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What do you know about the link between brain injury and homelessness?

Well I confess I did not know much. Knowing that a change of living situation is a common life change after brain injury it should have been something I had thought more about.

This all began when my friend, my ‘Roving Reporter’, sent me a media briefing about brain injury and homelessness that

a) Shocked me               and

b) Opened my eyes to other research.

What is presented here is not an exhaustive search, it is more a taster to get us thinking. It began with tracking down the research that prompted the article my friend sent. I found four further studies into brain injury and homelessness from four countries.

If you know of more please share them in the Comments below or send me an email HERE.

United Kingdom Brain injury and homelessness

The report that began this quest for me was this report published by the Disabilities Trust Foundation in the UK. The article describes a study into the link between brain injury and homelessness as the first of its kind in the UK. The results were summarised:

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• almost half (48%) of the homeless participants reported a history of traumatic brain injury compared to just 21% in the control group of the homeless participants,
• most (90%) indicated that they had sustained their first traumatic brain injury before they became homeless
• the mean age at first injury was 19.9 years, indicating that for many people their first TBI was sustained at a young age
• over half (60%) of the homeless participants with a history of TBI said that they had experienced more than one traumatic brain injury, compared to 24% of the control group

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You can read more about the study in this article from the DTF HERE.

Canada Brain injury and homelessness

Dr. Jane Topolovec-Vranic, et al, conducted research in an urban men’s shelter in Toronto, Ontario. This study was funded by the St. Michael’s Hospital Head Injury Clinic, the Canadian Institutes of Health (CIHR) Research Traumatic Brain Injury and Violence Research Team (TIR-103946) and the Ontario Neurotrauma Foundation.

The introduction broadly summarises the findings:

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• Almost half of all homeless men who took part in a study by St. Michael’s Hospital had suffered at least one traumatic brain injury in their life and 87 per cent of those injuries occurred before the men lost their homes.
• While assaults were a major cause of those traumatic brain injuries, or TBIs, (60 per cent) many were caused by potentially non-violent mechanisms such as sports and recreation (44 per cent) and motor vehicle collisions and falls (42 per cent).

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Here is a more detailed report about this research  “Traumatic brain injury among men in an urban homeless shelter: observational study of rates and mechanisms of injury“ published in the journal CMAJ Open.

A summary of the report was published on the St Michaels Hospital website

Australia Brain injury and homelessness

Brain Injury Australia has published information and a Fact sheet about the links between homelessness and brain injury.

The key points stated are:

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• People who experience a traumatic brain injury are at risk of homelessness where one or all of the following factors exist – alcohol and drug misuse, a psychiatric disability, social isolation and family breakdown.
• Families of individuals with acquired brain injury experience “an increasing intolerance to their family member’s limitations as time progresses”2. This is particularly so where the injury has experienced behavioural (eg violence, verbal aggression, inappropriate social behaviours, dependency etc), cognitive and personality changes…
• Many families of young adults who have experienced traumatic brain injuries will, within five years of the post-school period, reach ‘breaking’ point particularly where “repeated incidents involving police intervention have occurred. The young person at this point typically finds themselves homeless or potentially homeless with minimal survival skills

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You can access the full fact Sheet“The connection between acquired brain injury and homelessness”  for further information.

USA Brain injury and homelessness

A study reported by the National Health Care for the Homeless Council based in Nashville outlines the prevalence of   “Traumatic Brain Injury Among Homeless Persons”.

Across the World Brain injury and homelessness

As you review the studies above please do not read this to mean it only happens in these three countries.

I would set an unfortunate challenge that these statistics are reflected in many, if not most countries. Please feel free to share any studies or stats you might have available from your own country in the Comments below or by email HERE.

What Can We Do?

Recently the study conducted in Canada was picked up and widely reported across the internet, but what now? It is one thing to know this stuff and be shocked by it, but what about actions?

Imagine if the high percentage of people who are homeless and living with brain injury had the appropriate screening, diagnosis, and the right support to prevent homelessness occurring, or to establish each person in accommodation.

Big ask?

Maybe some simple steps to start with!

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• Be alert to the possibility of brain injury in all situations – no culture, country, situation, socio-economic group, age is exempt from brain injury. Brain injury can happen to anyone.
• The report mentioned above “Traumatic Brain Injury Among Homeless Persons” provides some great starting points for individuals, organisations and governments. Page 10 of the report lists some tips for supporters to manage cognitive difficulties such as finding meeting spaces without noise and distraction to aid concentration.
• A full history is critical to identify potential illnesses or injury that may cause brain injury. Factors that may even have been forgotten. The mother of a young man, who had had three previous traumatic brain injuries, casually reported in conversation “You know he was never the same after his cousin hit him over the head with a piece of wood when he was a little boy”. This had not been reported before and was not 1 of the 3 brain injuries!
• While not specifically about Brain Injury this self assessment for services around being informed and responsive to Trauma provides thinking points for supporters as well as organisations.  “Trauma-Informed Organizational Toolkit for Homeless Services”
• Support and encourage a person who may have an undiagnosed brain injury to have appropriate screening
• Refer (and support) a person to attend appropriate specialists and /or to their Doctor for further investigation
• Advocate for appropriate support to prevent homelessness occurring, or to establish a person in more appropriate accommodation.

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And Finally

If this topic is not so new to you and you have any information that can expand our thinking about brain injury and homelessness please share in the Comments below or email HERE.