Participant demographics

Demographic and clinical information for the male (n = 37) and female (n = 17) offenders are shown in Table 1. As this was a prison for adult female and young male offenders, these groups varied greatly in terms of average age (Females = 32.53 years, Males = 19.57 years). The highest level of education for the majority of participants was primary school (Females = 44.4%, Males = 56.8%). Maternal education was employed as a proxy measure for SES and showed that both males and females came from low SES backgrounds. Mothers of female offenders were educated to primary school level (22.2%), whilst mothers of male offenders were educated to secondary school level (21.6%). Rates of mental illness were higher amongst female offenders (83.3%) than males (62.5%); however, there was little difference shown between groups on alcohol abuse (Females = 61.1%, Males = 59.5%).

Table 1.

Characteristics of offenders by gender

*General Certificate in Secondary Education (GCSE) is a school qualification offered in the UK to students aged between 14 and 16 years.

**Advanced level (A-level) is a school qualification offered in the UK to students aged between 16 and 18 years.

Perceived causes of incarceration

Male responses were categorised into five themes. The three primary themes were ‘Substance Abuse’, ‘Anger/Aggression’, and ‘Perceptions of Consequence’ characterised by an inability to perceive the consequences of their behaviours. Male offenders also referenced a combination of ‘peer influence’ and ‘negative familial environments’ as precursors and influencers of their subsequent criminal behaviour. Figure 1 displays the most frequently mentioned words.

Figure 1.

Most frequently reported responses to question 1 for males: what do you feel led you to offend?

A significant proportion of males blamed either drug addiction or alcohol abuse for their incarceration. Alcohol use was often reported as a precursor to violent behaviour, with one male noting ‘… Turns me into a nasty fella. If I never drank, I would’ve never met the police’ (Male, 6 injuries), and another commenting ‘It was a drunken mistake. Two fellas jumped me and I hit one with a bottle’ (Male, 3 injuries). Among those who reported drug use/addiction as the precursor to offending, both actions to fund drug habits, and decisions made while under the influence of drugs were salient, ‘I had to pay off drug deals every week… I got some money from mum… I got away with a few things so I kept going’ (Male, 3 injuries), ‘Drugs were my big downfall. If I wasn’t off my head I wouldn’t have done those things… wouldn’t have hit him’ (Male, 5 injuries). Such notable overlap between substance use and aggressive or violent behaviours reflects the prevalence of ‘Anger/Aggression’ as a theme among respondents.

Though aggression was sometimes the result of alcohol or drug abuse, it was also characterised as a personality trait ‘…I made poor lifestyle choices… I was always fighting’ (Male, 6 injuries) ‘Stupidity, bad decisions, and acting out of anger’ (Male, 6 injuries). Some of this aggression appeared to be the product of environmental or socialisation factors ‘I got threw out of five homes for fighting… people my age liked to push you’ (Male, 3 injuries), such that aggressive masculinity was a means of surviving or asserting strength. However, a number of offenders indicated that they struggled to control or monitor their anger. One individual remarked that it was his ‘Stupidity’ and ‘… bad decisions’ that resulted in him ‘[acting] out of anger’ (Male, 6 injuries). Another noted that if he had of been able to ‘[talk] to people [I] wouldn’t have ended up in this situation… wouldn’t have resorted to violence’ (Male, 2 injuries). Male offenders appeared to often be blinded by their anger, reacting before considering the consequences of their actions. One male described how a ‘Mate was slobbering [talking aggressively] and telling me he was going to do this and do that. I just cracked [hit] him’.

Male offenders often referenced their inability to perceive the consequences of their criminal behaviours. Statements such as ‘I don’t think before doing things’ (Male, 3 injuries) ‘I was stubborn and impulsive. I made bad decisions’ (Male, 1 injury), and ‘Stupidity… already been down this road, but did it again’ (Male, 4 injuries) repeatedly placed the blame on offenders themselves. One individual summarised this as ‘I don’t think things through even though I know the consequences’ (Male, 6 injuries), suggesting that even though these males understood that what they were doing was wrong, they struggled to perceive the immediate consequences of their actions, inhibit their negative behaviours, and identify the appropriate actions to take in particular situations.

