The prevalence, characteristics, and impact of head injury in female prisoners: a systematic PRISMA review

Background: Although head injury (HI) is associated with offending behavior, there has been relatively little attention to female prisoners. This systematic review considers prevalence and characteristics of females prisoners with HI, with a view towards improving understanding of service needs. Methods: Electronic databases, two meta-analyses and two systematic reviews were searched for relevant papers. Studies describing the prevalence of HI in female prisoners were included and assessed for risk of bias. Results: Twelve studies were included. Prevalence of HI ranged from 19%-95%. It was lower if using hospital records rather than self-report and generally not different by gender. Risk of bias was high overall, with little consistency in assessment methods and definition of HI. Sample sizes of female prisoners with HI were often modest and not clearly representative of the population. The experiences/needs of prisoners can differ by gender, females having a higher risk of physical and mental health problems, including psychological trauma. Conclusion: HI is prevalent in female prisoners, and their needs and experiences may differ from male prisoners with HI and female prisoners without. Future research should address methodological limitations to allow a firm, evidence base for effective services and interventions for female prisoners with HI to be developed