Traumatic Brain Injury (TBI) is the result of damage to the brain caused by an event such as blunt force trauma to the head, a traumatic fall, sport related injuries, and motor vehicle accidents. The prevalence of traumatic and acquired brain injuries among society’s most vulnerable is overlooked.
Individuals involved in the justice system, those who struggle with substance use, and people living in poverty are disproportionately likely to have TBIs. Evidence shows that over half of people experiencing homelessness are living with acquired or traumatic brain injury—injuries that often occurred before they became homeless. Once secure housing is lost, re-injury becomes an all-too-common occurrence: a study in Vancouver revealed that up to 31% of the cohort studied has sustained a new TBI within a year of becoming homeless.
When these individuals try to access shelters and supportive housing, services that should support them, they are often turned away because the complex symptoms of TBIs are feared and misunderstood. When shelters, detox programs, and treatment centres are inaccessible or ill-equipped to meet the needs of people with TBIs, they are continually pushed back into environments that exacerbate their trauma and place them at further risk of re-injury. Without meaningful supports that recognize the cognitive and emotional realities of life after brain injury, individuals are left to navigate systems that were never designed for them. Shelters and supportive housing services often house people who use substances, meaning that when individuals with TBIs do access these services, they are exposed to substance use. The complex physical, mental and emotional symptoms make people with TBIs more susceptible to begin or continue using substances, further trapping them in the cycle of street-entrenchment.
To truly disrupt the cycle of harm, it must be acknowledged that brain injury is both a cause and a consequence of homelessness. This means creating pathways that are brain injury informed and ensuring that detox, treatment, and supportive housing are accessible and responsive to cognitive needs.
Strengthening brain injury informed, trauma aware pathways to stabilization, treatment, and long-term recovery by investing in upstream brain and trauma supports gives people a real chance to interrupt the cycle of reinjury, substance use, and street entrenchment. Individuals with TBIs deserve a safe environment where healing can begin.
Contributed by Amanda McFarlane, executive director at BrainTrust Canada