There was notable overlap between drug use and negative peer influence, with several males indicating that friends had introduced them to drugs or were involved in pushing them into crime. There was a clear recognition of the negative influences of anti-social peers, though males often blamed themselves for being ‘talked into it’ (Male, 2 injuries) or for not recognising ‘False friends’ (Male, 2 injuries). Vulnerability to peer influence has been previously recognised as a risk factor for offending (Andrews & Bonta, Reference Andrews and Bonta2010) and appears to play a key role in both drug and alcohol use. Individuals with TBI may be particularly vulnerable to such influence, failing to recognise when they are being taken advantage of or when the acts they are being ‘talked into’ are of particular risk.

Family difficulties were also reported, where issues from abusive parenting, to challenging experiences in the care system were noted. One individual indicated that other members of his family were offenders ‘All my biological family is in jail… I have no role models’ (Male, 3 injuries), and that his brother was also resident in the prison. Five other males made reference to issues in the home, ranging from criminal activity to being made homeless at an early age. For these males, offending appeared to be a consequence of the failings of others to support them whilst growing up. Drug use again featured heavily in these accounts, though this may have been more of a coping mechanism for the stress and trauma of such experiences. The impact of such negative early environments on TBI should also be considered, with individuals from difficult family backgrounds experiencing more severe and lasting consequences of TBI.

Among female offenders, ‘Substance Abuse’ was also the dominant theme, followed by ‘Mental Illness’, ‘Relationship/Partner problems’, ‘Abuse’ and ‘Peer Influence’. The most frequently mentioned words are presented in Fig. 2.

Figure 2.

Most frequently reported responses to question 1 for females: what do you feel led you to offend?

Substance abuse was also the dominant theme among female offenders who noted that either heavy drinking or drug usage had led them to offend. While drug use appeared more as a lifestyle choice among males, females were clear in communicating drugs as an addiction which controlled many aspects of their lives. There was clear overlap between theft and addiction, with one female noting ‘I had a drug habit. I was a heroin addict with 80 charges for shoplifting’ (Female, 6 injuries), and another stating ‘Gambling addiction… it led me to steal and that’s why I’m here’ (Female, 1 injury). While substance abuse was viewed as the main cause of subsequent offending, several females felt that other factors were to blame for this addiction.

The theme of ‘Relationship/Partner problems’ was common alongside substance abuse with comments such as ‘Alcohol and men, it doesn’t agree with me’ (Female, 6 injuries). Women often described their experiences more in terms of their vulnerability than their criminal intent and were more likely than men to describe themselves as victims of abusive or coercive partners. As stated by one female ‘My husband was selling counterfeit goods and I got pulled into it’ (Female, 1 injury). Difficult relationships appeared to pose particular stress and rarely occurred as isolated factors. As one woman described ‘I was in a bad place… struggling with things… with relationships and money… things just got out of hand’ (Female, 2 injuries).

In more extreme cases, women spoke of abusive partners and the struggles they faced in dealing with the results of abuse. One participant stated ‘I was sexually and physically abused, and I do drugs to block it’ (Female, 1 injury) while another described the ‘Combination [of] abuse and my children were removed from me’ (Female, 6 injuries). Despite a high rate of reported past abuse, only four women indicated a belief that this had contributed to their offending. Surprisingly, TBIs, resultant of such abuse, were not mentioned, with females placing greater emphasis on the emotional trauma experienced over the physical trauma. This may represent a failure to acknowledge the impact of such repetitive injuries, with females more likely to attribute subsequent mental health problems to emotional trauma rather than a TBI.

Victimisation often ran alongside themes of mental illness, where instead of an abusive or coercive partner, females described themselves as victims of a care system which failed to address their needs. One participant described this experience as ‘I didn’t have the resources and help out there…. I begged for mental health and alcohol services’ (Female, 3 injuries), while another blamed ‘Neglect from institutions, and my mental illness as well’ (Female, 1 injury). One female described how she ‘had a breakdown – I have mental health issues and my son was sexually abused. No help was there for me, it pushed me over the edge.’ Women were more vocal regarding the contributory impact that mental illness had on incarceration than men.

