Solicitors frequently encounter vulnerable individuals, yet one condition remains significantly under-recognised in many settings, including legal settings: Alcohol Related Brain Injury (ARBI).
With increasing levels of alcohol dependency across the UK and Ireland, the number of individuals living with cognitive impairment caused by long-term alcohol misuse is rising. In Northern Ireland alone it has been estimated that around 30,000 people may be affected by changes in brain function associated with long-term excessive alcohol use.Despite this, ARBI often goes unrecognised or misinterpreted. In legal settings, this has important implications. Clients with ARBI may appear:
- Inconsistent in their accounts
- Forgetful of advice previously given
- Unable to follow legal processes or follow through on instructions
- Behave Impulsively or with poor emotional regulation
- Appear disorganised, poorly motivated, evasive or “difficult”
These behaviours can easily be mistaken for non-cooperation or lack of credibility, when in fact they may reflect underlying neurocognitive impairment.
What is Alcohol Related Brain Injury?
Alcohol Related Brain Injury refers to a spectrum of neurological damage caused by long-term excessive alcohol use.
The condition can affect both the structure and function of the brain and nervous system.
ARBI includes several related conditions, including:
- Alcohol-related dementia
- Korsakoff’s Syndrome (severe memory impairment)
- Wernicke’s Encephalopathy (a neurological emergency)
- Hepatic encephalopathy linked to liver disease
These conditions can have a significant impact on cognition, behaviour, and daily functioning.
For solicitors, understanding ARBI is not simply a medical issue – it can directly affect a client’s capacity, reliability of instruction, and ability to participate in legal or medico-legal proceedings.
Why Awareness Matters in Legal Practice
Clients with ARBI may struggle with:
- Understanding information given to them
- Recalling information between consultations
- Recalling key events in their life along an accurate and detailed timeline
- Organising and communicating their thoughts
- Letting others know when they are not understanding information
- Making reasoned decisions
- Attending and engaging in consultations consistently
- Appreciation of the complexity of the situation they might face
These difficulties can impact capacity to instruct and ability to engage in the legal processes.
Greater awareness of ARBI can help solicitors recognise when a client may require additional support, assessment, or adjustments.
Recognising the signs can be the difference between a client being seen as uncooperative or appropriately supported in a legal or medico-legal setting.
If you have concerns about your client, and believe they would benefit from a neuropsychological assessment, you can reach out with instructions to admin@psychologicalpathways.com or make a referral via our website here
