Researchers at the Brain Injury Research Center at the Mt. Sinai School of Medicine are identifying previously unrecognized brain injury as the cause of many psychiatric problems. Wayne Gordon, the Center's Director and his team have identified high rates of "hidden brain injury"in individuals with other psychiatric and or addictions problems. The CDC acknowledges 5.3 million Americans living with brain injury. Dr. Gordon's research may find a link between mental health problems and addiction in many more cases than imaginable, making the CDC data look insignificant. The research may also lead us to a better understanding of why individuals fail in treatment. The neurocognitive problems from an untreated brain injury may prevent a person from benefiting from the traditional arsenal of medication and talk therapy.
Some years ago Dorothy Lewis, MD conducted a study of death row inmates and found an alarming rate of brain injury, neurological disease, child abuse and other factors which could account for the criminal conduct of these individuals. In another study involving incarcerated adolescent offenders, Dr. Lewis found a similar relationship between past neurological injuries and disease and dangerous criminal behavior. Were these adolescents waiting to join the death row adults?
In the 1970's when I was working for the Massachusetts Division of Legal Medicine we conducted an informal study of incarcerated males in the county system. Over 25% of the individuals we examined had untreated learning disabilities. The evidence is becoming increasingly clear. There is a relationship between many mental health and addiction problems and brain injury. We need to expand how we evaluate and assess individuals who enter into the mental health, substance abuse and criminal justice systems. Is there a history of brain injury that could be the cause of the problem? Does failure in earlier treatment relate to the person's diminished ability to benefit from an approach requiring specific cognitive skills, such as reading, memory, information process or decision making? Are the medications the ones we would use with a person who has a brain injury?
I think Dr. Gordon's study will tell us what we already know: there are more people with brain injuries than we can imagine.