So if in wording conditions, it's really important that judges provide clear conditions for a client that they can understand. And that I, as the supervising probation officer, explain those conditions, particularly if they're written in a very dense or complex way, I often, you know, before Google, I would just draw a map and I'd say, you can't, I'd highlight it. You can't go here. Now I can just print one off and I can pilot it and say, you can't go here. And really, so try to make that as concrete as possible.

Katie (14:56):

And I'll say, you know, there's, McDonald's on the corner and all I know where that is, that kind of thing. And I'll write down. Mcdonald's so things that are familiar to them that they may recall. I try to work with them and I always ask them to repeat back what I've told them. So I have some sense that they understand it because typically they in court, they just said yes to everything, and they really didn't understand the conditions being imposed. And then they're at great risk to breach those conditions. Not because they're criminals, but because they really don't understand what the parameters are. So I do a lot of I, my other problem, you know, as probation, parole officer, I talk really fast and I tend to, and this is something I really had to work on. I will ask three questions in one sentence and the client just stares at me. So I, I've learned to ask the questions in bite size chunks, wait for the response you know, reinforce the response, clarify it, move on. It's a longer conversation. And sometimes in the anxiety, sort of this anxiety, like I've gotta get all this, get this information from the client. They haven't come in lately. I really have to slow it down so that I get the information. So I get clearer information so that I'm not putting them at risk as well. That would be great, but you've

Carolyn (16:05):

Come to understand, yeah, somebody gets arrested. And then after that arrest, I mean, whatever upsetting event that there was, there's a barrage of information that happens. And, you know, anybody who's upset or anxious in the context of an arrest might have difficulty kind of parsing all of that and figuring it all out. But when you have a brain injury, it's a particular challenge. And what you've noticed is, is that very often, even people who are really wanting to comply with orders may get them in a format that they can't understand. And the whole process really is just kind of, it move very quickly. Some of the instructions are very abstract. And I know from my own, my own attempts to kind of get information from the court, it's a hard system to figure out.

Katie (16:53):

Yeah, exactly.

Carolyn (16:54):

So a big barrier is understanding court processes.

Katie (16:58):

Yeah. I think, I think that's why visual maps are often so useful, you know, sort of a journey map through the system, as opposed to explaining a lot of different concepts. I mean, you know, it's meaningless if the person doesn't know where they are situated in that system and where they could end up, I mean, the very concrete thing, if you do this, you could end up in jail, right? So I used, I'd used a journey map as well, a visual that we have that we prepared with the, at the HS JCC, which, and I can locate the client on the map and say, this is where you are now. And if you, if you don't abide by, if you don't obey this, you could end up here.

Carolyn (17:27):

So when you talk about this map, and this is something that I think might be included in some of the materials on the website, can you describe to us what the map is and how it helps?

Katie (17:36):

Well, I'm talking about the map that we use at the HS JCC that we created out of consultations, but there may be Mary might have information about one that they use as well as sort of the

Carolyn (17:48):

Navigation. So I'll just actually turn it over to you.

Merri (17:51):

Thank you. Actually, on ABI justice.org what I was going to say is, I think there'd be fewer barriers if like every person who dealt with people in the criminal justice system just, you know, followed what you do, Katie. And that's basically so much of what we have on their website, for people who are not familiar with brain injury, you know, you don't ask, do you some tell, ask somebody, do you understand? You say, tell me what you understood, right? And especially when you think of, as we've said, how stressful this process is, even if you don't have a brain injury, which I think you said Carolyn, like it, it's just so complex to try and understand. So, yeah. So what I, what I was just going to add is@abijustice.org, on the professional side, we have tips on things that perhaps you, even if with good intentions, you wouldn't think of that somebody with a brain injury is dealing with such, as you said, don't ask three questions in one sentence.

Merri (18:46):

As I'm sitting here, we're in a temporary office at BIS right now. And one of our tools is how to hold meetings that are accessible. And part of that is, is your office noisy. We do, sadly, we live we're in Toronto. So as I'm here, like we hear the street cars screeching, right? Like how do you reduce those sounds and conditions like lighting as well, that can really impact someone who's dealing with brain injury, who might be light sensitive, who might have hearing sensitivity and like sensitivity to noises rather, and, and just make sure they're comfortable. And as you said, like the clear language of it's not, don't go past Victoria street, it's, don't go to the Eaton center, right? This is all stuff that like for us, I saw you Carolyn trying to figure out what those boundaries meant and was like, oh, just don't go to the Eaton center. Right. That's it's simple. So that makes it better.

Ryan S (19:37):

Bartimaeus rehab services incorporated has been setting the standard of excellence in rehabilitation support workers since 1988, providing direct therapy, transitional support, and community integration to children, youth, adults, and seniors, recovering from an acquired brain injury or serious trauma. Don't just take our word for it. Here's what one of our clients said after working with us,

Amelia (20:03):

They were reliable, empathetic, caring, and always professional, truly a great resource for the community.

