A TBI Changes How the Brain Works

Correctional staff may experience a TBI from a hit to the head or to the body that causes their head and brain to “whiplash” back-and-forth, such as during a car crash. Other causes may include an object breaking the skull and entering the brain, such as from a gunshot wound. Bleeding, swelling, or tearing of nerve cells in the brain can set off chemical changes in the brain that impair its ability to function properly. And damage to the brain’s nerve cells can affect how different parts of the brain communicate with each other.

A TBI leads to a variety of different symptoms that may affect how a person thinks, learns, feels, acts, and sleeps.

Symptoms of TBI are different for each person and are generally most severe right after the injury. Some people will experience challenges with concentration and memory, while others may have changes in their reaction time or to their mood, behavior, or sleep. A study by Caccese and colleagues found that almost 60% of corrections and other law enforcement officers with a history of TBI experienced ongoing symptoms, such as problems with concentration, reaction time, and emotional control—all of which are critical to performing their regular duties.

It’s not always clear why some people recover quickly, and others experience long-term symptoms, but several studies point to a history of multiple brain injuries as a risk factor for a longer recovery. That means the more brain injuries a person experiences, the more likely the symptoms will last longer. Other factors can also influence recovery, such as the severity of the TBI, access to medical care, and current and past physical and mental health conditions, like depression, anxiety, and post-traumatic stress disorder (PTSD).

Accommodations and Education on TBI May Help with Recovery

Healthcare providers have treatments available to help support an individual’s recovery from TBI. They can also provide a handout with instructions on accommodations that may help with a person’s return-to-duty. Suggested accommodations from a healthcare provider might include limited time driving (especially within the first few days) and avoiding intense physical activity. TBI symptoms often change during recovery. A healthcare provider should adjust a person’s accommodations as symptoms improve or if new symptoms appear during their recovery.

Return-To-Duty May Be a Gradual Multi-Step Process

Correctional staff may be involved in intense physical activity and high-stress situations. These activities may worsen TBI-related symptoms and increase the chance of another brain injury. Research and programs on recovery from a TBI among correctional staff are currently limited. But some experts are looking at improvements in TBI care among military service members and athletes to guide return-to-duty protocols for correctional staff and other public safety officers. For example, Caccese and colleagues recently adapted a protocol from the DoD and the International Concussion in Sport Consensus Statement to create an example of a multi-stage return-to-duty protocol that healthcare providers can use for correctional and law enforcement officers recovering from a TBI. The American College of Occupational and Environmental Medicine also has guidance on return-to-duty for law enforcement officers following a TBI that is based on research on sports-related TBIs, including concussions.

It is important that correctional staff do not speed through a return-to-duty protocol. Healthcare providers will generally move an individual to the next stage when they do not have any new symptoms at the current stage. If symptoms worsen or new symptoms arise, a healthcare provider will advise on whether to stop at the current stage of the protocol or move down to the previous stage.

Some Individuals Need Ongoing Care After a TBI

Some individuals may need weeks, months, or longer before they are able to work. Others may not be able to return to work due to long-term disability or persistent symptoms. Clinical guidelines recommend that adults who experience ongoing symptoms see a healthcare provider who specializes in TBI management.

Help Is Available for Correctional Staff Following a TBI

The physical, behavioral, and mental health-related symptoms of TBI may affect all aspects of a person’s life. However, some correctional staff may not feel comfortable asking for help at work or know where to find help for TBI symptoms. In one study among correctional and other law enforcement officers with a TBI who reported that their injury affected their ability to do their job, only a quarter reported accessing or receiving support from their employer. Some agencies combine peer support with others who have had similar experiences and external Employee Assistance Programs (EAP) to promote the use of support services for health concerns. Others screen officers or require mental health counseling to improve the use of EAP services.

The Brain Injury Association of America, a not-for-profit support agency, established the National Brain Injury Information Center (NBIIC) to support individuals and families who experience the life-changing effects of TBI or other serious brain injury. Specialists at NBIIC assist those who reach out in locating the specific rehabilitative, legal, financial, and other support services. You can speak to a specialist at NBIIC by calling 1-800-444-6443 or by submitting a question through the BIAA website.