INDIANAPOLIS — A team of Indiana University School of Medicine scientists have developed and tested a new intervention for incarcerated people suffering from traumatic brain injuries, with the new tactic already showing promising results in keeping offenders from returning to prison or facing repeat arrest.
A recent study, published in the Archives of Physical Medicine and Rehabilitation, shared results from the Re-entry Continuum for Brain Injury (RCBI) trial, which included 91 Putnamville Correctional Facility inmates with a history of traumatic brain injury (TBI). About half of the men were given education on brain injuries, coping skills training, anger and aggression management, in addition to 12 months of post-release neuro case management.
This group returned to prison at a lower rate (17%) than the control group (46%). The men were also re-arrested at a lower rate (43% to 86%). Lowering the incarceration and arrest rates of the RCBI subjects also led to a 35% drop in related criminal justice expenses, thus saving taxpayer money.
People involved in the justice system experience traumatic brain injuries at a much higher rate — believed to be somewhere around 60% — than national general population averages (8.5%) and often do not know what has happened to them.
"Many participants described RCBI as a 'light bulb moment' when they realized that challenges with memory, attention, impulsivity or emotional regulation could be related to a brain injury rather than a personal failing," said Devan R. Parrott, PhD, associate research professor of physical medicine and rehabilitation and the study’s lead investigator.
"The most surprising part wasn't just how many participants had undiagnosed brain injuries, it was seeing what happened when they finally understood them."
Participants believed something was fundamentally wrong with them because of their injury symptoms, Parrott said.
"Learning that these challenges had a neurological explanation gave them a new way of understanding themselves and motivated them to engage in treatment," she said. "Watching that shift reinforced our belief that identifying a brain injury is only meaningful if it's followed by education, rehabilitation and support."
Anthony Laffoon, MA, an IU School of Medicine researcher who assisted Parrott, said traumatic brain injury among incarcerated people has been studied in the past, but this team’s trial is the first to offer intervention both prior to and after release from prison and track results in this manner.
The trial was done in partnership with the Indiana Department of Correction, with grant support and oversight from the U.S. Department of Justice. It was funded by the National Institute of Justice.
"This work provides critical evidence that targeted support for justice-involved individuals with brain injuries is a winning strategy," said Dawn Neumann, PhD, co-author on the study and a former IU School of Medicine researcher who is now manager of brain injury research at JFK Johnson Rehabilitation Institute at Hackensack Meridian Health in Edison, New Jersey. "I hope this research serves as a clear call for policy and practice changes."
Parrott stressed that traumatic brain injuries in prisons represent a public health issue worthy of further large-scale study.
"By identifying TBI, delivering effective treatment and connecting people with specialized supports, we have an opportunity to improve lives, strengthen public safety and reduce the long-term costs of incarceration," she said.
About the Indiana University School of Medicine
The IU School of Medicine is the largest medical school in the U.S. and is annually ranked among the top medical schools in the nation by U.S. News & World Report. The school offers high-quality medical education, access to leading medical research and rich campus life in nine Indiana cities, including rural and urban locations consistently recognized for livability. According to the Blue Ridge Institute for Medical Research, the IU School of Medicine ranks No. 15 in 2025 National Institutes of Health funding among all public medical schools in the country.
Writer: Rory Appleton, rapplet@iu.edu
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