Only two participants mentioned possible brain injury as a contributing factor to their behaviour ‘I’d like to get my brain properly checked. I definitely feel different since [my injury]’ (Female, 3 injuries), ‘[I was] assaulted in the head in primary school… everything went downhill after that’ (Male, 2 injuries). The lack of a strong narrative linking brain injury to offending among this population supports earlier findings by this group (O’Rourke et al., Reference O’Rourke, Linden and Lohan2018) that awareness of the consequences of brain injury, and the possible impact on behaviour, is not understood by offenders.

Experiences of incarceration

Overall, experiences of incarceration for both men and women were mixed, though many considered that the current prison setting was ‘alright’. Several respondents noted that it offered them space to develop as a person and provided opportunities to learn new things through the available education programmes ‘teachers do as much for you as possible’ (Male, 6 injuries), ‘you get the attention you need to grow up and learn’ (Male, 6 injuries). Notable differences between male and female responses included the tendency for males to describe their experience as ‘easy’, comparing the facility to a holiday camp or youth club. Comparisons such as these may have been intended to exhibit the ‘manliness’ of participants, suggesting that they did not perceive their time in prison as punishment ‘It was a gift. It’s a holiday camp in here. I’m used to it from coming in and out… you get used to it’ (Male, 3 injuries). However, as noted by another male ‘[It is] Difficult. If they [other offenders] tell you it’s easy they are lying’ (Male, 6 injuries). Females were much more critical however, believing the healthcare and mental health facilities to be significantly lacking. Respondents noted ‘there is no support for addicts’ (Female, 6 injuries), ‘… there is not enough counselling’ (Female, 3 injuries), and ‘there’s only one [staff member] I can speak to. He talks me down when I’m self-harming’ (Female, 3 injuries). While one male reported ‘I was waiting two weeks when I came in to be seen. I was on heroin and they wouldn’t detox me’ (Male, 3 injuries), no male respondents commented on the mental health facilities. This again may reflect a need to appear tough and hide any signs of vulnerability, despite demographics characteristics (see Table 1) indicating that mental illness was a significant issue among this group. Another potential reason for participants describing the prison environment as ‘easy’ could relate to its highly structured nature which inadvertently supports impairments in executive functioning (Linden et al., Reference Linden, O’Rourke and Lohan2020). For some, the prison environment, with its rules and checks, may prove easier than their ‘outside’ lives which are often chaotic and disruptive (Elbogen, Wolfe, Cueva, Sullivan, & Johnson, Reference Elbogen, Wolfe, Cueva, Sullivan and Johnson2015).

As with overall impressions of prison, comments about fellow prisoners were mixed for both males and females. Males within the prison are divided based upon reward status, with the best behaved or ‘enhanced’ offenders residing in one building (block) and those with poorer behaviour, or who routinely failed drug tests residing in a separate ‘basic’ status block. This divide was clearly noted among offenders, with individuals on ‘enhanced’ status described as ‘calm and wanted to get the time done’ (Male, 3 injuries) while individuals on ‘basic’ status were described as having a tendency to ‘…fuck about’ (Male, 2 injuries). While such a divide is intended to act as a motivation for the improvement of behaviour, it may in fact serve to re-enforce the ‘offender’ identity of individuals with TBI resulting in further behavioural infractions. One resident on ‘basic’ status described others on his landing as ‘Childish… taking drugs and failing tests’ (Male, 4 injuries) while another summarised this group as ‘one week out, three months in [prison]’ (Male, 3 injuries). Individuals from this block were often looked down upon as untrustworthy individuals to be avoided, while those in the ‘enhanced’ block were ‘100%’ (Male, 1 injury) and ‘dead on’ (Male, 6 injuries). Expressions of aggression among males took a more physical form than among females, often due to ‘people trying to be dominant’ (Male, 6 injuries). One male described how ‘a guy slapped me but you couldn’t hit him back because you are waiting on bail’ (Male, 4 injuries), while another described how he ‘had to break one of their noses’ (Male, 6 injuries) because they disrespected him. Responding to disagreements with violence appeared the norm, with one participant apprehensively describing how he had not ‘come to blows with anyone yet’ (Male, 2 injuries).

