Review written by Trina Hardiman
Senior Brain Injury Case Manager & Lead Case Manager for the Acquired Brain Injury Training Programme
A Reflection Upon
“The inter-relationship between acquired brain injury, substance use and homelessness, The impact of adverse childhood experiences, An Interpretative Phenomenological Analysis study”
This article discusses a study of the interrelation between Acquired Brain Injury (ABI), substance use and homelessness and the difficulties of accessing support often experienced by people within this group. This study was carefully undertaken using Interpretative Phenomenological Analysis of data collected via a series of sensitively managed interviews, conducted with 8 adults. Some ofthe information shared by the interviewees is potentially upsetting for readers. Analysis of the data also uncovered how adverse childhood experiences are commonly part of the history of this demographic and apparently increase the likelihood for a person to become dysfunctional and even to sustain injuries as an indirect result later in life.
Aspects of the interviewees’ experiences are shared verbatim which illustrate the practical nature of their difficulties and highlights the logistical problems of providing effective support for people with these complex needs. It shows how people with needs such as these are not able to advocate for themselves nor to navigate our complex and harried social / healthcare system and the symptoms of their needs can appear as anti-social presentations that serve to alienate them from support. They may well be the least favourite patient from whom professionals disengage first of all, resulting directly from their clinical communication difficulties and the consequences of poor decision making.
The thought-provoking content of the article leads to recommendations that all social and healthcare providers need to heed. Raised awareness of the invisible nature of executive dysfunction and the overlap of ABI, substance use and mental illness symptoms is vital. Recognition of how symptoms from eg: substance use, can mask symptoms from ABI needs to be commonplace knowledge. Recognition of communication problems and poor reasoning skills resultant from ABI offers a compassionate understanding of behaviour rather than a perception of an abrasive persona. Only when we assess clinical needs accurately can we create effective support systems and offer support in ways that people are able to engage with. This will not only help people to receive help it will also prevent wasted resources.
Read the full article here
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