Brains at Risk Program at RHCI Prevents Driving-Related Brain Injury

Featured in InsideRHCI, summer 2008

RHCI neuro case manager Jennifer Stickney, R.N., C.C.M., stands in front of a rag-tag group slouched in rows of chairs in the RHCI cafeteria. Their ages run from 17 to late 40s. Most wear T-shirts and baggy jeans. The younger ones wear hip hop baseball caps. All are male.  And they’re not there voluntarily.

“I want your full attention tonight," Jenny tells the group.  "No attitude, no putting your head down on your desk. I don’t want to have to stop because of somebody’s behavior.”

So begins another session of Brains at Risk, a court-ordered referral program which targets high-risk drivers and links their dangerous driving behavior to the effects of traumatic brain injury (TBI).  The Brain Injury Association of Massachusetts (BIA-MA) developed the program 15 years ago to try to reduce the number of impaired, reckless or distracted drivers on the roads.

Brains at Risk operates in more than 100 cities and towns across the Commonwealth. In  summer 2007, RHCI became BIA-MA's Cape partner to offer the program.  Jenny leads each session.         

Traumatic brain injuries are a huge problem in Massachusetts: 44,000 occur each year. Across the country, someone suffers a brain injury every 23 seconds. Not surprisingly, automobile accidents are one of the leading causes of TBIs – it is the leading cause among 21- to 35-year-olds. Alcohol and drug abuse are responsible for more than 50 percent of all brain injuries.

Jenny leads the tightly scripted two-hour session, using personal stories and a PowerPoint presentation peppered with statistics and graphic video clips. But what sets this program apart are the guest speakers.  Two people address the group on this night.

A 38-year-old woman from North Attleboro describes how a car plowed into the bicycle she and a friend were riding in 1981. “In that one instant, my life changed forever,” she says.  She was 11 years old.  She apologizes for having to read her remarks. “I have trouble finding the right words to say,” she explains. “I have short-term memory loss, and it takes me a few minutes to understand what I hear.” 

The other speaker is a young man from the Cape who requests that his name not be used.   He was involved in a near-fatal accident which left his best friend severely injured. 

“I get it. I used to be sitting where you are," he tells the men.  Then he describes a wild night of drinking the night before the accident. He tells them about sleeping in the next day, going for a late lunch a little hung over. The next instant, he’s in an accident with his best friend. 

“I remember cradling his head in my arms,” he says. “There was blood everywhere, a lot of blood. And something was oozing out of his head. It was his brain matter.

“It can happen to you,” he continues.  At the end, complete silence.  His message sinks in.

Emily Ring, court-related Programs Manager for BIA-MA, says Brains at Risk is making a difference on the Cape since it was introduced in June 2007. About 100 people have come through the RHCI program since last summer.  Statewide, the program educated 2000 offenders last year.

“Partnering with the Brains at Risk Program is an excellent way to foster the health of our community and help reduce the tragedy caused by preventable brain injury,” says David M. Lowell, M.D., RHCI medical director and head of the hospital’s Brain Injury Program. 

Does the program work? Yes, Emily says, citing statistics:

• 99.1 percent of attendees were either very satisfied or satisfied with the program.
• 98.5 percent said the program was successful in encouraging seat belt use.
• 97.4 percent said the program was successful in encouraging sober driving.
• 93. 6 percent said the program was successful in encouraging driving at posted speeds.

Jenny sums it up: “These terrible injuries are happening to real people right here.  Sometimes I get a really tough crowd, but they need to hear this.  This is a matter of life and death. I don’t hold back any punches.”

Leading causes of traumatic brain injuries

• Auto accidents (the major cause among 21 to 35-year-olds).
• Accidental falls.
• Sports concussions
• Violence (including Shaken Baby Syndrome).

        High risk behaviors

• Driving under the influence of drugs or alcohol.
• Operating a vehicle to endanger others.
• Aggressive driving.
• Speeding.
• Road rage.
• Not wearing a seat belt or proper car seat
• Not wearing a helmet

Fast facts about Brains at Risk

• Demographics: 70.5 percent male, 29.5 percent female.
• 86 percent of attendees referred after first offense.
• Driving under the influence is the most common offense.
• The program is available throughout Massachusetts, serving more than 100 cities and towns.
• Judges may require the program as a condition of probation or as an alternative to formal sentencing.

More information: 

RHCI's inpatient Brain Injury Rehabilitation Program  

Brain Injury Association of Massachusetts