Characteristics of Traumatic Brain Injuries Sustained Among Veterans Seeking Homeless Services

Abstract

This hypothesis-generating research describes the characteristics of traumatic brain injuries (TBIs) sustained among 229 Veterans seeking homeless services. Nearly all participants (83%) had sustained at least one TBI prior to their first episode of homelessness. Among participants with a TBI, assaults, transportation-related accidents, and falls were the most common causes of these injuries. Thirty percent of individuals sustained injuries with severity levels that would be expected to be associated with ongoing TBI-related deficits. Forty-three percent of the Veterans sustained at least one brain injury following their first episode of homelessness. Median lifetime number of TBIs was three. The severity of TBIs was similar among Veterans who sustained injuries before or after their first incident of homelessness. Findings suggest that future research should directly examine the potential bi-directional relationship between TBI and homelessness, as well as the impact of TBI-related deficits on Veterans' ability to benefit from homeless services and/or maintain stable housing.

Cognitive impairment and homelessness: A scoping review

“…This narrower definition of head injury, however, still gave a prevalence rate 5.4 times higher than the general population it was compared to. The highest rates of around 90% were found in the sample of veterans examined by Barnes et al () and Brenner et al () and may be partially accounted for by increased risk of TBI associated with serving in the armed forces.…”

“…Empirical studies mostly ( n = 29) recruited from homeless populations, with definitions of homelessness ranging from absolute homelessness to recently rehoused, or in unsecure or unsuitable accommodation. Additional sample criterion included veteran status (Barnes et al, ; Brenner et al, ) and older age (Brown et al, ; Brown, Kiely, Bharel, & Mitchell, ; Hurstak et al, ; Joyce & Limbos, ; Okamura et al, ). Of studies which did not sample from homeless populations, two recruited from prisons (Hennessey, Stein, Rosengard, Rose, & Clarke, ; McCarthy et al, ), and other sampling frames included professionals who worked with the homeless (Colman, Hebblethwaite, Hames, Forsyth, & Donkin, ), mental health service clients (Keyser & Mathiesen, ), and records of hospital admissions (McMillan et al, ).…”

“…Some papers reported on the same project or sample. These papers are at times reported on independently due to differences in sample type (Colman et al, ; Hebblethwaite, Colman, Hames, Forsyth, & Donkin, ) and measures or methodology employed (Barnes et al, ; Brenner et al, ; Brown et al, ; Hurstak et al, ; Pluck et al, ; Van Straaten et al, ).…”

“…Few studies investigated how head injury occurred; those which found assault to be the most common cause (Barnes et al, ; Gargaro, Gerber, & Nir, ; Topolovec‐Vranic et al, ). Cause of injury which was further examined by Topolovec‐Vranic et al () who found TBI in participants below 40 was mostly caused by substance misuse leading to a fall and those 40 and over by assault.…”

“…Cause of injury which was further examined by Topolovec‐Vranic et al () who found TBI in participants below 40 was mostly caused by substance misuse leading to a fall and those 40 and over by assault. TBI studies found the majority (70%–90%) of TBIs occurred prior to the onset of homelessness (Barnes et al, ; Hwang et al, ; Oddy, Moir, Fortescue, & Chadwick, ; Topolovec‐Vranic et al, ), though it was acknowledged that once homeless risk of TBI increased. Nikoo et al () found that over 3 years, 37% of their homeless cohort suffered a further TBI.…”