Research to Integrate Services for Individuals with Traumatic Brain Injury, Mental Health, and Addictions: Proceedings of a MultiDisciplinary Workshop

We present the findings from a one-day, multidisciplinary meeting to gather feedback for an integrated knowledge translation research project addressing the integration of health services and supports for individuals with traumatic brain injury, mental health, and/or addictions; especially those who experience homelessness/vulnerably housed, intersect with the criminal justice system, and are survivors of intimate partner violence. This meeting brought together persons with lived experience, service providers, decision makers, and researchers, who provided feedback that further refined the research methodology and highlighted existing gaps. This event was successful in inviting collaboration, knowledge exchange and dissemination, and advancing an important knowledge-to-action cycle for this research.

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Exploring the intersection of traumatic brain injury and mental health in survivors of intimate partner violence

University of Toronto Journal of Public Health ◽

10.33137/utjph.v2i2.37002 ◽

2021 ◽

Vol 2 (2) ◽

Author(s):

Danielle Toccalino ◽

Amy Moore ◽

Sophia Chuon Gutierrez ◽

Angela Colantonio ◽

Christine M. Wickens ◽

...

Keyword(s):

Mental Health ◽

Traumatic Brain Injury ◽

Intimate Partner Violence ◽

Brain Injury ◽

Partner Violence ◽

The United States ◽

Intimate Partner ◽

Future Research ◽

Heterosexual Relationships ◽

Economic Implications

Introduction: One in four Canadian women experience intimate partner violence (IPV) in their lifetime. The COVID-19 pandemic has significantly increased rates of IPV globally and the level of violence encountered, exposing IPV survivors to greater risk of physical injury, including traumatic brain injury (TBI). Up to 75% of survivors are suspected of sustaining a TBI and 50-75% experience mental health or substance use challenges (MHSU) as a result of IPV, resulting in extensive personal, social, and economic implications. Objective: The objective of this scoping review was to synthesize what is currently known in the literature about MHSU and TBI among survivors of IPV and identify gaps. Methods: MEDLINE, EMBASE, PsycINFO, CINAHL, Cochrane, Scopus, and Web of Science were searched for relevant articles using a search strategy including text words and subject headings related to TBI, IPV, and MHSU. Two reviewers independently assessed articles for inclusion. Results: The search identified 399 unique articles, 34 of which were included in this study. Of these, 11 articles reported on MHSU in IPV-related TBI and 9 articles reported on both TBI and MHSU in IPV but did not discuss the groups together. The remainder were reviews or theses that noted MHSU in IPV-related TBI. Included articles predominantly focused on cis-gendered women in heterosexual relationships and were conducted in the United States. Only three articles focused on the experiences of Black or Indigenous women and none of the included studies discussed implications of co-occurring TBI and MHSU on survivor’s healthcare-related needs or access to care. Conclusions: Despite the high rates of co-occurring TBI and MHSU among survivors of IPV, there is little research on this intersection and no investigation of the impacts on the health system. Future research should focus on identifying the healthcare-related needs of survivors and identifying and mitigating barriers to access.

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Protocol for a scoping review on rehabilitation among individuals who experience homelessness and traumatic brain injury

BMJ Open ◽

10.1136/bmjopen-2021-052942 ◽

2021 ◽

Vol 11 (11) ◽

pp. e052942

Author(s):

Vincy Chan ◽

Maria Jennifer Estrella ◽

Jessica Babineau ◽

Angela Colantonio

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Lived Experience ◽

Scoping Review ◽

Service Providers ◽

Grey Literature ◽

Future Research ◽

Reference List ◽

Cochrane Central Register ◽

Scientific Meetings

IntroductionRehabilitation is key to improving outcomes and quality of life after traumatic brain injury (TBI). However, individuals experiencing homelessness are rarely represented in research that informs evidence-based rehabilitation guidelines even though TBI is disproportionately prevalent among this population. This protocol is for a scoping review to explore the extent to which rehabilitation, including the types of rehabilitation interventions, is available to, or used by, individuals who experience homelessness and TBI to inform (1) opportunities to integrate rehabilitation for individuals experiencing homelessness and TBI, (2) considerations for existing clinical and practice guidelines for rehabilitation and (3) recommendations for future research.Methods and analysisThe scoping review will be guided by six stages described in scoping review methodology frameworks. Electronic databases (MEDLINE, Embase and Embase Classic, Cochrane CENTRAL Register of Clinical Trials, CINAHL, APA PsycINFO, Applied Social Sciences Index and Abstracts, and Nursing and Allied Health), reference list of included articles and scoping or systematic reviews identified from the search and grey literature, defined as reports from relevant brain injury, housing and rehabilitation organisations, will be searched. Two reviewers will independently screen all articles based on predetermined inclusion and exclusion criteria. A descriptive numerical summary of data items will be provided and qualitative content analytic techniques will be used to identify and report common themes. Preliminary findings will be shared with stakeholders to seek feedback on the implications of the results.Ethics and disseminationEthics review will not be required, as only publicly available data will be analysed. Findings from the scoping review will be published in a peer-reviewed journal and presented at scientific meetings and to stakeholders, defined as service providers in the housing and TBI sectors; health professionals who provide care for individuals with TBI and/or homelessness; health administrators, decision-makers and policy-makers; researchers; and caregivers or family members of individuals with lived experience of TBI and homelessness.

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The Effect of Intimate Partner Violence and Probable Traumatic Brain Injury on Mental Health Outcomes for Black Women

Journal of Aggression Maltreatment & Trauma ◽

10.1080/10926771.2019.1587657 ◽

2019 ◽

Vol 28 (6) ◽

pp. 714-731 ◽

Cited By ~ 2

Author(s):

Andrea N. Cimino ◽

Grace Yi ◽

Michelle Patch ◽

Yasmin Alter ◽

Jacquelyn C. Campbell ◽

...

