More than one in three of Toronto's homeless suffered a traumatic brain injury prior to ending up on the streets, a new study indicates, suggesting that mental health is linked to homelessness.
The paper, published yesterday in the Canadian Medical Association Journal, found that more than half of the homeless population in the city have experienced a severe brain injury, and 70 per cent of them did so before ending up on the streets.
"This raises the possibility that brain dysfunction as a result of a trauma to the head might cause people to essentially drift downwards in society in a way that might end up causing them to become homeless," Stephen Hwang, one of the study's authors and a research scientist at St. Michael's Hospital, said yesterday.
Traumatic brain injury is usually caused from car accidents, falls or assaults, and can result in cognitive impairment, attention deficits and emotional instability.
While not everyone who has suffered from brain trauma will end up homeless, the research paper shows a disproportionately large number of homeless people with traumatic head injuries.
In the study, Dr. Hwang and his colleagues surveyed 904 people at homeless shelters and meal programs between 2004 and 2005. Traumatic brain injury was defined as a self-reported head injury that left the person dazed, confused, disoriented or unconscious.
"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," Dr. Hwang said.
Anita Palepu, a professor in the department of medicine at the University of British Columbia, said health-care providers should take note of the findings and look to see whether patients with head trauma are at risk for subsequent mental health illnesses or addictions.
"This is really going to be a wake-up call for people to do better inquiries around traumatic brain injury amongst the vulnerable populations," Dr. Palepu said.
For Gary Mulligan, 47, a severe head injury three decades ago left him in a coma for three months, ruined his life, and years later, put him on the streets.
While riding a friend's motorcycle in Dawson Creek, B.C., Mr. Mulligan failed to yield, got hit by a pickup truck and was pinned under a car. Since then, he has moved in and out of rehab several times, eventually ending up in Toronto where he was accepted into a co-op housing unit.
But things got worse when Mr. Mulligan started drinking and taking drugs. He was kicked out of the housing unit.
With the help of his sister, he got help from the Community Head Injury Resource Services of Toronto, a non-profit charitable organization. Today, Mr. Mulligan, who is blind in his left eye and partly paralyzed on the left side of his body, lives in the group's apartment complex in Scarborough where he receives support.
"As soon as you can, find a structured program ... because it's a big world out there and you're not the only one who has issues," he advised others like him.
"The brain injury makes a big difference in your life. You become naive and taken advantage of."