Ryan S (20:09):

You can learn more by visiting ww.Bartimaeusrehab.com

Carolyn (20:16):

For professionals. It sounds like going to ABI justice.org. Yeah. ABI

Merri (20:22):

Justice.Org.

Carolyn (20:22):

Yeah. It's probably worth repeating going to that website and, and getting familiarized with some of the potential consequences of a brain injury, things like sensory overload and difficulty with distractions and communications tips and tricks. So that I'm guessing lawyers and other court personnel will have a, an easier time kind of communicating with folks and, and making sure that they get the messages that they need. Is, is there anything that you can, if, if a person is themselves is to find themselves in a situation where they have to come to the court, do you have any suggestions for them about how to prepare for that kind of event and, and what might be helpful?

Merri (21:06):

For us on our site, part of our resources include either printable or I guess like downloadable resources, like as such as simple checklists again, like things we've had, cuz we also do provide case coordination for, for people living with brain injury at best and something our coordinators have encountered is clients who have not shown up for court because their executive function is impaired and the problem solving of how do I take public transportation to court to show up just, just that like an, all the steps that are involved with leaving on time, having money saved for public transit how to get there, all, all of that can be something that is not possible for some people with, for many people with brain injury. Right. So, so yeah, it's like whether it's for the, the person with the brain injury or it's someone in their life who's supporting them. We do have those, like here, you're going to court, this is what you need to do before you go to court. And this is a checklist. And part of that checklist is how are you getting there? Do you have money for parking? Do you have money for public transit? Do you know when to leave so that it it's just it's laid off, it's laid out for them rather to have the cognitive prompts to, to to hopefully be more successful

Carolyn (22:22):

Mm-Hmm <affirmative> so, you know, just the, just the mechanics never mind understanding the justice system itself, but getting across town at a particular time and place might be difficult remembering when that date is and, and getting there. And so there's some guidance some concrete guidance about how to help folks kind of negotiate those really mechanical, important things to ensure that they don't wind up with charges upon charges for non-compliance which is something unfortunately that, that we have we have seen,

Catherine (22:53):

I would just like to add something and every, you know, the, everything that everyone has raised so far is, is so extremely important. The first thing that I would just want to say is that you know, once they do get into the court system, you know, there are laws that in both Ontario and in Canada, in Ontario, we have the Ontario Arians with disabilities act and the accessible Canada act and communication is, is a recognized disability. And so there's a couple of things. First of all, we recommend that the accessibility coordinator at every courthouse be notified when there is a client with with a brain injury. Secondly there is an, or communication intermediaries which is CI Canada. And those are speech language pathologists who have specific training on supporting individuals in court. So they should also be brought in to support the individual.

Catherine (23:58):

Secondly I think one of the really important issues, you know, we're talking a lot about what we can do to support the individual with the brain injury. But part of the reason we're here today is that there's such a need for education and training of people in the justice system about the prevalence of brain injury. What it looks like to have a brain injury, because we know that brain injury is most often a hidden disability. And so oftentimes people with brain injuries are either the, the disability is minimized which is absolutely incorrect because we, we do know that brain injury meets the criteria of the world health organization as a chronic, lifelong disease that can change over, over time. And in fact issues can come up years down the road from the injury that are related to, to the initial injury.

Catherine (24:55):

So it's recognizing that it really is a disability regardless of whether or not it's visible or not. Secondly as I mentioned, providing training across all levels of the justice system first responders, police officers, court, staff, legal staff, justice of the peace judges crown attorneys, all of them and then correction staff, bail staff across literally the whole trajectory of the justice system need to have training in screening for and understanding brain injury and what they legally need to do to support someone who has a disability under, under those under those acts. So the, the other thing that I just wanted to add if we can back up a little bit, Carolyn, I think the first question you asked us was about barriers. So I would also like to suggest that screening for brain injuries should be absolutely mandatory in the justice system.

Catherine (26:01):

And in fact it is, this is in place in other jurisdictions across the world, and certainly the UK, Australia and New Zealand, our leaders in, in the field. I can also share that in the UK anyone who comes into the justice system is actually provided with a communication and language screening by a registered speech, language therapist, speech language pathologist. Wow. Yeah. So that's in, in in the UK and there are speech language therapists with all of the offending teams. I, I don't like that word offending. I mean, people have committed an offense. It doesn't mean they are offenders per se. And also with the youth offending teams, each one has a dedicated speech language therapist who, as I say, does a communication screening. And then the findings from that are summarized and provided to all of the people, whether it's the lawyer, the judge, etcetera bail that are involved in that young person or the adults case. And then the individual is also offered an opportunity to do some therapy. So I think that that's absolutely critical in something that I would like to see implemented both in Ontario in, and and in Canada, I just would say reiterate that, you know, one of the biggest barriers is just really lack of awareness and we need to implement routine screening.