All females were housed in a single building, which resulted in a complex mix of individuals on each floor. As such, women were more selective about who they associated with, one woman noted ‘most of them are off their faces [high on drugs]. A few of them are grand [Good] though’ (Female, 1 injury). The dynamic of relationships was also notably different among females relative to males, with less violent or aggressive conflicts noted. Instead, it was noted that women ‘have their own cliques’ (Female, 3 injuries) which would intimidate or bully others, ‘…you have to fight your corner. They would try to set you up…vindictive… they reported I had drugs in my cell.’ ‘If someone’s getting bullied you can’t help her or everyone turns on you… If told to, others will avoid that person’ (Female, 2 injuries). While outward aggression was mentioned less frequently, hostility appeared to manifest through ‘bitchy [behaviour] particularly for new people coming in’ (Female, 2 injuries).

Impressions of staff were also mixed for both genders, with some reporting positive interactions ‘[staff are]… really brilliant, very helpful’ (Female, 6 injuries), ‘they have to be firm, but they do have a good side’ (Female, 1 injury), ‘[staff are] lovely, you get respect when you give respect’ (Male, 4 injuries), ‘they do their best, you have to empathise with what they put up with’ (Male, 1 injury) and others reporting negative impressions ‘some are wankers’ (Male, 3 injuries), ‘slimy, tell you one thing and then something else happens’ (Male, 2 injuries), ‘Some go out of their way to annoy you’ (Male, 2 injuries), ‘[they are] Two faced… think they’re better than everyone else’ (Female, 6 injuries), ‘Awful, I was assaulted by two staff… they threw me to the ground. I’m very wary of the staff, I don’t interact [with them]’ (Female, 2 injuries). There was a clear sense from offenders that several of the staff disliked their work and so would employ authoritarian approaches when dealing with individuals. This was often perceived by offenders as an abuse of power, with one female describing how officers would ‘make life miserable’ (Female, 6 injuries). Such abuses of power led to distrust and resentment alongside a feeling of stigmatisation ‘[some officers] …look at you like scum’ (Male, 3 injuries). Particularly, worrying was the perception that certain officers would provoke offenders they knew struggled with aggression in order to ‘get hit so they can get six months [off with] full pay’ (Male, 4 injuries). The position of power held by prison officers was well understood by offenders, and how an officer was perceived as using (or abusing) that power had significant implications for their relationships with offenders.

Expectations of life following release

Among the post-release goals of male offenders, the dominant theme reported was ‘Employment’. Males also placed significant emphasis on ‘Family’, ‘Education’, and ‘Accommodation’ though a number also reported that they had not or did not want to think about post-release. As displayed in Fig. 3, while employment was the key goal, male offenders placed significant importance on starting families and raising their children.

Figure 3.

Most frequently reported responses to question 3 for males: have you thought about your plans for after release?

The majority of male offenders prioritised a return to work post-release. It was felt that returning to their old job or securing new employment was the first step in re-integrating into society and many had indicated forward planning on how to achieve this ‘Get a job in catering, I have a level two course education but want to work to level three’ (Male, 6 injuries), ‘My brother owns a company. I worked for him before and the job is waiting’ (Male, 4 injuries), ‘[I am] meant to be back to Harland and Wolff [manufacturing company based in Belfast]. If not then I will get work through a mate in a hotel or go back to the shop with dad’ (Male, 4 injuries). The level of planning and thought put in to employment goals varied between individuals, ‘I’m going to be a rapper, like Eminem. [There is] a lot of overlap in how we both grew up’ (Male, 2 injuries), ‘[I want to] set up a business selling personalised t-shirts, mugs, and calendars and get it funded by the national lottery’ (Male, 2 injuries). The challenge many offenders face when attempting to follow through on their plans was noted by one offender ‘guys go out with the impression they can do this and that and end up turning back to drugs’ (Male, 4 injuries).

