The invisible causes of homelessness

Traffic accidents and falls can mean complexities of daily life are too much to handle

You know all those times you dash across the street when you really ought to wait for the traffic to clear? Or the times you pull out from a side road when you ought to wait for that car that has just appeared to get past even if it’s really annoying that it appeared in the first place? And afterwards you tell yourself, I really ought to have waited and then you forget all about it?

The danger of this kind of behaviour was underlined for me recently when I learned of connections between traumatic brain injury, homelessness and road traffic accidents.

In the United Kingdom, about 50 per cent of homeless people have suffered a traumatic brain injury and the vast majority of these injuries occurred before they became homeless, according to a recent report in The Psychologist.

Those with brain injury can too easily be seen only as people with challenging behaviours

A brain injury can leave you facing emotional difficulties and less able to negotiate the health and social services system including keeping appointments, speaker and researcher Steph Grant told a conference hosted by the University of Liverpool.

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Those with brain injury can too easily be seen only as people with challenging behaviours or with drink or drug problems. As with epilepsy (which homeless people are also more likely to have) a brain injury is invisible.

Different problems

It can lead, according to Dr Stephen Mullin, a clinical neuropsychologist in the Leigh Infirmary neurorehabilitation unit to “a wide spectrum of different problems with language, perception vision, attention, concentration, memory and difficulties with executive and emotional functioning”.

Put all that together and you can see that if the injury is particularly serious (though invisible) it could handicap a person terribly in dealing with a world which cannot see the injury.

Of course, many people function well with minor brain injuries but none of us can say whether we would be in the lucky or unlucky group if it happened to us.

A road traffic accident or a fall could leave you living on the street

If you think all this has nothing to do with you, think again. In the United States, motor vehicle crashes are the leading cause of hospitalisation with traumatic brain injury for people aged 15-44. For people over and under these ages, the leading cause is falls.

So, yes, a road traffic accident (or a fall) could leave you living on the street. I imagine the effect of a fall would be more harmful in a young person because their  behaviour would be misinterpreted by society in general from an early age.

Those between 15 and 29 years of age are three times more likely to sustain a brain injury than any other group

I realise that I’m extrapolating from British and US research to an Irish situation. What’s the situation in Ireland?  Here, from 9,000 to 11,000 people suffer a traumatic brain injury every year, according to Headway Ireland. That’s not counting people who have a stroke.

Young people

It’s a scary number. It means that today alone, about 30 people will sustain a brain injury. The majority of these injuries will be mild but for some everything will change.

Up to 30,000 people are living with the long-term problems following a brain injury, according to Headway Ireland. It adds in an information document that brain injury is the foremost cause of death and disability in young people. Those that are between 15 and 29 years of age are three times more likely to sustain a brain injury than any other group.

These are big numbers for a country of our size. They are also big numbers for a condition we don’t really think about very much. Not only is the injury itself invisible but it is even invisible in our own thinking and awareness.

We need to bring it into our awareness. That means not taking stupid chances when crossing the road or pulling into traffic. It means better enforcement of speed limits which means we need more gardaí on the road. And falls as a health issue and as potentially catastrophic events need a more important place in our awareness too.

And remember – the next homeless person you see might be that way because of an invisible brain injury and not for any of the other reasons we so quickly generate.