Carolyn (27:29):

Yeah. And, and, and you make a fantastic point that if justice is gonna be served for anybody that an individual really needs to be able to understand the process what's occurring,

Catherine (27:40):

Mm-Hmm, <affirmative> absolutely.

Carolyn (27:42):

And, and as you say, it's an invisible disability, so screening is an important thing. And it's, it's, it's amazing to know two things that you said that I'd like to highlight. One is that there are models in the world that we could be replicating, that we know are successful in identifying some of these barriers and rectifying them in likely reducing cost to society by reducing the likelihood of reoffending and certainly getting better outcomes for everyone involved. So I think that that's prime importance. The other thing that you said, I think that really bears repetition is that each courthouse does have an accessibility coordinator. And so and, and I guess for anybody listening, you would want to know that you can ask for that person's support, right. Without if you don't have another say advocate with you or helping you, knowing that there is an accessibility coordinator could be a very important and for families to know that could be a very important piece of information.

Carolyn (28:45):

So thank you for emphasizing that that is a legal right, that folks have, and that there's some accommodation for it, I guess. What I'm really I'm interested in because you mentioned the health and justice committee the H S JCC. I'm probably not getting that Ackerman entirely. And I'm wondering if you could talk a little bit Katie and Catherine about the work of that committee and what we should know, if, if there's anything that we should know about that and how we can support that kind of community effort to increase awareness and justice in, in in the system.

Katie (29:27):

So the, the human services and justice coordinating committee, which I know is a mouthful was start, they was first started and they were in about 1997. And we now have 30, we have 14 regions in the province with HS, JCCs, provinces broken down into 14 regions and 38 local committees. So the local committees are sort of grassroots on the ground problem, solving many brain injury organizations belong to those committees. And the, what we do is we try to solve problems sort of in the moment or in the month, or take longer. And then what we do when there are issues that consistently come up in our provincial in scope, what we do is we, we sort of push them up the food chain for lack of a better word to provincial committee. And originally there was not a provincial committee, but there were so many issues that were consistently raised that we thought we have to do something about this.

Katie (30:20):

And what we do has to be congruent with the, with the policy direction of the province, because we receive a small amount of money from funding from the ministry of health. And so we, we struck a provincial committee and we have a provincial secretariat with its staff and that secretariats job is to help us with the policy, coordinate our network, reach out to our network. We have regular meetings, webinar series. We have a great website just type in HS JCC, and we have wonderful people like Katherine sitting at the committee. We also have Dr. Flora Mathison who works in the area of of brain. So that's great. They've been great voices at the committee because it demystifies well sort of combination of things in the academic world and academic work that's been done on great injury. And then, and then also looks at what the on the ground work is being done.

Katie (31:07):

And until they joined the committees, I'm not sure that was happening. If I could just quickly speak to what you were talking about earlier Catherine, about the need for education and training. There's a general acknowledgement that we should be providing education and training on brain injury and on developmental disabilities. But that's not happening yet. And because this hasn't happened yet and it probably hopefully will happen sooner later than later over the years, I've just developed my only own ways of asking questions to try to suss out if a client is struggling with a brain injury, because anecdotally it went from being anecdotal to being this isn't anecdotal anymore. I see a lot of people reporting a history of brain injuries as children or, and, or as adults because they have such risky lives. So they really are they really are vulnerable. So the HS JCC strives to highlight those issues and try to solve them as much as possible at the local level. And then raise things up to the provincial level.

Catherine (32:01):

Theoretically <laugh> is sort of our pipeline to the ministry of the solicitor general, the ministry, the community, and children. And I always forget the exact name but you know, we really need to inform policy at, at a provincial level and at, at a a federal level as well. You know, for example there are mental health courts, you know, in my view, I think it would be extremely valuable to have a brain injury court for anyone with, with cognitive disabilities. And oftentimes they get shuffled over if I understand correctly, Katie to the mental health court. And sometimes a lot of the behaviors that are actually a result of the brain injury per se, are misattributed to being specifically, or just due to mental health challenges. You know, all of these individuals have experienced trauma, emotional trauma abuse, and, and of course there are mental health considerations.

Catherine (33:04):

But a lot of the times it really is an issue around the brain injury. For example, you know, the emotional liability, the not picking up on social cues sometimes the inappropriate social responses perhaps laughing when they should be showing remorse in, in the court system or, you know, saying something that that's really inappropriate and that really is a result of the brain injury. So again, I, I think that having the HS JCC, where we have access to people in the justice system, you know, from police officers to correction officers, to on the ground workers, to judges, legal professionals probation and parole mental health workers, et cetera. I think that really affords a, a very unique opportunity to to really provide education across a number of fields, as well as, as I said earlier, to provide in theory, a pipeline of information at the ministry level, because really that's where change does need to be affected.

