Mark Holloway is a Brain Injury Case Manager, based at Head First, Hawkhurst, UK.
AbstractPurpose -The purpose of this paper is to examine the research into prevalence of acquired brain injury in non-ABI specialist services, the impact of the invisible aspects of executive impairment and loss of insight upon functioning and to question how this is assessed and managed by generalist services. Design/methodology/approach -A literature search was undertaken to identify where people with an ABI may come in to contact with services that are not specifically designed to meet their needs. Findings -ABI is prevalent amongst users of a variety of community, inpatient and criminal justice services. The common albeit invisible consequences of ABI complicate assessment, service use and or treatment particularly in the context of a lack of under pinning knowledge and experience amongst the staff in non-specialist ABI services. As a consequence risks to children and adults are increased, opportunities for rehabilitation and growth are lost and human potential squandered. Addressing the first stage in this process, developing knowledge of the consequences of ABI and how to assess need, is a pre-requisite for change. Practical implications -An absence of basic underlying knowledge of the consequences of ABI impacts upon assessment and so limits the effectiveness of services. A consequence of this is manifest in the over-representation of people with an ABI to be found in non-specialist settings. Originality/value -Little research is undertaken from a social and community perspective into the impact of ABI over the longer term for those who have no contact with specialist services and yet, quite clearly by their use of other services, have unidentified, unrecognised and un-responded to needs. Keywords Acquired brain injury, Assessment of need, Executive impairment, Loss of insight, Social work, Non-ABI specialist services Paper type Viewpoint As those working in the field of social care our assessments and the knowledge that underpins and informs those assessments are key to our roles. My professional practice as a social work qualified brain injury case manager leads me to question how we develop that knowledge when it sits outside of what we (or our employers) may expect? If our knowledge excludes factors that have a major impact upon what we are assessing can we Safeguard children for example?In this paper I outline the prevalence and impact of acquired brain injury and the likelihood that such injuries are a daily feature of social work and social care practice, whatever our chosen field of endeavour. I argue that the impact of acquired brain injury is a fact of our professional lives, one which many individuals and services seem structurally ill-equipped to deal with, starting with a very basic absence of knowledge of the impact of acquired brain injury.