Traumatic brain injury is so common among the homeless that prevention should be prioritized for people facing multiple challenges and worse outcomes compared to “affluent populations,” says lead author of Vancouver study that monitored symptoms of participants every month for a year.
Tiffany O’Connor said brain injury rates are endemic among the homeless and in poor housing, so health professionals and service providers need standardized training to spot symptoms of even minor injuries involving people. who often struggle with challenges like mental illness and cognitive decline.
“Substance use is pretty pervasive. Nearly everyone in this population that we studied reported some form of alcohol or drug use. Serious mental illnesses were very common, neurological illnesses were very common,” said O’Connor, a recent Ph.D. graduate in the psychology department at Simon Fraser University.
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The study, published this week in the journal EClinicalMedicine-Lancet, included 326 participants recruited from Vancouver’s low-income Downtown Eastside, a community court, and the emergency department of a nearby hospital.
Researchers who were also from the University of British Columbia found that 31 percent of those they interviewed between December 2016 and May 2018 reported at least one traumatic brain injury during that time.
Nearly 10 percent of brain injuries were related to substance use among people who may have fallen and hit their heads or been assaulted later, O’Connor said.
More than half of the participants reported a history of brain injury, creating greater challenges, even for those with a physical disability and a lack of resources to adequately recover, he said.
Falls accounted for 45 percent of brain injuries, mostly among homeless women, followed by assaults at 25 percent, especially for men.
“Now we know that this is essentially the population with the highest known incidence of traumatic brain injury, even more so when we consider populations of athletes and other known populations like veterans,” said O’Connor, now a clinical neuropsychologist in the injury program. brain cells acquired at Hamilton Health Sciences.
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The study was more rigorous than others that evaluated the rate of traumatic brain injuries among homeless people because participants were given information about symptoms and met with researchers regularly, which resulted in better estimates, he said.
“With methodological improvements in the rate of traumatic brain injuries, what we found in this study was a rate more than 10 percent higher than what has been found in this population,” O’Connor said of other comparable studies. in Canada.
For example, a University of BC-led study of homeless people in Vancouver, Toronto, and Ottawa found that between 17 and 19 percent of participants reported having suffered a brain injury. But research published in 2017 included follow-ups every 12 months for nearly 1,000 participants in each of the three years of research.
O’Connor said the latest study’s findings have prompted researchers to get information about homeless people’s brain injuries to access health care and to health care providers who should lower the threshold for testing them.
Other issues these people have often become the focus of when they interact with the health care system or service providers, without the potential underlying link to brain injury being recognized and addressed, he added.
More research is needed on concussions and brain injuries among the homeless, compared to “affluent populations” such as athletes, O’Connor said.
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“For sports-related concussions, policies have been developed across the country. That is what needs to happen at this level for people in poor housing,” he said.
“With this knowledge, it’s really about us reaching out to other researchers, reaching out to policymakers to try to do something where we can have a big change across the country.”
Geoff Sing, president of the British Columbia Brain Injury Association, said the organization has reached out to the province’s Ministry of Mental Health and Addictions to provide early interventions such as housing and training for agencies that serve them.
“These impediments lead to poor decisions, leading, for example, to not paying rent and being evicted and forced to become homeless and vulnerable,” Sing said.
The ministry said it recently provided a total of 103 housing spaces in Vancouver, Surrey and Abbotsford for people with complex health and mental health issues, some as a result of brain injury.
However, Sing said that leaves people in most of the province, including Vancouver Island, where he lives, in dire need of housing.
“In the last year, they lost eight to 10 beds in Nanaimo and they haven’t been able to replace them. So we would like the ministry to support brain injury by providing more housing options because people are missing out. They are becoming the homeless population.”
Melissa Vigar, executive director of the Brain Injury Society of Toronto, said a homeless prevention coordinator provides training to shelter employees on recognizing signs of brain injury.
“Our funding is only for one person and his plate is very full. But we have started to train City of Toronto staff more,” she said, adding that homeless people with a brain injury should be accommodated just like anyone else with a disability.
“It is an invisible injury. You can see that they are lazy, they don’t care, they don’t make an effort”.
© 2022 The Canadian Press
Reference-globalnews.ca