Brain Injury and Homelessness
In the Globe and Mail (Toronto) of October 8th a story appeared about brain injury being found in 50% of Toronto's homeless population and, of the homeless with a brain injury, 70% experienced their brain injury prior to becoming homeless. The results of the study conducted by Dr. Stephen Hwang and his colleagues was published in a recent edition of the Canadian Medical Association Journal. Our own long term outcome studies at NRI at Brookhaven and NRIO in Toronto indicate the increased likelihood for mental health and substance abuse problems, particularly in the critical period of the return to home and community. We also saw a high correlation of individuals with behavior, mental health and substance abuse problems to relationship failure and ongoing problems with peers, family and friends, often resulting in legal, employment and housing problems. The period of risk is extensive and not one which can be thought of in terms of weeks or months. In some problems, like suicide, the risk period can extend for fifteen years.
As Dr. Hwang's study points out, people with brain injuries are more vulnerable. Dr. Anita Palepu from the University of British Columbia supported Dr. Hwang's observations with her own concerns for the risks faced by people living with a brain injury and the need for healthcare providers to identify the risk factors created by brain injury and to address these needs through effective treatment options.
Brain injury creates a lifetime of disability and the services need to be designed to effectively reach the person in the areas of their life where they are experiencing problems. I am always deeply troubled by the story of a client who is discharged from a program due to non-compliance when we know that compliance is a problem stemming from their injury.We need to think about realistic solutions "outside of the traditional box" to keep people with brain injury from experiencing problems which can be easily addressed.
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