For incarcerated people with disabilities, making space in health equity
Neurocognitive disorders affect a person’s ability to process speed and attention, memory, executive function, and verbal recall. Other factors, like cultural understanding, also play an important role when helping individuals navigate the legal system.
Many of the individuals seen by Diomaris Safi, Psy.D., a clinical neuropsychologist and founder and director of the Social Justice in Criminal Neuropsychology (SJCN) program at UCLA, lack school records, birth certificates, or medical records, making it difficult to verify whether there are histories of disabilities that would affect their legal proceedings.
“I’ve had clients that speak Indigenous languages and don’t understand English or Spanish, or are illiterate, which makes it challenging for them to aid in their defense,” Dr. Safi says.
Housed in the Hispanic Neuropsychiatric Center of Excellence at UCLA, the SJCN program aims to educate justice partners and future neuropsychologists working with incarcerated people with neurocognitive disorders and from underrepresented populations, including monolingual Spanish-speaking Hispanic/Latinos.
While two to three percent of the general population have an Intellectual or Developmental Disability (IDD), a report from the U.S. Department of Justice states that 38% of people in state and federal prison have at least one disability, with 23% reporting a cognitive disability.
Neurocognitive disabilities can make it hard for individuals to understand their situation, communicate their needs, goals and impulses and learn from traditional punishment and rehabilitation models.
“When disabilities go unidentified, it can lead to more behavioral problems in prison, and people may miss out on the services they are entitled to under federal law,” Dr. Safi says.
A section of the Americans with Disabilities Act (ADA) states that criminal justice entities are required to ensure people with disabilities are treated equally and have the opportunity to benefit from safe, inclusive environments.
Improving life outcomes
Individuals with multiple marginalized identities – ability status, immigration status, language, sexual orientation, gender, etc. – are disproportionately represented in the justice system.
One of Dr. Safi’s aims is to equip justice partners, such as local public defenders, district attorneys, probation departments, and state correctional facilities, with “cultural know-how.”
The SJCN program, which doubles as a two-year fellowship, trains fellows to provide linguistically inclusive and culturally sensitive triage and consultation services, psychodiagnostic assessments, neuropsychological evaluations and targeted treatment recommendations. The goal, Dr. Safi says, is to improve time to diagnosis, to shorten incarceration time, and to identify appropriate diversion and treatment options.
For example, Dr. Safi recently partnered with Noah Cox, an attorney with the Los Angeles County Public Defender’s Office.
"We're seeking to improve my office’s methods of identifying clients who have these disorders and incorporate them into our representation," Cox says. "We can then refer clients for more appropriate treatment and support so they can receive improved legal and life outcomes.”
This includes reducing the risk of recidivism, or reoffence. People incarcerated with a designated developmental disability were more likely to reoffend at a higher rate (up to 64%) than those without a developmental disability designation (up to 42%), according to an Outcome Evaluation Report from the California Department of Corrections and Rehabilitation (CDCR).
While recidivism negatively impacts the lives of people that are incarcerated and their families, it is also a financial burden on taxpayers. According to a report from Cal Matters, the cost of incarceration is upwards of $100,000 per inmate, per year. In contrast, reentry programs cost approximately half that amount.
“We want to improve outcomes for these individuals and reduce taxpayer dollars spent on treating recidivism when we fail to get things right the first time,” Dr. Safi says.
For more information, and to find out how you can help, go to Semel Institute for Neuroscience and Human Behavior | (ucla.edu)