Half of homeless people have experienced traumatic brain injury: study

Health

Studies of former boxers and football players show they can have problems regulating their mood, depression, irritability, and problems with thinking and planning due to damage to the frontal cortex, he said.

Dr. Gary Bloch, who has worked with homeless and marginalized populations for 17 years as a family doctor with Toronto’s St. Michael’s Hospital and Inner City Health Associates, said the numbers are “shocking” but not that surprising.

His patients are often experiencing many mental and physical health challenges at once, he said, so teasing them out can be tricky. When he sits down with a patient to try to get a detailed medical history, “There’s often a piece that seems to be missing.”

When he digs deeper, he often finds a history of head injuries.

“Having a history of traumatic brain injury becomes interwoven with just about every other health issue that a person is dealing with,” he said.

“So I think knowing that someone has experienced traumatic brain injury raises my index of suspicion for other health issues, physical health issues and mental health issues.”

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Traumatic brain injuries happen both before and after a person becomes homeless, according to the study. They can contribute to the likelihood that someone becomes homeless, Stubbs said, and make it harder to get out.

“TBI is obviously an important factor in the health and functioning of this population, but it actually might be a component that represents a barrier to exiting homelessness or unstable housing, given that homelessness and unstable housing itself is a risk factor for sustaining more TBIs.”

Michelle McDonald, executive director of Brain Injury Canada, agrees that these injuries could contribute to a higher risk of becoming homeless.

“Many, many people with TBI or brain injury in general live below the poverty line,” she said.

“There’s many factors that lead to homelessness, but brain injury can be the root cause of some of those factors, such as unemployment, substance abuse, family breakdown.”

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These injuries can often be treated, Churchill said, though the exact treatments will vary considerably depending on the nature of the brain injury.

But the care needs to be available. Even just having a place to rest and recover, and getting some immediate medical attention after the injury is “critical,” he said.

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This is obviously a problem for many people who are experiencing homelessness. It’s “near impossible” for his patients to get proper treatment and rehabilitation for TBI, Bloch said.

“It is a source of constant frustration to me on the front lines, that I do not have access to the resources to either identify or address the needs of people who have experienced these types of injuries.”

He argues for a holistic approach to address both the health and social issues that people encounter while homeless, including a heightened risk of traumatic brain injury.