Keyword(s):

Mental Health ◽

Traumatic Brain Injury ◽

Intimate Partner Violence ◽

Black Women ◽

Brain Injury ◽

Health Outcomes ◽

Partner Violence ◽

Intimate Partner ◽

Mental Health Outcomes

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Battered and Brain Injured: Assessing Knowledge of Traumatic Brain Injury Among Intimate Partner Violence Service Providers

Journal of Women s Health ◽

10.1089/jwh.2018.7299 ◽

2019 ◽

Vol 28 (7) ◽

pp. 990-996 ◽

Cited By ~ 6

Author(s):

Halina (Lin) Haag ◽

Sandra Sokoloff ◽

Nneka MacGregor ◽

Shirley Broekstra ◽

Nora Cullen ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Intimate Partner Violence ◽

Brain Injury ◽

Partner Violence ◽

Service Providers ◽

Intimate Partner ◽

Brain Injured

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Traumatic brain injury and intimate partner violence: Addressing knowledge and service gaps among indigenous populations in Canada

Brain Impairment ◽

10.1017/brimp.2019.16 ◽

2019 ◽

Vol 20 (2) ◽

pp. 197-210 ◽

Cited By ~ 1

Author(s):

Halina (Lin) Haag ◽

Melissa Biscardi ◽

Noel (Natalia) Smith ◽

Nneka MacGregor ◽

Angela Colantonio ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Intimate Partner Violence ◽

Brain Injury ◽

Partner Violence ◽

Service Provision ◽

Service Providers ◽

Intimate Partner ◽

Indigenous Women ◽

Direct Service ◽

Direct Service Providers

AbstractBackgroundTraumatic brain injury (TBI) is a serious consequence of intimate partner violence (IPV) that is often overlooked. In the case of Indigenous women in Canada the challenges are broad, multidimensional, and left almost entirely unexplored. Given the elevated rates of violence and injury experienced by women exposed to IPV and the increased levels of physical assault among Indigenous women in Canada, it is important to understand the unique experiences and service needs of these women. This study sought to identify barriers and facilitating factors for TBI-sensitive service provision for Indigenous women experiencing IPV.Method:As part of a larger national stakeholder consultation process to develop a TBI educational toolkit for IPV service providers, input from Indigenous stakeholders was specifically sought to allow for insights into unique challenges and strengths related to this population. Interviews and focus groups were conducted with IPV direct-service providers, support professionals, and advocates working with Canadian First Nations and Inuit women.Findings:Findings suggest that multiple intersections of marginalization, shame and stigma, and colonization, coupled with significant barriers to service provision in remote communities are such that solutions generated for urban-based settler populations are ineffective.Conclusions:Recommendations include a widespread educational campaign to raise awareness of the seriousness of TBI among Indigenous women exposed to IPV. Education is particularly important among healthcare and direct service providers, survivors and their families and communities, legal professionals and child protection agencies, and Indigenous and settler government bodies. Future research should focus on expanding our understanding of this complex issue and developing culturally sensitive, community-based supports.

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Supporting Employment and Mental Health for Women Survivors of Intimate Partner Violence & Traumatic Brain Injury: A Community-Based Participatory Research Study

Archives of Physical Medicine and Rehabilitation ◽

10.1016/j.apmr.2021.07.714 ◽

2021 ◽

Vol 102 (10) ◽

pp. e81

Author(s):

Halina Haag ◽

Danielle Toccalino ◽

Amy Moore ◽

Angela Colantonio

Keyword(s):

Mental Health ◽

Traumatic Brain Injury ◽

Intimate Partner Violence ◽

Brain Injury ◽

Women Survivors ◽

Partner Violence ◽

Research Study ◽

Community Based Participatory Research ◽

Intimate Partner ◽

Community Based

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Critical Characteristics of Housing and Housing Supports for Individuals with Concurrent Traumatic Brain Injury and Mental Health and/or Substance Use Challenges: A Qualitative Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182212211 ◽

2021 ◽

Vol 18 (22) ◽

pp. 12211

Author(s):

Maria Jennifer Estrella ◽

Bonnie Kirsh ◽

Pia Kontos ◽

Alisa Grigorovich ◽

Angela Colantonio ◽

...

Keyword(s):

Mental Health ◽

Traumatic Brain Injury ◽

Substance Use ◽

Brain Injury ◽

Service Providers ◽

Systems Of Care ◽

Qualitative Description ◽

Service Users ◽

Structural Barriers ◽

Critical Characteristics

Traumatic brain injury (TBI) and mental health and/or substance use challenges (MHSU) are commonly co-occurring and prevalent in individuals experiencing homelessness; however, evidence suggests that systems of care are siloed and organized around clinical diagnoses. Research is needed to understand how housing and housing supports are provided to this complex and understudied group in the context of siloed service systems. This study aimed to describe critical characteristics of housing and housing supports for individuals with concurrent TBI and MHSU from the perspectives of service users with TBI and MHSU and housing service providers. Using basic qualitative description, in-depth interviews were conducted with 16 service users and 15 service providers. Data were analyzed using thematic analysis techniques. Themes capture core processes in finding and maintaining housing and the critical housing supports that enabled them: (1) overcoming structural barriers through service coordination, education and awareness raising, and partnerships and collaborations; and (2) enabling engagement in meaningful activity and social connection through creating opportunities, training and skills development, and design of home and neighborhood environments. Implications for practice, including the urgent need for formalized TBI and MHSU education, support for service providers, and potential interventions to further enable core housing processes are discussed.

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