Findings show that early screening may help prevent homelessness

Toronto (Oct. 6, 2008) - A study published today in the Canadian Medical Association Journal (CMAJ) shows more than half (53 per cent) of homeless people in Toronto have experienced a traumatic brain injury and in 70 per cent of these individuals, the injury occurred before the person's first experience of homelessness.

The article, "The Effect of Prior Traumatic Brain Injury on the Health of Homeless Persons", by authors Dr. Stephen Hwang, St. Michael's Hospital, and Dr. Angela Colantonio, Toronto Rehabilitation Institute (Toronto Rehab), shows that homeless people with a history of brain injury are more likely to suffer from poorer mental and physical health than homeless people who have not experienced a brain injury.

"While not everyone who has had a traumatic brain injury will go on to experience homelessness, this study shows that a disproportionately large number of homeless people have suffered from trauma to the brain," says Hwang. "We should be asking our homeless patients about their history of brain injuries and ensure that those with head injuries get the care and support they need to attain stable housing."

Colantonio adds, "The findings of this study are especially important when you consider the conditions in which many homeless people live. Early screening has the potential to lead to the development of supportive housing that takes into consideration the various challenges people living with brain injuries encounter on a daily basis. This includes difficulty remembering scheduled appointments to problems using ordinary household items. Consider also that many of these people may qualify for disability payments, instead of welfare."

The Ontario Alliance for Action on Brain Injury estimates that close to half a million Ontarians currently live with an acquired brain injury - this number is greater than the prevalence of breast cancer, HIV/AIDS and spinal cord injury combined.

Toronto has approximately 5,000 individuals who are homeless each night and about 29,000 individuals who use shelters each year. Nine hundred and four people from the homeless community chose to participate in the CMAJ study. Of these 904, 58 per cent of the men and 42 per cent of the women were found to have had a brain trauma.

Traumatic brain injury most commonly results from falls, motor vehicle-traffic crashes and assaults, and is the leading cause of permanent disability in North America. It can contribute to cognitive impairment, attention deficits, impulsivity and emotional instability.

Hwang says, "This study is the first to show that the roots of homelessness may sometimes lie in a serious head injury that occurred in the person's past. We need to explore the possibility that providing better rehabilitation and services for vulnerable people with head trauma may help prevent them from becoming homeless in the future."

St. Michael's Hospital is a large and vibrant, teaching and research hospital in the heart of Toronto. Fully affiliated with the University of Toronto, St. Michael's Hospital leads with innovation, and serves with compassion. Renowned for providing exceptional patient care, St. Michael's Hospital is a regional trauma centre and downtown Toronto's designated adult trauma centre.

Toronto Rehab celebrates its 10th Anniversary in 2008. Canada's largest teaching and research hospital specializing in adult rehabilitation, complex continuing care and long-term care, Toronto Rehab has a legacy of excellence that extends beyond a decade and is rooted in more than 350 years of collective service by its founding hospitals. Each year, Toronto Rehab's patient care, research and education programs make a difference in the lives of more than 15,000 people living with disabling injury, illness and conditions associated with aging.

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