Vinny Zecchino was hit by a car and knocked unconscious while walking to school at age 7. When he was about 12, his uncle whacked him in the head with a baseball bat.
So Zecchino wasn’t surprised when a neuropsychological screen at a Denver drug court, where he landed because of his heroin addiction, determined he has traumatic brain injury.
Through a project that began five years ago, researchers have screened 4,100 people in jail, on probation or assigned to drug courts in Denver and five other counties to find out how many have traumatic brain injury — an impairment that could impact the likelihood of their return to the criminal justice system. The results were stark: 54 percent had a history of serious brain injury, compared with 8 percent of the general population.
“This is a picture of the most vulnerable segment of our entire community population,” said Dr. Kim Gorgens, a clinical professor of psychology at the University of Denver, which runs the project along with the traumatic brain injury division at Colorado Department of Human Services. “This is not a group of serial murderers or notable psychopaths. This is the standard, average, typical probationer or jail inmate.”
Finding out they have traumatic brain injury changes inmates’ perspectives. “It’s a new narrative — so much more empowering than thinking, ‘I’m a loser. I’m a failure.’ That’s been so stunning,” Gorgens said.
Discovering that the impairment affects their “auditory memory” and they should write everything down in a notebook or that they are prone to impulsiveness and should take multiple steps before making decisions can change the trajectory of their lives, Gorgens said.
The initial screen used by researchers is a list of questions about previous head injuries, concussions, car accidents, assaults or partner abuse that involved blows to the head. Researchers aren’t counting people who’ve had their “bell rung” playing sports or were concussed after a fall. They’re concerned with the more serious injuries — those who’ve been knocked unconscious for 30 minutes or more or been in a coma; people who lost consciousness before age 15; and those who have sustained multiple blows to the head, perhaps because of domestic violence.
Those with a history of brain injury detected on the initial questionnaire were offered a more scientific, neuropsychology screen that tests memory and reaction time. Among the 1,200 who took that test, nearly all were found to have the impairment.
About 100 people with the most serious impairments have been linked with a case manager from the Brain Injury Alliance of Colorado and invited to attend the organization’s classes and workshops. DU doctoral students in psychology who conduct the screens give written recommendations for support to the person’s probation officer, the drug court or the jail.
A probation officer, for example, could set weekly appointments for the same day and time to help a probationer remember to come. And instead of giving a list of expectations for a year, the officer could break it down in weekly increments. Jail staffers could incorporate rest breaks during a therapy session, and people with a brain injury could speak first during group therapy, before they forget what they were about to say.
DU graduate students in 2013 began screening inmates in the Denver Jail’s high-risk unit, a section of the jail for people considered a risk to themselves or others. They found that 96 percent had traumatic brain injury. Those results led to a federal grant to fund the research, $1 million over four years. Ten states have federal funding for the project and Colorado is leading the research.
Symptoms of traumatic brain injury include poor judgment, impulsiveness, lack of inhibitions, short temper and inability to solve problems. Although a New Zealand study found that young people who had brain injury were more likely to commit crimes later in life, Colorado researchers said there isn’t enough research to definitively establish a link.
“We’re careful not to say that brain injury is the cause for the behavior,” said Judy Dettmer, head of Mindsource Brain Injury Network at the state human services department. She noted that the majority of people who screened positive for traumatic brain injury also had mental health issues or substance abuse disorders or were victims of childhood abuse. “Trying to sort this out is really challenging.”
In other words, it’s hard to discern whether someone has a higher propensity for crime because they grew up in an abusive home or because they were knocked unconscious as a child. People with substance abuse issues are at higher risk for head injury, but it’s also true that people with brain injury are more likely to use drugs.
For Zecchino, though, the question of whether his brain injury led him to jail is easy. “One hundred percent,” he said. Since he was a kid, Zecchino said, he would “do dumb things” and “act on impulse,” getting in trouble at school often.
His impairment also led to depression, he said, and he used street drugs to cope. People lose patience with him because of his memory problems, faltering sense of direction and inability to plan ahead, he said. Zecchino, 29, has lost multiple jobs because of his impairment, most recently at a kids gym because he couldn’t remember the order of activities and songs.
Zecchino, the top layer of his thick, dark hair pulled into a ponytail and his guitar propped nearby, was at the downtown Denver Public Library last week to meet his case manager. They’ve been meeting since 2016, when Zecchino began probation, working on how to navigate his life.
Joni Lee, a former teacher who is now a certified brain injury specialist, has coached him to set alarms and reminders on his smartphone, turn down the volume on his earbuds so he is more aware of his surroundings, and use maps to navigate public transportation.
“The most important thing is to be present with people, to spend time and figure out what their needs might be,” said Lee, a case manager for dozens of clients with brain injury. After two years of meetings, the goal is to leave a “little voice in their head that they can take with them.”
The life coaching has helped him stay clean for nine months, said Zecchino, who is working as a furniture mover and has gotten his music on Spotify under the name Vinny Zeek. “It’s changed my life,” he said. “Anyone can still do anything, you just have to work a lot harder at it.”
