METHODS Subjects were recruited from 6 shelter clinics, 2 hospital clinics and the Barbara McInnis House (medical respite unit) 94-item questionnaire administered.

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Presentation transcript:

METHODS Subjects were recruited from 6 shelter clinics, 2 hospital clinics and the Barbara McInnis House (medical respite unit) 94-item questionnaire administered to 227 subjects Chart reviews for subjects reporting head injury to be completed

Descriptive Data (N= 227) Gender Males 184 (81%) Females 43 (19%) Mean: 47 Median: 47

82% homeless at the time of the interview. Descriptive Data (N=227) 82% homeless at the time of the interview. Subjects’ reported place of stay the night prior to the interview*: Shelter 63.5% Streets 8.5% Respite 8.4% Friends/family 7.1% Treatment Facility 1.6% Own Place 18.0% *Some subjects reported more than one location.

RESULTS 152 (67%) subjects reported at least one head injury. Of these subjects: 71% reported having had more than 1 injury. 73% reported losing consciousness with the injury. 73% reported being hospitalized after the head injury. 23% reported receiving any type of therapy after the injury (including speech, physical, occupational, language, psychiatric and behavioral). 44% reported using alcohol or drugs when the injury occurred.

Individuals Reporting Head Injuries (N=152) Gender - Male 132 (87%) - Female 20 (13%) Mean = 47.5 Median = 47

Reported Head Injury by Race/Ethnicity

Causes of Head Injury

Age at First Head Injury

Head Injury and Substance Use p = .002 p = .005 p = .022

Headaches, Concentration and Memory Head Injury (N = 152) No Head Injury (N = 75) History of Headaches 64% 52% Trouble with Concentration 53% Problems with Short-term Memory 66% (p = .045) Problems with Long-term Memory 41% 33%

History of Head Injury and Symptoms Associated with Headaches

Mental Health, Criminal Conviction and Veteran Status Head Injury No Head Injury Irritability and Anger 65% (p < .005) 39% Convicted of a Crime 67% (p = .002) 45% History of Mental Illness 52% 31% History of Depression 62% (p = .003) 41% Veteran 32% (p = .005) 14%

Length of Homelessness and History of Head Injury

Last Grade Completed and History of Head Injury

Reported Co-Morbidities and History of Head Injury

CONCLUSION The dramatic proportion of subjects who reported a history of head injury supports our anecdotal observation that homeless individuals are at a high risk of TBI. Increased chronicity of homelessness was associated with increased prevalence of head injury. Those suffering from head injury have increased prevalence of mental illness, cognitive problems and behavioral dysfunction, yet a relatively low percentage received any post-injury therapy addressing these issues.

CONCLUSION These findings suggest that homeless persons should be routinely screened for a history of TBI. The complex co-morbidities of mental illness, substance abuse, cognitive and behavioral issues should be considered when developing interventions to assist in the recovery of functional status for these vulnerable individuals.

Acknowledgement We want to thank the following interns and volunteers who assisted in the recruitment and data collection activities: Aita Amaize Sahar Aminipour Ian Hopper Tim Judson Emily Kaplan John Lin Jonathan Wolf