Tied closely to employment was the desire to provide for their family or to build a life with their partners and children. Seven males indicated already having children, though for others this was described as ‘what everyone wants, kids, a girlfriend, a job’ (Male, 1 injury). Starting a family was also considered a turning point or sign of adulthood that males had matured beyond their past crimes, ‘Now I have kids, I want to be a better person’ (Male, 6 injuries), ‘[I want to] Get my family back together… I proposed a few weeks before coming in, she’s sorting it. We’re planning it for two years… She’s been there for me all the way through, I want to treat her to a nice wedding’ (Male, 3 injuries). This may also have been considered a way of shifting from being identified as an ‘offender’, to developing the identity of a father and provider.

Among many of those who wished to return to work, returning to education or upskilling was also a key goal. Statements such as ‘I’m working in a catering course… I’m on a level 2 [qualification] and building to a level 3… If I get this, there’ll be a big improvement’ (Male, 3 injuries), ‘I want to be a personal trainer… I’m getting my level 2 in Maths and English’ (Male, 1 injury), ‘[I want to] Go to tech [technical college] to do engineering… I’ll do the basics here to go back to school’ (Male, 6 injuries) indicated a drive to improve upon participants’ levels of low educational attainment. As with employment, it was unclear whether offenders had considered the possible barriers to education they may face.

While the majority of male offenders had put some thought into their plans post-release, a small number reported either having not thought about this or not wanting to think about it. For some, this appeared to be the result of fear, trying to protect themselves from disappointment and pain ‘I don’t know. No point in making plans… if you have no plans, no expectations, you never get hurt’ (Male, 2 injuries). For others, it seemed difficult to focus on anything other than their current incarceration ‘Can’t think about it until 12 months before I get out’ (Male, 3 injuries), ‘I’m never coming back. I’ll decide when I’m out. I don’t know’ (Male, 3 injuries). The stress and difficulties of coping with incarceration may leave offenders unable to think about the future, particularly for those on long custodial sentences.

Among half of female offenders, ‘Employment’ also represented the primary goal following release. Themes of ‘Returning to family’ and ‘Education’ were also evident, with only two respondents indicating they did not know or had not thought about their plans post-release. Figure 4 displays the words most frequently identified from transcripts.

Figure 4.

Most frequently reported responses to question 3 for females: have you thought about your plans for after release?

Many of the same goals were expressed by females as males. Again, offenders recognised employment and education as representing key steps in their re-integration into society. Several women planned to return to their pre-incarceration occupations, noting they wanted to ‘… go back to my sales job’ (Female, 6 injuries), ‘get my business [personal trainer] back’ (Female, 2 injuries), ‘I need to get back to work, I was self-employed as a cleaner’ (Female, 5 injuries). For others, prison had provided them with the training to seek out further education ‘[I plan to] go to tech [technical college]. Study catering or something’ (Female, 6 injuries). Another noted they were ‘taking a coaching course’ within the prison gym and saw themselves ‘training and working in the gym’ following release (Female, 6 injuries). There was clear acknowledgement of the benefits to education and training, with many viewing the programmes offered as a stepping stone to bettering themselves upon release.

Possible barriers to such re-integration were not mentioned however, despite a significant number acknowledging the impact of their drug abuse and mental illness on offending. There appeared to be a general lack of awareness of potential pitfalls and barriers individuals with co-occurring TBI, drug abuse and mental illness may face. While the controlled environment of prison may have aided in female offenders’ access to education, many females were of the belief that they could simply ‘Get back on track’ (Female, 6 injuries) or pick-up where they left off. Only two females indicated a lack of planning for the future, with one stating they had ‘Nothing planned, I don’t know. I want a better life than the last few years, I’m never coming back’ (Female, 1 injury) and another describing release as being ‘Back to square one. Until something else happens – I will be back in here again no doubt about that’ (Female, 4 injuries). Both responses indicated markedly different beliefs regarding post-release. The latter response suggested a strong offender identity, such that she was powerless to change her situation. This response, though extreme, did indicate a certain degree of recognition regarding the challenges she would face upon release. Nonetheless, it also suggested a sense of hopelessness or having given in to her circumstances which may also indicate that she felt the factors which contribute to her offending had not been addressed within prison.