The intersection between housing and health was clearly amplified by COVID-19. But while we were all sanitizing our groceries and scrounging the internet for specialty masks, researchers in Canada were evaluating another housing and health intersection.
This less-known connection is between Traumatic Brain Injuries (or TBI) and homelessess.
What is a traumatic brain injury (TBI)?
TBI is an injury that affects how the brain functions and is often caused by a bump or blow to the head, or a penetrating injury, such as a gunshot. Falls, firearm-related suicide attempts, and motor vehicle crashes are common ways that a person may receive a TBI.
These injuries can lead to difficulties with memory, concentration, mood, and decision-making, making it even more challenging for someone to secure stable housing. TBI not only increases the risk of becoming homeless, but being homeless also increases your risk of experiencing TBI.
According to recent research, those experiencing homelessness are two-to-four times more likely to have a history of any type of TBI. They are also up to ten times more likely to have had a moderate or severe TBI.
TBI symptoms may contribute to the misperceptions we have about those experiencing homelessness. Effects are not often clearly visible, and may present as mental health concerns or substance use disorders. Some individuals may miss appointments or not follow through with important tasks, which could lead them to be considered non-compliant with program rules or not “motivated.” Disruptive behaviors may prevent people from accessing shelter or other services.
TBI screening for persons experiencing homelessness can be simple. There are several easy-to-use tools that help identify the possibility of a TBI based on questions related to experiences, rather than past diagnoses.
If you know or suspect a history of TBI, you can engage with someone from the start of a relationship and make the right referrals and adaptations. These may be low-tech, like helping someone set up a paper calendar or reminders on their cell phone. You can use verbal or other kinds of prompts and provide just a little bit of information at a time. These steps can certainly help anyone, but they go an especially long way for people living with a traumatic brain injury.
If you would like to learn more about traumatic brain injury, or how to support someone with a traumatic brain injury, there are organizations available to help. Contact the Brain Injury Association of Virginia or the Brain Injury Services Unit at the Virginia Department for Aging and Rehabilitative Services.
Chris Miller is the Director of the Brain Injury Services Coordination Unit at the Virginia Department for Aging and Rehabilitative Services (DARS). DARS’ mission is to improve the employment, quality of life, security, and independence of older Virginians, Virginians with disabilities, and their families. Chris’ first job was as a live-in manager of a residential program helping individuals with serious mental illness transition from state hospitals to community living. She has believed that a secure home is the foundation of all wellness ever since.
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