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14 Jun 2012
Barrie Oldham, chief executive of VODG member The Disabilities Trust

Brain injury: the silent epidemic among the homeless

With over 20 years experience in brain injury, through our Brain Injury Rehabilitation Trust (BIRT), we know that the condition is something of a silent epidemic. However the effects of this disability – which can bring major cognitive, communication and memory problems - aren’t always apparent to social care or housing professionals, or indeed the person with a brain injury themselves, who may lack insight into or awareness of their condition.  Such injuries can shatter people’s lives and lead, for example, to family breakdown.

Barrie OldhamThis experience, combined with our wider disability expertise, led us to create The Disabilities Trust Foundation. Our focus is on developing new ways of supporting people affected by disabilities whose needs are not being met by existing services. Current Foundation work is concentrated on the possible links between brain injury and social exclusion, including homelessness and offending.

Sabah Ahmed is our specialist brain injury linkworker at St George’s Crypt, a Leeds homeless hostel. She supports people who are homeless or at risk of becoming so, and have a history of possible brain injury.

Take Richard, 24, who told Sabah that his life was “a mess”. Diagnosed with epilepsy at 16, his seizures resulted in falls where he would often hit his head.

Richard had moved back to his native Leeds from Leicester to get back in touch with family and friends but soon found himself homeless. “My friends and family had turned their back on me and I didn’t know who to turn to for help.”

However, with Sabah’s support, Richard slowly began to get his life in order.  She helped set up an appointment with an epilepsy consultant and Richard was able to have his medication reviewed, to help stabilise his condition and reduce the number of falls he had. The linkworker also helped him make the crucial step from the homeless hostel to shared accommodation and finally to his own flat.  Richard was therefore able to gain independence and begin to rebuild his life.

He says now: “I’m in a much better situation than when I came to the hostel.  I live independently and in the near future I’d like to get a part-time job so I can redecorate my flat and meet new people.” Richard has been lucky enough to receive specialist care and support for his brain injury, but an estimated 100,000 people in the UK live with long term disabilities as the result of conditions like his.

Richard received support from The Disabilities Trust for his brain injury; others are not so lucky.

As part of our work supporting vulnerable people like Richard, we also carried out our own research on brain injury and homelessness – the first study in the UK to consider the possible link between the two.

The research, recently featured on the VODG website, revealed that brain injury could affect almost half of homeless people and may in fact contribute to someone becoming homeless.

The study asked 75 homeless men and 25 homeless women in Leeds if they had experienced a traumatic brain injury. The data was then compared to results from a group of people from Leeds who were not homeless.
The findings showed that:

  • 48% of homeless people interviewed said they had experienced a traumatic brain injury - over twice the number in the non-homeless group (21%).

Of the 48%:

  • 90% reported their first injury had been sustained prior to becoming homeless
  • over half said they had sustained more than one brain injury - over twice as many as in the control sample (24%)
  • the average age when they said they had experienced their first brain injury was 19

So what next?

Our new one-stop clinic in Leeds aims to break the cycle of homelessness by ensuring a brain injury diagnosis, where appropriate, and by creating a formal care pathway for each individual to ensure they are receiving the right support from the right services. We have also launched a free helpline (0800 690 6069) for homeless people in the Leeds area with a brain injury. Donated by Core Telecom, it puts people in direct touch with our specialist support worker.

More widely, we want to work with new partners and expand this work to other cities, and through the development of tailored training, ensure that health, social care and housing professionals are aware of how someone’s needs may differ if they have a brain injury. For example, they may require extra prompts and support for attending appointments.

We also plan further research and are currently conducting a study into brain injury and homelessness in Glasgow. Additionally, a Foundation research project to establish the prevalence of brain injury in offenders is underway at HMP Leeds, using our innovative Brain Injury Screening Questionnaire (BISQ).  We hope these results will be available later this year.

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