Homelessness and Traumatic Brain Injury

I remember hearing a statistic not too long ago about the prevalence of brain injury among the homeless. Today I looked it up and came across a few studies. Over half of all homeless people may have experienced a traumatic brain injury, according to a study highlighted in this Guardian article. Additionally:

A large study compiling research results from six high-income countries – Australia, Canada, Japan, South Korea, the UK and the US – found that 53% of homeless people had suffered a traumatic brain injury (TBI). This, estimate the authors, could be 2.3 to four times the rate for the population as a whole.

The study referenced in the Guardian article can be found here(2019).

Another study published in 2014 finds similar results from a sample of men from a Toronto homeless shelter. This study found that almost half of the men sampled had a traumatic brain injury, and perhaps more importantly:

“87 per cent of those injuries occurred before the men lost their homes.”

The university of Colorado Medical school compiled a bunch of research from the past few decades on this topic as well, include the research mentioned above:

The far right column notes the percentage of that sample group which had a TBI in the past. Finally, in the same presentation:

The majority of study participants experienced a TBI before they became homeless.

This data is particularly troubling because it suggests that for around half of homeless people, the problems they faced which led to their homelessness may have been caused by a brain injury. My opinion generally is that how we treat the least well off reflects on us all. That isn’t to say however that I don’t reflexively judge those people I see on the street drinking out of paper bags and asking for money. The research suggests that it is because of TBI that patients turn to drugs and alcohol and a means of coping. By establishing that most TBI’s in homeless people occur before homeless episodes, we have illuminated the fact that we have failed to provide mental health care to the most vulnerable.

What I reflect the most on is that there are thousands of decent, upstanding people who fell, or got into a car accident, and then watched as their lives unravelled because they couldn’t focus on anything or couldn’t leave the house due to anxiety or headaches. These people are no different than paraplegics who we have rightly accommodated within the community because we realize they have every right to participate in society as anyone else.

The question is: why are we not able to connect disability insurance with those sufferers of TBI? Is it a lack of resources? Are representatives wary of taking this upon as a mission, for fear of how their constituents would feel? Would more research establishing a causal relationship between TBI and homelessness make the public more comfortable in investing in solutions? If research proves that the homeless with TBI are no different than those with autism or cerebral palsy, and we have left them to wander the streets, how will we defend this to future generations? Will those looking back on us from the future glare at us, knowing that we knew, and chose to do nothing?

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