Katie (34:14):

I was just gonna say the provincial table has, I, I, I say the people who write the checks, the directors, and the higher level folks at the ministries that are the human services and justice ministries and correctional service Canada, and a number of other organizations that are provincial in scope. So the whole idea of the provincial meetings is to get their ear about what we're talking about at the local committees. Sorry, Caroline.

Carolyn (34:34):

No, I was just gonna say so, so now I'm getting a picture that, that committee really does connect the dots. It connects the dots between the academic work and what we understand about the occurrence of brain injury and how it impacts an individual in their life and as a result of justice system. But then also to, to, to, to connect those kind of what can be really kind of siloed administrative structures, getting everyone talking and doing some of that advocacy of work, hopefully bringing about some of the changes that, that Catherine was talking about in, in the UK where we're really much more aware of and compensating better for these things. You know, it's the other piece to this too. In addition to connecting the dots is actually when a person is incarcerated and if they have a brain injury, my impression is from, from the clients that I've served, that they seem to be at a significant risk for having a bad time while they're incarcerated. Having difficulty with following roles sometimes winding up with extensions of their sentences as a result of that. And sometimes re-injury as a result of the assault. And so, you know, throughout, it sounds like the correction system there really needs to be some advocacy regarding recognizing this invisible disability and, and helping folks to compensate providing administrative structures that are gonna reduce the negative impacts of that.

Katie (35:59):

I, if I could just jump in here and say, right now, I'm actually working on a project with our community reintegration unit. So we are, we've just launched a community reintegration strategy. So it's to provide a warm handoff for clients with complex needs, from the institutions to the community and staffed by wonderful people, working very hard to try to affect change and have that linkage between the institution, the community, and to ensure that those community organizations are aware of the individual. It can provide them with help starting when they're inside. So this is a fairly recent development, and it's moving pretty fast and it's getting you know, sort of early days, but I'm sure that we'll get some good results. So that is that's come about for large part because of, of work that people have done behind the scenes about how vulnerable our clients are

Carolyn (36:45):

To recognizing the folks who are vulnerable while they're inside and then helping them to make the transition to get out. I know that I've talked to folks in the John Howard and sometimes it's, it's hard even to, to just get a person across the parking lot, literally to get some basic supports. And so that's a, I think what you've laid out today is that from the very beginning from the arrest to any processing through the judicial system and it, and if there is incarceration through that release process, but at every step along the way, we really have to be aware of this invisible disability and providing the kinds of accommodation that's necessary to help a person understand what's happened to get the support that they need to address whatever issues are existing and whatever therapy and to make a successful community reentry when that's possible. I'm, I'm thinking that we're, we're getting close to the end of our time and I, and, and you guys have mentioned some really important resources that I think we should probably make sure that we repeat those cool websites so that people know where to go to get all of that good follow up information. So I guess Mary it's kind of an omnibus website. Can you, can you give us the coordinates to get back in touch with ABI justice?

Merri (38:01):

Yep. Www.Abijustice.Org. Yeah. Lots of great resources for people living with brain injury and also professionals who serve them. So check it out.

Carolyn (38:13):

<Laugh> so fantastic. Are there any other particular websites that we should be repeating as we end here?

Catherine (38:19):

Well, I would like to once again, just share the compassionate justice fund. So it is all one word, compassionate justice fund.org. And as I mentioned, you know, we are currently accepting applications.

Carolyn (38:35):

We actually have a number of, of people who we're supporting, who are currently incarcerated. So we, we welcome applications from across the province.

Katie (38:45):

Sure. I'm just gonna say the HS JCC, it's just HS, J C C. You don't even need to type in the rest of it. It'll come up. Great website, lots of good resources available that a fair amount there about brain injury. And we have, we post information about a number of webinars, places to go for training and education papers that have been written. It's, it's a, it's we're very lucky. We have a man named Trevor, Tim, Tim, Tim, Chuck, who's, our communications and knowledge exchange coordinator who sits on her committee and it it's his baby. And he's done a great job of shepherding us through changes in the website. It's an excellent resource. It's a lot of good information.

Carolyn (39:22):

Oh, that's so, that's so nice to hear. I mean, it, I really is a great source of optimism to know that this is a recognized issue and that there's so many amazing efforts being put to addressing it. So thank you so much for everyone, for joining us and putting out all those great resources and, and helping us to better understand brain injury and the justice system.

Speaker 15 (39:43):

Thank you so much for listening to this episode on brain injury and justice. If you've found the content in this conversation valuable, we would love to hear it. Please let us know by providing a rating and review of the podcast below.