Salzburg Global Fellow Huw Williams suggests a public health approach for breaking the cycle of trauma, poverty, and traumatic brain injuries in the criminal justice system
This article was written by Salzburg Global Fellow Huw Williams, who participated in the Global Innovations on Youth Violence, Safety and Justice initiative, along with his colleagues Professor Stan Gilmour and Dr. Hope Kent at the University of Exeter.
The criminal justice system disproportionately incarcerates individuals who have experienced significant and intersecting life adversities. Factors such as trauma, poverty, and neurodisability — particularly Traumatic Brain Injury (TBI) — are not only over-represented among incarcerated individuals but also deeply interconnected. These factors create a vicious cycle that entrenches individuals within the justice system, limiting opportunities for rehabilitation and long-term recovery.
Trauma and Criminalized Behavior
Traumatic experiences in childhood – often termed Adverse Childhood Experiences (ACEs) – are common amongst people who are criminalized. ACEs are generally recognized in a framework of ten experiences including sexual and physical abuse, emotional and physical neglect, and familial violence.
Threat detection biases instilled through such adverse childhood experiences can also lead to hypervigilance, ultimately coalescing in complex forms of post-traumatic stress disorder (PTSD). Cumulatively, these harmful childhood experiences lead to psychological dysregulation because of critical phases of development occurring in stressful, unpredictable, and often dangerous environments, leading to chronically altered expectations and perceptions of the world.
There is also over-representation of individuals who have been involved with social care as children in custodial settings. This may include children who have been fostered, adopted, or recognized by local authorities as being “in need” or vulnerable. Children may be removed from their family homes when family environments are harmful, but a lack of familial support, placement instability, and an increased police presence in secure children’s homes all contribute to the criminalization of children who have experienced trauma.
The Role of Poverty
Poverty exacerbates the impact of trauma by limiting access to protective resources, such as stable housing, transport, and access to education. This is in part due to systemic factors like the challenges associated with accessing employment whilst experiencing homelessness. In addition, the “school to prison pipeline” compounds these difficulties, as children who live in poverty are more likely to be excluded from school, another disadvantage known to impact risk of being criminalized.
Furthermore, poverty increases exposure to community violence and chronic stress, which in turn heightens the likelihood of experiencing trauma and sustaining injuries, including traumatic brain injuries (TBIs). Individuals living in poverty are also less likely to receive adequate medical care following a TBI, leading to long-term cognitive and behavioral difficulties that can contribute to criminalized behaviors.
Traumatic Brain Injury and Criminalization
People in the criminal justice system experience disproportionately higher rates of TBI, often described as a “silent epidemic” due to under-recognition across health, justice, education, and social care services. TBIs often result from accidents, assaults, falls, or sports injuries, leading to disrupted brain function. Living in precarious environments substantially increases the risk of TBI – children from the poorest five percent of society, when under 5 years of age, are 5 times more likely to have a TBI.
TBI leads to cognitive impairments (memory, attention, decision-making), emotional dysregulation (impulsivity, aggression, difficulty interpreting social cues), and communication challenges, making it harder to navigate school, employment, and legal proceedings. Up to 60% of incarcerated individuals have a history of TBI, compared to about 12% of the general population.
Children with TBIs struggle to meet educational demands, increasing the risk of school exclusion and reinforcing the school-to-prison pipeline. TBI also exacerbates impulsivity, irritability, and risk-taking behavior, particularly when combined with Adverse Childhood Experiences (ACEs) and Developmental Trauma.
Cognitive impairments hinder individuals from following legal proceedings, adhering to probation, or engaging in rehabilitation. This leads to increased reoffending, not through intent but due to neurological impairments. Judges may misinterpret communication difficulties as a lack of remorse, reinforcing systemic discrimination. Addressing these barriers through early intervention and specialist support is crucial in reducing reoffending rates and ensuring fair treatment within the justice system.
The Feedback Loop: Trauma, Poverty, and TBIs
The relationship between trauma, poverty, and TBIs is not linear but cyclical, forming a feedback loop that perpetuates criminal justice involvement. Exposure to adversity increases the risk of sustaining a brain injury, while the effects of TBI further exacerbate social and economic vulnerabilities. Without appropriate support, individuals with complex needs remain trapped in a cycle of disadvantage, institutionalization, and reoffending.
Breaking the Cycle: A Public Health Approach and Rights Based Approaches
Addressing the intersection of trauma, poverty, and TBIs in the criminal justice system requires shifting from punishment to prevention and rehabilitation. A public health approach offers a framework for change.
Trauma-Informed Justice: Courts, police, and correctional facilities should adopt practices that acknowledge the impact of adversity and provide support rather than punishment.
Specialist Support for TBIs: Screening for brain injuries in justice-involved populations and providing tailored interventions—such as cognitive rehabilitation—can reduce reoffending and improve long-term outcomes.
Early Intervention in Schools: Keeping vulnerable children engaged in education can prevent pathways into the justice system and promote positive development.
Economic and Social Policies: Addressing poverty through improved healthcare, education, and stable housing can mitigate many of the risk factors for justice system involvement.
Rights-Based Approaches: A justice system that respects fundamental human rights must recognize the dignity and agency of all individuals, including those with neurodisabilities and those affected by poverty and trauma. This means ensuring access to legal representation, healthcare, and rehabilitative support, as well as upholding protections against discriminatory or inhumane treatment.
In 2019, the UN Committee on the Rights of the Child recognized the increased vulnerability for children with neurodisabilities when they issued general comment number 24 on children’s rights in the criminal justice system, which specified that “children with developmental delays or neurodevelopmental disorders should not be in the justice system at all, even if they have reached the minimum age of criminal responsibility”. Embedding rights-based principles within justice policies ensures that interventions do not merely mitigate harm but actively promote equity, inclusion, and long-term well-being.
By recognizing the complex interplay between trauma, poverty, and TBIs, we can work towards a fairer justice system—one that prioritizes rehabilitation and long-term well-being over punishment. We can also work to prevent criminal justice system contact upstream, by providing more equitable access to housing, education, and health and social care services.
Since 2021, Fellows participating in the Global Innovations on Youth Violence, Safety and Justice initiative have contributed to the Global Innovations on Youth Violence, Safety and Justice Report. Each section highlights the key challenges and opportunities identified by the initiative’s international participants, with illustrative case studies, recommendations for consideration and action, and suggestions of where the research agenda should focus in future. This report is continuously updated to reflect new findings, case studies, and resources.
Explore the full digital report here.
Learn more about the Global Innovations on Youth Violence, Safety and Justice initiative.
Salzburg Global is grateful to the MacArthur Foundation and the Harry Frank Guggenheim Foundation for their generous support and partnership that made this program possible.
